Abstract
BackgroundType 2 Diabetes (T2DM) is a public health concern. Several risk factors are associated with increased risk of T2DM, including unhealthy diet and physical inactivity. Most recently, sleep is being considered as an important factor in the prevention and management of T2DM. Short, long and poor sleep have been associated with increased risk of T2DM and worse diabetes management in people with T2DM. On the other hand, sleep is associated with dietary food intake. However, the association between sleep and diet (as two important risk factors of T2DM) is yet to be known.
Methods
A secondary data analysis was conducted on data from Early Activity in Diabetes (Early-ACTID). This was a randomised control trial (RCT) on people newly diagnosed with T2DM targeting diet and physical activity. Cross-sectional and longitudinal models explored the association between %E macronutrient and sleep outcomes (sleep duration, Sleep Onset Latency (SOL), Wake After Sleep Onset (WASO) and Awakening>5 mins). A qualitative study was conducted to explore how sleep was experienced and perceived by people with T2DM. The focus group was conducted on people with T2DM who had previously taken part in research projects. A total of 12 participants were included in the qualitative study.
Results
The results suggested that a 1% higher energy from protein in place of 1% lower energy from either carbohydrate or fat was associated with 4 minutes longer sleep duration.
A 1% increase in energy from protein in place of 1% lower energy from either fat or carbohydrate was associated with shorter SOL duration and higher odds of good SOL in both cross-sectional and longitudinal analysis.
Higher %E fat (in place of %E carbohydrate) was associated with longer WASO, only in cross-sectional models. Awakening>5mins was not associated with %E macronutrient intake.
Sleep duration was shorter than recommended duration, and 84%, 66%, and 58% of the participants had good SOL, WASO, and Awakening>5 mins, respectively.
The qualitative study suggested that people with T2DM did not consider sleep as an important factor in managing T2DM. Further, people with T2DM were unfamiliar with “sleep Hygiene” but showed to practice sleep hygiene.
Conclusion
The quantitative study suggested that sleep duration was shorter than recommended, and the majority of the participants had good sleep quality. The %E protein was associated with longer sleep duration and improved SOL.
The qualitative study suggested that despite the importance of sleep in managing T2DM, sleep is an unknown factor amongst people with T2DM.
| Date of Award | 24 Jan 2023 |
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| Original language | English |
| Awarding Institution |
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| Supervisor | Laura Johnson (Supervisor), Clare Y England (Supervisor) & Angeliki Papadaki (Supervisor) |