Sleep impairment in patients with painful diabetic peripheral neuropathy

Objective: This study evaluated sleep impairment associated with painful diabetic peripheral neuropathy (DPN), a neuropathic pain condition. Sleep is of critical concern for DPN because sleep impairment and its comorbidities may influence type 2 diabetes progression. Methods: This is a supplemental analysis of sleep data from a burden of illness study of patients with painful DPN (N = 255, 61 +/- 12.8 y old, 51.4% women). Sleep was evaluated using the Medical Outcomes Study Sleep measure (MOS-Sleep). MOS-Sleep scores were compared with general population norms (N = 10 11), the MOS chronic disease sample (N = 3445), and patients with postherpetic neuralgia (N = 89). The MOS-Sleep Sleep Adequacy score was compared with data from the MOS diabetes subsample (N = 590). Results: Patients with painful DPN reported impaired sleep relative to the general population (P < 0.001), the chronic disease sample (P < 0.001), and postherpetic neuralgia patients (P < 0.05). Self-rated MOS-Sleep Sleep Adequacy was significantly less for the painful DPN than for the diabetes sample (P < 0.001), although self-reported hours of sleep were not significantly different. Multiple regression indicated that age, average daily pain, and anxiety and depression symptom levels were each significantly (P < 0.01) associated with, and collectively accounted for, 47% of variance in the MOS-Sleep Sleep Problems Index. Discussion: Painful DPN is associated with considerable sleep impairment. Given the recognized association between sleep impairment, type 2 diabetes and metabolic and affective disturbance, and the known adverse impact of affective disturbance on diabetes self-care, addressing these features-pain, sleep, and affective disturbance-is an important aspect of care for patients with painful DPN.