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. 2019 Oct 11;105(3):614–643. doi: 10.1210/clinem/dgz065

Table 2.

Characteristics of Included Studies in the Systematic Review (n = 78), Studies L-Z

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
Koyanagi (2014) (65) - General population - Finland, Poland, Spain (2011–2012) China, Ghana, India, Mexico, Russia, South Africa (2007–2010) - 3285 DM (NR) - Median: 60–65 y - NR - Self-report - NR - Self-report - Sleep problems: severe or extreme problems with falling asleep, waking up frequently during the night or waking up too early in the morning the last 30 days x
Lecube (2016) (66) - Outpatient clinic - Spain (2013–2014) - 135 (44%) - 61 ± 13 y - >5 y - Clinically diagnosed - NR - PSQI - PSQI >5 = insomnia symptoms x
Lopes (2005) (67) - Outpatient clinic - Brazil (NR) - 100 (27%) - 58 ± 12 y - 10 ± 8 y - Clinically diagnosed - 59% OAD 32% insulin - PSQI - PSQI ≥6 = insomnia symptoms x
Lou (2012) (68) - General population - China (2008) - 954 DM (43%) - 49 ± 13 y - NR - Clinically diagnosed - NR - Self-report - Sleep quality during previous year = good, common or poor x
Lou (2015) (69) - Health centers - China (NR) - 944 (39%) - 64 ± 10y - 6 ± 5y - Clinically diagnosed - 12% insulin - PSQI - PSQI ≥8 = insomnia symptoms x x
Luyster (2011) (70) - NR - USA (NR) - 300 (43%) - 64 ± 10y - 9 ± 7y - Clinically diagnosed - 12% insulin - PSQI - PSQI >5 = insomnia symptoms x
Manodpitipong (2017) (71) - Hospital - Thailand (2014) - 189 (40%) - Unemployed: 65 ± 8 Day work: 53 ± 9 - Unemployed: 14 ± 10 Day work: 9 ± 8 - Clinically diagnosed - Unemployed: 42% Day work: 35% - PSQI - NR x
Mahmood (2013) (72) - Diabetes clinic - Ireland (NR) - 114 (64%) - Healthy: 64 ± 11 Insomnia: 66 ± 10 - NR - Clinically diagnosed - Healthy/insomnia: 66%/65% OAD 23%/15% insulin 21%/15% diet - PSQI - PSQI ≥6 = insomnia symptoms x x x x x x x x x
Medeiros (2013) (73) - Outpatient clinic - Brazil (NR) - 110 (35%) - 58 ± 11 y - NR - Clinically diagnosed - NR - PSQI - PSQI >6 = insomnia symptoms x
Meng (2015) (74) - Hospital - China (2014-2015) - 332 (57%) - Insomnia: 59 ± 9 y Healthy: 53 ± 14 y - Insomnia:12 ± 7 y Healthy: 7 ± 7 y - Clinically diagnosed - NR - PSQI - PSQI ≥7 = insomnia symptoms x x x x x x x x
Narisawa (2017) (75) - Outpatient clinic - Japan (2014) - 622 (76%) - 57 ± 10 y - NR - Clinically diagnosed - 10% OAD 27% insulin - PSQI - PSQI >5.5 = insomnia symptoms x
Nefs (2015) (76) - Websurvey - Netherlands (2011) - 361 (54%) - 62 ± 9 - 11 ± 8 y - Self-report - 44% OAD 49% insulin - PSQI - PSQI >5 = insomnia symptoms x
Osonoi (2015) (77) - Outpatient clinic - Japan (2013–2014) - 724 (63% ) - 58 ± 9 y - 10 ± 7 y - Clinically diagnosed - 86% OAD/insulin/ both - PSQI - PSQI ≥9 = insomnia symptoms x x x x x x x x
Rajendran (2012) (78) - Tertiary care - India (2010–2011) - 120 (54%) - 54 ± 9 y - 7 ± 6 y - Clinically diagnosed - 100% OAD/insulin/ both - PSQI - PSQI ≥5 = insomnia symptoms x
Ramos (2015) (79) - Registry black participants - USA (NR) - 612 (NR) - 62 ± 14 y - NR - Clinically diagnosed - NR - Unspecified questionnaire - Insomnia symptoms yes/no x
Ramtahal (2015) (80) - Outpatient clinics - Trinidad and Tobago (2013) - 291 (33%) - 59 ± 11 y - 10 [6–19] y - Clinically diagnosed - 30% OAD 17% insulin 47% both - NHANES sleep questionnaire - Insomnia = patients answered “often” or “almost always” to sleep-related questions x
Sakamoto (2018) (81) - Hospital - Japan (2014–2016) - 3294 (61%) - 65 [55–72] y - 11 [5–17] y - Clinically diagnosed - 60% OAD 29% insulin/GLP - PSQI - PSQI >5 = insomnia symptoms x
Seligowski (2013) (82) - Primary care - USA (NR) - 86 (97%) - 62 ± 8 y - NR - Clinically diagnosed - 100% insulin or OAD - PSQI - NR x
Shamshirgaran (2017) (83) - Diabetes clinic - Iran (2013-2014) - 256 (29%) - 54 ± 9 y - NR - Clinically diagnosed - 58% OAD 29% OAD + insulin - PSQI - PSQI >5 = insomnia symptoms x x x
Shim (2011) (84) - Outpatient clinic - Korea (2008) - 784 (50%) - 54 ± 12 y - 9 ± 7 y - Clinically diagnosed - 0% insulin - PSQI - PSQI >5 = insomnia symptoms x
Skomro (2001) (85) - Outpatient clinic - Canada (NR) - 58 (50%) - 57 ± 15 y - 10 y - Clinically diagnosed - NR - Interview - Difficulty with sleep onset or maintenance ≥3 times/wk x
