The Relationship Between Pain, Daily Function, and Sleep Quality in Diabetic Neuropathy

Background and Aims: Poor sleep quality affects insulin sensitivity and glucose metabolism. There were limited information about sleep quality in individuals with diabetic peripheral neuropathy. The Pittsburgh Sleep Quality Index was used in this study to measure sleep quality and determine how sleep quality and pain were related in patients with diabetic peripheral neuropathy. Methods: This is a secondary analysis of an aerobic exercise research study in patients with diabetic peripheral neuropathy. Participants performed the Pain Inventory and the Pittsburgh Sleep Quality Index at baseline to measure clinical pain and sleep quality, respectively. Pain Inventory consists of two com¬ponents including The Pain Severity Index and the Pain Interference Index. The relationship between pain and sleep quality was evaluated using Pearson’s correlations. Results: The study showed that 77.8% of the subjects had low sleep quality (i.e., Pittsburgh Sleep Quality Index scores > 5) (mean score of Pittsburgh Sleep Quality Index scores was 9.94±4.35). The mean scores of the Pain Interference Index and Pain Severity Index were 3.54±2.90 and 3.36±2.21, respectively. Both Pittsburgh Sleep Quality Index and Brief Pain Inventory-Pain severity index had positive relationship (r= 0.642, p = 0.004). In addition, there were positive relationship between Pittsburgh Sleep Quality Index and Brief Pain Inventory-Pain interference index (r= 0.591, p = 0.01). Conclusions: The majority of patient with diabetic peripheral neuropathy had low sleep quality. A higher pain intensity and more interference with daily activities were both strongly linked with poor sleep quality. The item of sleep discomfort in everyday activity was highly influenced in patients with diabetic peripheral neuropathy. Future studies are needed to determine if addressing poor sleep quality would impact perception of pain as well as diabetes management.