TABLE 3.

Exemplars demonstrating the empirical use of sleep disturbance in people with diabetes

Exemplar	Participant characteristics	Attributes reflected	Antecedents reflected	Consequences reflected
Case 1	14-year-old girl with type 1 diabetes (Perfect & Elkins, 2010) Diabetes duration: 9 years Diabetes treatment regimen: insulin pump A1C: 8.9% Sleep: (i) complained about symptoms of trouble falling and staying asleep due to stress; (ii) experienced frequent awakenings due to concerns about hypoglycaemia; (iii) had an average of 6.8 hr of sleep, less than the recommended 8–10 hr for teenagers Sleep intervention effect: after the sleep intervention using cognitive-behavioural therapy and hypnotic relaxation, patient glucose regulation improved. The authors suggested that “the improvement may have been attributable, at least in part, a reduction in her stress and improvement in sleep.” (p. 9)	Sleep disturbance as a symptom Sleep disturbance as impaired sleep quality (difficulty in initiating and maintaining sleep/frequent nocturnal awakenings) and abnormal sleep duration	Reduced psychological wellbeing (excessive stress)	Impaired glucose regulation as a consequence (supported by improvement in glycaemic control after treatment)
Case 2	52-year-old female with type 2 diabetes (Yoosefinejad et al., 2014) Diabetes duration: 10 years Diabetes complication: neuropathy characterised by a sensation of tingling and numbness in feet for 1 year Sleep: frequently awakened during the night by this abnormal sensation accompanied by pain scored 6 of 10	Sleep disturbance not explicitly described as a symptom Sleep disturbance as impaired sleep quality characterised by frequent nocturnal awakenings	Diabetes-related physiological changes (i.e., neuropathic pain)