Sokwalla (2017) (86) - Outpatient clinic - Kenya (2012) - 228 (42%) - 57 ± 12 y - 10 ± 8 y - Clinically diagnosed - 36% OAD 13% insulin 50% insulin + OAD - PSQI - PSQI >5 = insomnia symptoms x x
Song (2013) (87] - Outpatient clinic - China (2012) - 140 (59%) - 57 ± 14 y - 20% = >10 y - Clinically diagnosed - 100% insulin - PSQI - PSQI >5 = insomnia symptoms x
Sridhar (1994) (88) - Diabetes center - India (NR) - 184 (82%) - 46 ± NR - Normal sleep: 5 ± 6 y Abnormal sleep: 4 ± 5 y - Clinically diagnosed - NR - Self-report - Variable 1: difficulty falling asleep ≥3 times/ wk for ≥2 wks - Variable 2: difficulty in maintaining sleep; interrupted sleep ≥2/night and problems going back to sleep x
Sudore (2012) (89) - Diabetes registry - USA (2005–2006) - 13 171 (52%) - 60 ± 10 y - 10 ± 8 y - Clinically diagnosed - 21% insulin - PHQ9 - Sleep disturbance = almost every day difficulty initiating or maintaining sleep or excessive sleep x
Tang (2014) (90) - Hospital - China (2013–2014) - 551 (55%) - 57 ± 10 y - 9 ± 8 y - Clinically diagnosed - NR - PSQI - PSQI >5 = insomnia symptoms x
Tanjani (2015) (91) - General population - Iran (2012) - 297 DM (41%) - 60–76 y - NR - Self-report - NR - GDS - Insomnia: yes/no x
Telford (2018) (92) - Primary care clinic - USA (NR) - 281 (52%) - 62 ± 9 y - NR - Clinically diagnosed - 44% insulin - PSQI - PSQI >5 = insomnia symptoms x x x x x
Thongsai (2013) (93) - Outpatient clinic - Thailand (2013) - 209 (40%) - 40% > 60 y - 62% = 3–5 y 38% >5 y - Clinically diagnosed - NR - CES-D questionnaire - Difficulty sleeping (never, sometimes, quite often, always) x
Torella (2015) (94) - Diabetes clinic - Spain (2011–2013) - 145 (51%) - 60 ± 10 y - 14 ± 10 y - Clinically diagnosed - 73% insulin - PSQI - PSQI >5 = insomnia symptoms x
Trento (2008) (95) - NR - Italy (NR) - 47 (68%) - 61 ± 5 y - 17 (8–31) y - Clinically diagnosed - 100% OAD - Actigraphy: sleep efficiency + sleep latency - NA x
Tsai (2012) (96) - Outpatient clinic - Taiwan (2009) - 46 (61%) - 60 ± 10 y - >1 y - Clinically diagnosed - NR - PSQI - PSQI ≥8 = insomnia symptoms x
Tsujimura (2009) (97) - NR - Japan (NR) - 19 (58%) - 63 ± 10 y - 7 (1–20) y - WHO 1981 - NR - Actigraphy: sleep efficiency + wake after sleep onset - NA x x
Vernon (2008) (98) - Clinical centers - North America, Australia, Germany, Hungary, Poland, South Africa, United Kingdom - 388 (±58) - ±59 (21–85) y - ±11 y - Clinically diagnosed - NR - MOS-SS questionnaire - MOS score >52.5 = sleep disturbance x
Wei (2017) (99) - Outpatient clinic - China (2015) - 206 (50%) - 60 [56–63] y - Newly diagnosed - WHO 1999 - 0% OAD - PSQI - PSQI >5 = insomnia symptoms x x x x x x x x
Yagi (2011) (100) - Outpatient clinic - Japan (baseline 1996–1998) - 270 (55%) - 67 ± 10 y - 18 ± 9 y - Clinically diagnosed - 41% insulin - PSQI - PSQI >5.5 = insomnia symptoms x
Zelman (2006) (101) - Tertiary care - USA (2003) - 255 (45%) - 61 ± 13 y - 9 [4–18] y - Clinically diagnosed - NR - MOS-SS - No, some or sleep problems x
Zhang (2016) (63) - T2D registry - China (2012) - 944 (39%) - 64 ± 10 y - 6 ± 5 y - Clinically diagnosed - 12% insulin - PSQI - PSQI ≥7 = insomnia symptoms x
Zhu (2014) (102) - Hospital - China (2013–2014) - 206 (66%) - 57 ± 11 y - 10 ± 7 y - Clinically diagnosed - 60% insulin - PSQI - PSQI ≥8 = insomnia symptoms x x x x x x x x
Zhu (2018) (103) - Convenience sample - USA (2013–2014) - 90 (48%) - 57 ± 8 y - 9 ± 7 y - Self-report - NR - PROMIS - Sleep disturbance = perceived difficulties in getting or staying asleep x

Abbreviations: AIS, Athens Insomnia Scale; BMI, body mass index; CES-D, Center for Epidemiologic Studies Depression scale; DBP, diastolic blood pressure; DM, diabetes mellitus; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders-IV; FPG, fasting plasma glucose; GDS, Geriatric Depression Scale; GLP, glucagon-like peptide; HDL, high-density lipoprotein; IQR, interquartile range; LDL, low-density lipoprotein; 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; SBP, systolic blood pressure; SD, standard deviation; TG, triglyceride; UAE, United Arabic Emirates; WHO, World Health Organization.