چکیده (انگلیسی):

Background:Poor sleep quality and depression negatively impact the health-related quality of life of patients with
type 2 diabetes, but the combined effect of the two factors is unknown. This study aimed to assess the interactive
effects of poor sleep quality and depression on the quality of life in patients with type 2 diabetes.
Methods:Patients with type 2 diabetes (n= 944) completed the Diabetes Specificity Quality of Life scale (DSQL)
and questionnaires on sleep quality and depression. The products of poor sleep quality and depression were added
to the logistic regression model to evaluate their multiplicative interactions, which were expressed as the relative
excess risk of interaction (RERI), the attributable proportion (AP) of interaction, and the synergy index (S).
Results:Poor sleep quality and depressive symptoms both increased DSQL scores. The co-presence of poor sleep
quality and depressive symptoms significantly reduced DSQL scores by a factor of 3.96 on biological interaction
measures. The relative excess risk of interaction was 1.08. The combined effect of poor sleep quality and depressive
symptoms was observed only in women.
Conclusions:Patients with both depressive symptoms and poor sleep quality are at an increased risk of reduction
in diabetes-related quality of life, and this risk is particularly high for women due to the interaction effect. Clinicians
should screen for and treat sleep difficulties and depressive symptoms in patients with type 2 diabetes.