Impaired sleep and its association with type 2 diabetes, depression, and stress in the Boston Puerto Rican health study

• Main Author: Foley, Linda A
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01.01.2017
• Subjects: Data collection; Nursing; Sleep
• ISBN: 9781369936919; 1369936915

Background. The Puerto Rican population has increased risk for and high prevalence of insomnia, type 2 diabetes (T2D), depression, and stress. Yet, there is a paucity of literature about this Hispanic subpopulation and these conditions. Objective. There were three overarching objectives in this study: to examine the association between impaired sleep symptoms and T2D, to examine the association between impaired sleep symptoms and depressive symptomatology, and to examine the association between impaired sleep symptoms and perceived stress. Method. This study is a secondary analysis utilizing cross-sectional and longitudinal data from the second and third waves of data collection in the Boston Puerto Rican Health Study. The sample included 955 Puerto Rican adults living in Boston in the cross-sectional data and 723 in the longitudinal data. Participants were aged 45-75 years old. Results. There was no significant association between impaired sleep symptoms and T2D. Predictors of impaired sleep in individuals with T2D included women and individuals with perceived health of good/very good/excellent with 47% lower odds compared with perceived health fair/poor. There was poor glycemic control in individuals with T2D with mean glycosylated hemoglobin of 7.93 (+/- 1.68). Sixty-three incident cases of T2D occurred over a 3-year period but impaired sleep was not predictive. A high prevalence of impaired sleep (48%), type 2 diabetes (40%), depression (64%), and stress (68%) existed in this population. Persons with depressive symptoms had 2 times the odds of having impaired sleep. High (vs. low) perceived stress was associated with a 4.3% increase in odds of impaired sleep. Those with depressive symptoms were 11 times more likely to report stress and those with high stress had a 23% greater odds of having depressive symptoms. Conclusion. Impaired sleep was not associated with type 2 diabetes in this population. Impaired sleep, T2D, depression, and stress were highly prevalent. There was poor glycemic control in individuals with T2D. Impaired sleep symptoms and depressive symptomatology were positively associated which remained after adjusting for covariates. However, the association was no longer significant after adjusting for perceived stress. Impaired sleep symptoms and perceived stress were positively associated in fully adjusted models. Keywords: Impaired Sleep; Type 2 Diabetes; Depression; Stress; Puerto Rican, Hispanic