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Yıl:2020; Cilt: 7; Sayı: 3>> Özet
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Türk Uyku Tıbbı Dergisi; 2020;7(3):106-111
Tip 2 Diabetes Mellitus Hastalarında İnsomni Varlığının ve İlişkili Faktörlerin İncelenmesi
B Yıldız, Ö Haliloğlu, E Baran, M Y Afacan, G Benbir Şenel, Z Oşar Siva, D Karadeniz
İstanbul Üniversitesi-Cerrahpaşa , İstanbul,
Amaç: Diyabet ve insomni dünya çapında halk sağlığı problemleridir ve aralarında önemli bir neden-sonuç ilişkisi mevcuttur. Çalışmamızda tip 2 diabetes mellitusu (T2DM) olan hastalarda insomni varlığı ve ilişkili faktörleri değerlendirmeyi planladık. Gereç ve Yöntem: Kesitsel olarak yapılan çalışmamıza, T2DM tanısı ile takip edilen, 45’i kadın, 36’sı erkek toplam 81 hasta dahil edildi. Çalışmadan dışlanma kriterleri olarak, akciğer hastalığı, konjesif kalp yetmezliği, Obstrüktif Uyku Apnesi sendromu varlığı belirlendi. Hastaların demografik özellikleri ve hastalık ile ilişkili verileri not edildi. Yüz yüze görüşme yöntemi ile Pittsburgh Insomnia Derecelendirme ölçeği-20 (PİDÖ-20), Pittsburgh Uyku Kalitesi indeksi (PUKİ), Beck Depresyon ölçeği (BDÖ), Beck Anksiyete ölçeği (BAÖ), Berlin anketi ve Douleur neuropathique-4 (DN-4) anketi dolduruldu. Bulgular: Hastalarımızın yaş ortalaması 60±11,6 yıl, ortanca diyabet süresi 15 (7-18) yıl, hastaların PİDÖ ortanca puanı 16 (9-24) puan idi ve PİDÖ kesim (“cut-off”) değeri 20 olarak kabul edildiğinde %43,2’sinde (n=35) insomni mevcuttu. Hastaların PUKİ ortanca puanı 6 (3,5-8) puan olarak bulundu ve %50,6’sında (n=41) kötü uyku kalitesi mevcuttu. İnsomnisi olan ve olmayan diyabetik hastalar arasında sosyodemografik özellikler, mikro ve makrovasküler komplikasyonlar, glisemik kontrol ve Huzursuz Bacaklar sendromu açısından istatistiksel anlamlı farklılık saptanmadı. PİDÖ ile PUKİ arasında (r=0,78; p<0,001), T2DM süresi ile BDÖ arasında (r=0,24; p=0,02) ve DN-4 ile BAÖ arasında pozitif yönlü ilişkiler (r=0,46; p<0,01) mevcuttu. Sonuç: T2DM hastalarında, insomni ve gece kötü uyku kalitesinin yüksek oranda olduğu görülmektedir. Ancak insomni varlığı ile demografik veya hastalık ile ilişkili faktörler arasında anlamlı ilişki saptanmamıştır. Genel tıbbi değerlendirmenin bir parçası olarak insomni ve diğer uyku bozukluklarının değerlendirilmesi hastalık yönetimine katkı sağlamaktadır
Insomnia and Related Factors in Patients with Type 2 Diabetes Mellitus
Objective: Diabetes and insomnia are serious public health problems worldwide. The cause-and-effect relationship between them is rather complicated. This study planned to evaluate the presence of insomnia and associated factors in patients with type 2 diabetes mellitus (T2DM). Materials and Methods: A total of 81 (36 male and 45 female) patients with T2DM were recruited into our study. Pulmonary disease, congestive heart failure, Obstructive Sleep Apnea syndrome, and cognitive disorders were determined as exclusion criteria from the study. Demographic and disease characteristics were noted. Pittsburgh Insomnia Rating scale 20 (PIRS-20), Pittsburgh Sleep Quality index (PSQI), Beck Depression inventory (BDI), Beck Anxiety inventory (BAI), Berlin questionnaire, and Douleur neuropathique-4 questionnaire (DN-4) to detect neuropathic pain were filled in a face-to-face interview. Results: The mean age of our patients was 60.0±11.6 years, and median diabetes duration was 15 years (7-18 years). Median PIRS-20 score was 16 points (9-24 points) and 43.2% (n=35) had insomnia. Median PSQI score was 6 points (3, 5-8 points), and poor sleep quality was present in 50.6% (n=41) of the patients. There was no statistically significant difference between patients who had diabetes, with and without insomnia, in terms of sociodemographic features, micro- and macrovascular complications, glycemic control, and Restless Legs syndrome. Conversely, significant association was observed between PIRS-20 and PSQI (r=0.78; p<0.001), between T2DM duration and BDI (r=0.24; p=0.02), and between DN-4 and BAI (r=0.46; p<0.01). Conclusion: Insomnia symptoms and poor night sleep quality are commonly encountered in T2DM patients. Considering the negative effects of sleep disturbance on T2DM, it is recommended that insomnia and other sleep disorders be evaluated as a part of routine clinical evaluation.

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