Self-compassion, sleep quality and psychological well-being in type 2 diabetes: a cross-sectional study

Sarah Gunn, Joseph Henson, Noelle Robertson, John Maltby, Emer M Brady, Sarah Henderson, Michelle Hadjiconstantinou, Andrew P Hall, Alex V Rowlands, Thomas Yates, Melanie J Davies, Sarah Gunn, Joseph Henson, Noelle Robertson, John Maltby, Emer M Brady, Sarah Henderson, Michelle Hadjiconstantinou, Andrew P Hall, Alex V Rowlands, Thomas Yates, Melanie J Davies

Abstract

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.

Keywords: diabetes mellitus, type 2; health behavior; sleep; stress, psychological.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Consolidated Standards of Reporting Trials flow diagram. *CODEC, Chronotype of Patients with Type 2 Diabetes and Effect on Glycaemic Control; HbA1c, hemoglobin A1c.
Figure 2
Figure 2
Mediation models for direct and daytime sleepiness-mediated effect on diabetes-related distress of (A) SCS total; (B) SCS self-judgment; (C) SCS isolation; (D) SCS overidentified. SCS, Self-Compassion Scale.

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