The relationship between depression, anxiety, and stress levels and sleep quality in diabetic patients: A quantitative study utilizing DASS-42 and PSQI questionnaires

Abstract

Background: Diabetes mellitus, a chronic metabolic disorder, is often associated with various psychological conditions such as depression, anxiety, and stress. The interplay between these psychological factors and sleep quality can further complicate disease management and patient outcomes. This study aims to evaluate the relationship between psychological distress, assessed using the Depression Anxiety Stress Scales (DASS-42), and sleep quality, measured by the Pittsburgh Sleep Quality Index (PSQI), in diabetic patients with HbA1c levels above 6.5%. Materials and Methods: This cross-sectional study was conducted in a tertiary care hospital in India. A total of 150 diabetic patients with HbA1c > 6.5% were recruited. Psychological distress was evaluated using the DASS-42 questionnaire, which measures depression, anxiety, and stress. Sleep quality was assessed using the PSQI questionnaire. The correlation between DASS-42 scores and PSQI scores was analysed using Pearson’s correlation coefficient, and statistical significance was determined by the p-value. Results: The study findings indicated a significant positive correlation between the DASS-42 total scores and PSQI scores, suggesting that higher levels of psychological distress are associated with poorer sleep quality in diabetic patients. Specifically, Pearson’s correlation coefficient was found to be 0.56 (p < 0.01), demonstrating a moderate correlation. Further analysis revealed that all three subscales of the DASS-42 (depression, anxiety, and stress) were individually correlated with poor sleep quality, with stress showing the strongest correlation (r = 0.62, p < 0.01). Conclusion: The study emphasise the significant association between psychological distress and sleep quality in diabetic patients. Given the moderate positive correlation observed, it is imperative for healthcare providers to consider psychological evaluations and interventions as part of comprehensive diabetes management. Addressing psychological issues may not only improve sleep quality but also potentially enhance overall disease outcomes. Further research is warranted to explore the causal relationships and potential therapeutic interventions.