Table 1.
Characteristics of Included Studies in the Systematic Review (n = 78), Studies A-K
| Author (Y), Reference | - Setting - Country (Period of Analysis) | - N (% men) - Age ± SD/[IQR] | - Diabetes Duration - Diabetes Diagnosis - Diabetes Treatment | - Insomnia or Insomnia Symptoms Measure - Distribution/Cutoff | Metabolic Parameters and Glycemic Control | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| None | HbA1c | FPG | BMI | Waist | HDL | LDL | Chol | TG | SBP | DBP | |||||
| Abdelgadir (2009) (24) | - Outpatient clinic - Sudan (NR) | - 60 (67%) - 57 y | - 16 ± NR - Clinically diagnosed - NR | - MOS-SS - Insomnia yes/no | x | ||||||||||
| Al Tannir (2016) (25) | - General population - Saudi Arabia (2014-2015) | - 161 DM (42% in general population) - General population: 33 ± 12 y | - NR - Self-report - NR | - Unknown questionnaire - Sleep disturbance yes or maybe/no | x | ||||||||||
| Aribas (2015) (26) | - Outpatient clinic - Turkey (NR) | - 78 (39%) - 50 ± 9 y | - 6 [2–12] y - Clinically diagnosed - NR | - PSQI - PSQI >5 = insomnia symptoms | x | x | x | x | x | x | x | x | x | x | |
| Bani-Issa (2017) (27) | - Community health care setting - UAE (NR) | - 268 (38%) - 42 ± 13 y | - 75% = 0–10 y - Clinically diagnosed - NR | - PSQI - PSQI ≥5 = insomnia symptoms | x | ||||||||||
| Bedi (2011) (28) | - Outpatient clinic - India (NR) | - 201 (50%) - 40-60 y | - NR - Clinically diagnosed - 100% oral medication | - PSQI - PSQI >5 = insomnia symptoms | x | ||||||||||
| Bener (2010) (29) | - Health care center/ primary care - Qatar (2009) | - 847 (47%) - 59% = 40–59 y | - NR - Clinically diagnosed - 100% oral medication | - PSQI - PSQI >5 = insomnia symptoms | x | ||||||||||
| Bhaskar (2016) (30) | - Outpatient clinic - India (2015) | - 68 (NR) - 18-60 y | - NR - NR - NR | - AIS - Score >6 = insomnia | x | ||||||||||
| Bilge (2016) (18) | - Outpatient clinic - Turkey (2015) | - 40 (30%) - 48 ± 10 y | - NR - NR - NR | - PSQI - PSQI >5 = insomnia symptoms | x | ||||||||||
| Budhiraja (2011) (31) | - General population - USA (<2010) | - 207 (NR) - General population: 42 ± 13y | - NR - Self-report - NR | - DSM-IV insomnia criteria - yes/no | x | ||||||||||
| Celik (2012) (32) | - Tertiary care - Turkey (NR) | - 46 (52%) - 59 ± 12 y | - NR - Clinically diagnosed - NR | - PSQI - PSQI >5 = insomnia symptoms | x | ||||||||||
| Chang (2017) (33) | - Secondary care - Taiwan (2013–2014) | - 275 (0%) - 58 ± 8 y | - ≥3 mo - Clinically diagnosed - 78% OAD 14% OAD + insulin 4% diet + exercise | - PSQI - PSQI >6 = insomnia symptoms | x | ||||||||||
| Cheng (2019) (34) | - Secondary care - Taiwan (2014-2016) | - 201 (52%) - 70 ± 6.9 y | - NR - Self-report - NR | - Self-report - Sleep disturbance ≥1 night per week yes/no | x | ||||||||||
| Cho (2014) (35) | - Secondary care - South Korea (2011) | - 614 (62%) - 60 ± 11y | - 10 ± 8 y - Clinically diagnosed - NR | Insomnia variable 1: - Self-report - Insomnia = difficulty falling asleep, maintaining sleep, early morning waking and non- restorative sleep ≥3 times/wk Insomnia variable 2: - PSQI - PSQI ≥5 = insomnia symptoms | x | ||||||||||
