Introduction Low self-compassion and poor sleep quality have been identified as potential key predictors of distress in type 2 diabetes (T2D). This study investigated relationships between sleep behaviors (sleep duration, social jetlag and daytime sleepiness), diabetes-related distress (DRD) and self-compassion in people with T2D.
Research design and methods This cross-sectional study used data from 467 people with T2D derived from self-report questionnaires, accelerometer-assessed sleep measures and demographic information (clinicaltrials.gov registration: NCT02973412). All participants had a diagnosis of T2D and no comorbid sleep disorder (excluding obstructive sleep apnea). Hierarchical multiple regression and mediation analysis were used to quantify relationships between self-compassion, sleep variables and DRD.
Results Significant predictors of DRD included two negative subscales of the Self-Compassion Scale (SCS), and daytime sleepiness. The ‘overidentified’ and ‘isolation’ SCS subscales were particularly important in predicting distress. Daytime sleepiness also partially mediated the influence of self-compassion on DRD, potentially through self-care around sleep.
Conclusions Daytime sleepiness and negative self-compassion have clear associations with DRD for people with T2D. The specific negative subscale outcomes suggest that strengthening individuals’ ability to mindfully notice thoughts and experiences without becoming enmeshed in them, and reducing a sense of separateness and difference, might be key therapeutic targets for improving well-being in T2D. Psychological interventions should include approaches focused on reducing negative self-compassion and improving sleep behavior. Equally, reducing DRD may carry beneficial outcomes for sleep and self-compassion. Further work is however crucial to establish causation and long-term impact, and for development of relevant clinical resources.
- diabetes mellitus, type 2
- health behavior
- stress, psychological
Data availability statement
Data are available on reasonable request. The dataset generated during this study is not publicly available but is available from the corresponding author on reasonable request.
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Contributors SG: literature search, data preparation and analysis, interpretation, writing, review, editing, and guarantor. JH: conceptualization, funding acquisition, data collection, data curation, interpretation, review and editing. NR: conceptualization, interpretation, writing, review and editing. JM: data analysis, interpretation, review and editing. EMB: conceptualization, funding acquisition, interpretation, review and editing. SH: conceptualization, literature search, writing. MH: conceptualization, data curation, interpretation, review and editing. APH: conceptualization, funding acquisition, interpretation, review and editing. AVR: conceptualization, funding acquisition, data collection, data curation, interpretation, review and editing. TY: conceptualization, funding acquisition, interpretation, review and editing. MJD: conceptualization, funding acquisition, interpretation, review and editing.
Funding The research was supported by the NIHR Leicester Biomedical Research Centre (which is a partnership between University Hospitals of Leicester NHS Trust, Loughborough University and the University of Leicester).
Disclaimer The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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