Clinically Moderate to Severe Insomnia without Excessive Daytime Sleepiness in Diabetic Patients with Chronic Neuropathic Limb Pain (P7.315)

OBJECTIVE: To evaluate sleep pattern and excessive daytime sleepiness in diabetic patients. BACKGROUND: Previous studies suggest that diabetic patients may have more difficulties with sleep than the general population. The sleep problems may not only be due to obstructive sleep apneas, but also due to the other clinical and social factors. METHODS: One-hundred-one individuals with diabetes (11 type 1) were randomly recruited from the diabetic outpatient clinic. Excessive daytime sleepiness and sleep pattern were evaluated with Epworth scale (ES) and Insomnia Severity Index (ISI). Simple logistic model for excessive daytime sleepiness (ES score 蠅10) and clinically moderate to severe insomnia (ISI蠅15) were performed in patients with type 2 diabetes based on age, disease duration, education and presence of neuropathic pain. RESULTS: Participants with diabetes type 2 were significantly older (62±15 vs. 35±14; all years) with shorter disease duration (10±8 vs. 17±7; all years) than patients with diabetes type 1. Mean ES (5.3± 4.3 vs. 4.6± 2.5) and ISI (10.3±6.7 vs. 9.2±7) score were non-significantly higher in type 2 diabetes. Twenty-six percent of individuals with diabetes type 2 suffered from neuropathic limb pain; 13[percnt] scored 蠅10 on ES and 20[percnt] 蠅15 on ISI. None of the patients with type 1 diabetes scored 10 on ES and only two patients had 蠅15 ISI. There was a week correlation between ES and ISI (rho=0.212; p<0.05). Variables which predicted clinically moderate to severe insomnia were age and chronic limb pain (model fit 82[percnt]), while excessive daytime sleepiness was predicted only by higher education (model fit 80[percnt]). CONCLUSIONS: Our results indicate that insomnia in random diabetic patients is more prevalent than excessive daytime sleepiness. Older patients with chronic pain have a poorer quality of sleep. Excessive daytime sleepiness in our diabetic patients may be due to life style and not due to diabetes per se. Disclosure: Dr. Rakusa has received personal compensation for activities with Pfizer Inc. as a speaker. Dr. Rakusa has nothing to disclose. Dr. Cokolic has nothing to disclose.