| Colbay (2015) (36) | - Secondary care - Turkey (2011) | - 53 (42%) - 51 ± 8 y | - 8 y - Clinically diagnosed - 49% OAD 42% OAD + insulin 9% insulin | - PSQI - PSQI >5 = insomnia symptoms | x | ||||||||||
| Cuellar (2008) (37) | - Secondary care - USA (2004-2005) | - 35 (44%) - 61 ± 11 y | - NR - Clinically diagnosed - NR | - PSQI - PSQI >6 = insomnia symptoms | x | ||||||||||
| Cunha (2008) (38) | - Secondary care - Brazil (2005) | - 50 (24%) - Median: 62 (range 44–79) y | - 38% >10 y - Clinically diagnosed - NR | - PSQI - PSQI >5 = insomnia symptoms | x | ||||||||||
| El-Aghoury (2017) (39) | - NR - Egypt (NR) | - 46 (NR) - 48 ± 7 y | - NR - Clinically diagnosed - NR | - NHANES sleep questionnaire - Insomnia = difficulty initiating or maintaining sleep | x | ||||||||||
| Ford (2015) (40) | - General population - USA (2002, 2007, 2012) | DM: - 2002: 2179 (43%) - 2007: 2028 (44%) - 2012: 3526 (44%) - Mean age: 45 y in 2002; 47 y in 2012 | - NR - Self-report - NR | - Self-report - “During the past 12 months, have you regularly had insomnia or trouble sleeping?” | x | ||||||||||
| Fritschi 2017 (41) | - Veteran Hospital + flyers - USA (2012–2013) | - 80 (53%) - 58 ± 8 y | - 9 ± 7 y - Self-report - 70% metformin | - Actigraph: sleep efficiency, wake after sleep onset - Not applicable | x | ||||||||||
| Fukui (2012) (42) | - Outpatient clinic - Japan (NR) | - 296 (100%) - 64 ± 10 y | - 14 ± 11 - Clinically diagnosed - 63% OAD 25% insulin 12% diet | - PSQI - PSQI >5 = insomnia symptoms | x | ||||||||||
| Gozashti (2016) (43) | - Outpatient clinic - Iran (2014) | - 118 (76%) - 58 ± 11 y | - NR - Clinically diagnosed - 100% OAD | - PSQI - PSQI >5 = insomnia symptoms | x | x | x | x | x | x | |||||
| Grandner (2011) (44) | - General population - USA (2006) | - 18 888 DM (41%) - General population: ±53 y | - NR - Self-report - NR | - Self-report - Sleep complaints: reporting difficulty falling asleep, staying asleep or sleeping too much ≥6 days over 2 weeks | x | ||||||||||
| Han (2002) (45) | - Hospital - Korea (NR) | - 82 (61%) - 50 ± 9 y | - With insomnia: 26 ± 23 y, Without insomnia: 20 ± 19 y - Clinically diagnosed - NR | - Self-report - Reporting difficulty falling asleep, awakening during the night, or/ and early morning awakening for ≥2 months = insomnia | x | x | |||||||||
| Hayashino (2013) (46) | - Outpatient clinic - Japan (2009–2010) | - 1513 (51%) - 63 ± 13 y | - 17 ± 10 y - Clinically diagnosed - 100% insulin | - PSQI - PSQI >5 = insomnia symptoms | x | x | |||||||||
| Hood (2014) (47) | - Endocrinology clinic - USA (NR) | - 194 (30%) - 58 ± 13 y | - NR - Clinically diagnosed - NR | - PSQI - PSQI >5 = insomnia symptoms | x | ||||||||||
| Huang (2017) (48) | - Endocrinology department in hospital - China (2014–2015) | - 81 (56%) - 66 ± 10 y | - NR - Clinically diagnosed - Diet or OAD | - PSQI - PSQI >7 = insomnia symptoms | x | x | x | x | x | x | x | x | x | ||
| Hung (2013) (49) | - Prevention Health Center - Taiwan (2002–2006) | - 103 (66%) - 56 ± 9 y | - NA: newly diagnosed - Clinically diagnosed - NA: newly diagnosed | - PSQI - PSQI >5 = insomnia symptoms | x | ||||||||||
