Impact of Sleep Duration and Quality on the Burden of Diabetes Among Urban and Rural Community Dwellers in Cameroon

Abstract

Background: Sleep disorders are known to be linked with numerous cardiovascular comorbidities including type 2 diabetes mellitus. The prevalence and impact of sleep quality and duration on diabetes in the Cameroonian population is not well established. This study evaluates the isolated and combined contribution of two aspects of sleep (duration and quality) on glucose homeostasis in an urban and rural Cameroonian population. Methods: This was a cross-sectional prospective survey conducted among 249 rural and 250 urban community dwellers in Cameroon aged ≥18 years. Self-reported sleep duration (SD) and quality were evaluated using the Pittsburgh Sleep Quality Index (PSQI). Poor sleep quality was considered for PSQI score>5 and short SD was considered≤ 6h. Diabetes was considered for fasting blood glucose>126mg/d Land/or use of glucose-lowering medications. Results: Mean age was 36±12 years, and men accounted for 39.1%. Frequency of poor sleep quality was 50.3% and was similar in urban and rural groups (48.2% vs 52.4% respectively, p=0.395). Short SD was present in 30.5% of subjects and was more frequent among urban dwellers (36.1% vs 24.8% in rural, p=0.006, respectively). Short SD was significantly associated with diabetes (OR 2.62, 95%CI 1.38-5.00). Although the frequency of diabetes was higher in participants with poor sleep quality compared to those with PSQI ≤5 (10% vs 6.5%, respectively), the observed difference was not significant (p>0.05). The combination of poor sleep quality and short SD was strongly associated with diabetes (OR 2.67, 95%CI 1.23-5.79). Conclusion: This survey demonstrates a significant association between short sleep duration as well as the combination of short sleep duration and poor sleep quality with type 2 diabetes prevalence. It is appropriate to consider sleep quality and duration as potentially modifiable variables associated with the presence or management of diabetes in these Cameroonian populations.