Stress and Quality of Sleep Among Individuals Diagnosed with Diabetes

Several studies have suggested that stress and sleep may be related to diabetic disease progression. Cortisol is one physiological indicator of stress that has been well validated in previous research. The primary objectives of the present study were (1) to examine the experiences of stress among patients diagnosed with diabetes and (2) to evaluate the quality of sleep among these participants. Participants (mean age = 34.99 years) were 20 adolescents and adults with Diabetes Mellitus; 13 had Type I and 17 were female. Primary measures included actigraphy, the Pittsburgh Sleep Quality Index (PSQI), salivary cortisol and the Perceived Stress Scale (PSS). Participants reported a moderate amount of stress (mean PSS scores = 20.2), slept an average of 6.51 h and exhibited at least one clinical indicator of sleep disturbance. Objectively measured total sleep time was associated with awakening cortisol (r = 0.62, p = 0.004) and PSQI Global scores (r = -0.51, p = 0.021). Awakening cortisol and PSS scores were not associated with PSQI Global scores, but were related to specific self-reported sleep disturbances. Given the interacting physiological pathways of stress and sleep, both of which were evident in this small sample, these variables warrant further study. Copyright (C) 2009 John Wiley & Sons, Ltd.