| Hyyppa (1989) (50) | - Diabetics born and living in a particular district - Finland (NR) | - 63 (NR) - 45–65 y | - 1-14 y - Clinically diagnosed - NR | - Questionnaire on sleep habits 1. Sleep latency >50 min 2. Habitual insomnia 3. Difficulty maintaining sleep | x | ||||||||||
| Jain (2012) (51) | - Diabetic clinic - USA (NR) | - 81 (28%) - ±50 y | - NR - Clinically diagnosed - 0% insulin | - History of insomnia - Yes/no | x | x | x | ||||||||
| Johnson (2017) (52) | - Diabetic clinic - USA (NR) | - 168 (54%) - 66 ± 10 y | - 14 ± 9 - Clinically diagnosed - NR | - Self-report - “Ever been told by a doctor or health professional that you have a sleep disorder?” | x | ||||||||||
| Kara (2015) (53) | - Outpatient clinic - Turkey (2013–2014) | - 180 (41%) - 55 ± 17 y | - 11 ± 9 y - Clinically diagnosed - NR | - PSQI - PSQI ≥5 = insomnia symptoms | x | ||||||||||
| Kasenova (2017) (54) | - NR - Kazakhstan (NR) | - 136 (34%) - 59 ± 6 y | - 10 ± 7 y - Clinically diagnosed - NR | Insomnia variable 1: - PSQI - PSQI >5 = insomnia symptoms | x | ||||||||||
| Katic (2015) (17) | - Websurvey - USA (2013) | - 405 DM (49%) - 56 ± 10 y | - 11 ± 9 y - Self-report - NR | Insomnia variable 1: - Self-report - At risk for insomnia: waking up unrefreshed, difficulty falling asleep, waking in the middle of the night, or waking tooearly at least a few nights/week and affectingdaily activities Insomnia variable 2: - Self-report - Diagnosed with insomnia yes/no | x | ||||||||||
| Keskin (2015) (55) | - Family medicine clinics - Turkey (2014) | - 575 (33%) - 57 [50–64] y | - 7 [3–12] y - Clinically diagnosed - 66% OAD 30% insulin | - PSQI - PSQI ≥5 = insomnia symptoms | x | x | x | x | |||||||
| Keskin (2016) (56) | - Outpatient clinic - Turkey (2014) | - 208 (29%) - Adult group: 53 ± 9 y; geriatric group: 71 ± 5 y | - NR - Clinically diagnosed - NR | - PSQI - PSQI ≥5 = insomnia symptoms | x | ||||||||||
| Khosravan (2015) (57) | - Diabetes clinic - Iran (2012) | - 1600 (NR) - 35–70 y | - NR - Clinically diagnosed - NR | - PSQI - PSQI >5 = insomnia symptoms | x | ||||||||||
| Knutson (2011) (58) | - General population - USA (2003–2006) | - 40 DM (30%) - 46 ± 4 y | - NR - Clinically diagnosed - NR | - PSQI + actigraph - Insomnia: not falling asleep <30 min >3 times/wk or waking up in the middle of the night >3 times/wk + sleep efficiency <80% | x | ||||||||||
| Knutson (2006) (6) | - Tertiary care - USA (NR) | - 161 (26%) - 57 ± 13 y | - 11 ± 9 y - Clinically diagnosed - 48% insulin or in combination with OAD | - PSQI - PSQI >5 = insomnia symptoms | x |
Abbreviations: AIS, Athens Insomnia Scale; CES-D, Center for Epidemiologic Studies Depression scale; DM, diabetes mellitus; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders-IV; GDS, Geriatric Depression Scale; GLP, glucagon-like peptide; MOS-SS, Medical Outcomes Study - Sleep Scale; NA, not applicable; NHANES, National Health and Nutrition Examination Survey; NR, not reported; OAD, oral antidiabetic drugs; PHQ9, Patient Health Questionnaire; PSQI, Pittsburgh Sleep Quality Index; UAE, United Arabic Emirates.