Background: Adherence to medications is vital for glycemic control in type 2 diabetes. It is unclear if insomnia is a barrier to medication adherence. The aim of this secondary analysis was to examine the association between insomnia and adherence to insulin therapy.

Method: Using a cross-sectional design, baseline data from subjects (N=139) prescribed insulin from the Diabetes Sleep Treatment Trial were analyzed. Measures included demographics, A1C, BMI, the Insomnia Severity Index, and the Pittsburgh Sleep Quality Index. Self-reported adherence to insulin therapy was determined by response to the question: How many of the past 7 days did you take your recommended insulin injections and scored as 7 days for adherent (77.7%; n=107) and 0 to 6 days for non-adherent (23.0%; n=32). Data were analyzed using univariate and backward multivariate logistic regression.

Results: The sample was diverse (55.4% white; 46.0% female; 41.7% married/partnered; 55.4% >2 years post high school with a mean age of 56.3±10.9 years, BMI of 35.2±6.6 kg/m2; and A1C of 8.3±1.7%). Individuals with insulin adherence had a lower A1C than those with non-adherence (8.0±1.6% vs. 9.5±1.7%, p<.001). Insomnia was negatively associated with insulin adherence in univariate and multivariate logistic regression.

Conclusion: These results suggest insomnia severity and race are associated with deceased insulin adherence. The mechanisms for these potential associations need to be further explored.

Y. Zheng: None. M.T. Korytkowski: None. S.M. Sereika: None. L.E. Burke: None. C.W. Atwood: None. P.J. Strollo: Consultant; Self; Emmi, Inspire Medical Systems, Philips Respironics. Research Support; Self; Jazz Pharmaceuticals, ResMed. B. Jeon: None. E.R. Chasens: Research Support; Self; National Institute of Diabetes and Digestive and Kidney Diseases, Philips Respironics, ResMed Inc.


National Institutes of Health (R01DK096028)

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