Nonlinear relationship between sleep quality and prevalence of type 2 diabetes: A cross-sectional study of community patients with chronic diseases

OBJECTIVE: To delve into the intricate relationship between sleep quality and prevalence of type 2 diabetes (T2D) among community-dwelling chronic disease patients, and to provide insights that can inform clinical practice. METHODS: Data on basic information and sleep quality of patients with chronic diseases were collected via questionnaire surveys. Following descriptive and logistic regression analyses, restricted cubic spline regression was further applied to explore a possible nonlinear dose-response relationship between sleep quality and prevalence of T2D among these patients. RESULTS: A total of 902 valid samples were included in this study, among which 565 were cases of T2D, accounting for 62.64%. The average score of the Pittsburgh Sleep Quality Index (PSQI) was 11.11. In all three models, a positive association was observed between higher PSQI scores and prevalence of T2D. Subsequent analysis employing RCS regression substantiates this nonlinear association and discerns two inflection points at 12 and 13 When the PSQI score was greater than 12, the odds ratio (OR) increased with higher PSQI scores, suggesting a significant increase in the association with the prevalence of T2D. When the PSQI score reaches 13, the OR stabilises, indicating that the rate of increase in risk has slowed. CONCLUSION: Sleep quality is an important factor for the prevalence of T2D, exhibiting a threshold range effect. Community health practitioners may consider sleep quality assessment as a supplementary tool, particularly in patients with existing chronic conditions. Implementing targeted sleep improvement interventions in this high-risk subgroup (PSQI≥12) may holds substantial potential to be associated with reduced T2D prevalence.