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CC BY-NC-ND 4.0 · Sleep Sci 2024; 17(01): e45-e54
DOI: 10.1055/s-0043-1773786
Original Article

Effectiveness of Mediterranean Diet on Daytime Sleepiness among Individuals with Type 2 Diabetes Mellitus in Oman

Najwa Salim AlAufi
1   Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia
,
Yoke Mun Chan 
1   Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia
2   Research Centre of Excellence Nutrition and Non-communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia
3   Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang 43400, Malaysia
,
Yit Siew Chin
2   Research Centre of Excellence Nutrition and Non-communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia
4   Department of Nutrition, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang 43400, Malaysia
,
Norliza Ahmad
5   Department of Community Health, Faculty of Medicine and Health Science, Universiti Putra Malaysia
,
Barakatun Nisak Mohd-Yusof
1   Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia
2   Research Centre of Excellence Nutrition and Non-communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia
,
Mostafa I Waly
6   Department of Food Science and Nutrition, College of Agriculture and Marine Sciences, Sultan Qaboos University, Muscat, Oman
,
Noor Al Busaidi
7   National Diabetic and Endocrine Center, Muscat, Oman
,
Sulaiman Al-Shuriqi
7   National Diabetic and Endocrine Center, Muscat, Oman
,
Khadija Al Amri
7   National Diabetic and Endocrine Center, Muscat, Oman
,
Fatma Al Bulushi
7   National Diabetic and Endocrine Center, Muscat, Oman
,
Sajda Al Bulushi
7   National Diabetic and Endocrine Center, Muscat, Oman
› Author Affiliations Funding Source The author(s) received no financial support for the research.
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Abstract

Background Sleep disturbance is a major complaint among individuals with diabetes mellitus and may be augmented by dietary interventions. The objective of this randomized controlled trial was to determine the effectiveness of a Mediterranean diet intervention on daytime sleepiness among individuals with type 2 diabetes mellitus (T2DM) in Oman.

Methods In total, 134 eligible individuals with T2DM (61 and 73 participants in the intervention and control groups, respectively) were recruited. The intervention participants underwent a 6-month Mediterranean diet intervention consisting of individual dietary counseling, cooking classes, phone calls, and social media messages, while the control group continued with standard diabetes care. Daytime sleepiness was assessed using the Epworth Sleepiness Scale. All data was analyzed using IBM SPSS Statistics for Windows, version 26.0 (IBM Corp., Armonk, NY, USA).

Results Daytime sleepiness was evident, with ∼ 30% of the participants experiencing it, with no significant difference between control and intervention participants at baseline. There was a significant reduction in daytime sleepiness in both the intervention and control groups after 6 months, with daytime sleepiness significantly lower in the intervention group, with a modest difference of 42.56% (p < 0.001).

Conclusion Adherence to the Mediterranean diet is effective in reducing daytime sleepiness among individuals with T2DM.

Clinical Trial UMIN000041152

Keywords

daytime sleepiness - Mediterranean diet - type 2 diabetes mellitus

Ethics Committee Number

JKEUPM-2018–456




Publication History

Received: 27 September 2022

Accepted: 18 May 2023

Article published online:
26 March 2024

© 2024. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Sateia MJ. International classification of sleep disorders-third edition: highlights and modifications. Chest 2014; 146 (05) 1387-1394
    CrossrefPubMedGoogle Scholar
  • 2 Ohayon MM, Dauvilliers Y, Reynolds III CF. Operational definitions and algorithms for excessive sleepiness in the general population: implications for DSM-5 nosology. Arch Gen Psychiatry 2012; 69 (01) 71-79
    CrossrefPubMedGoogle Scholar
  • 3 Li X, Huang H, Xu H. et al. Excessive daytime sleepiness, metabolic syndrome, and obstructive sleep apnea: two independent large cross-sectional studies and one interventional study. Respir Res 2019; 20 (01) 276
    CrossrefPubMedGoogle Scholar
  • 4 Cavaillès C, Berr C, Helmer C, Gabelle A, Jaussent I, Dauvilliers Y. Complaints of daytime sleepiness, insomnia, hypnotic use, and risk of dementia: a prospective cohort study in the elderly. Alzheimers Res Ther 2022; 14 (01) 12
    CrossrefPubMedGoogle Scholar
  • 5 Hashimoto Y, Sakai R, Ikeda K, Fukui M. Association between sleep disorder and quality of life in patients with type 2 diabetes: a cross-sectional study. BMC Endocr Disord 2020; 20 (01) 98
    CrossrefPubMedGoogle Scholar
  • 6 Al-Abri MA, Al Lawati I, Zadjali F, Ganguly S. Sleep patterns and quality in omani adults. Nat Sci Sleep 2020; 12: 231-237
    CrossrefPubMedGoogle Scholar
  • 7 Jaussent I, Morin CM, Ivers H, Dauvilliers Y. Incidence, worsening and risk factors of daytime sleepiness in a population-based 5-year longitudinal study. Sci Rep 2017; 7 (01) 1372
    CrossrefPubMedGoogle Scholar
  • 8 Chasens ER, Sereika SM, Burke LE. Daytime sleepiness and functional outcomes in older adults with diabetes. Diabetes Educ 2009; 35 (03) 455-464
    CrossrefPubMedGoogle Scholar
  • 9 Asplund R. Daytime sleepiness and napping amongst the elderly in relation to somatic health and medical treatment. J Intern Med 1996; 239 (03) 261-267
    CrossrefPubMedGoogle Scholar
  • 10 Bioulac S, Micoulaud-Franchi JA, Arnaud M. et al. Risk of motor vehicle accidents related to sleepiness at the wheel: a systematic review and meta-analysis. Sleep 2017;40(10):
    Google Scholar
  • 11 Young T, Finn L, Peppard PE. et al. Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort. Sleep 2008; 31 (08) 1071-1078
    PubMedGoogle Scholar
  • 12 Tahrani AA. Obstructive sleep apnoea in diabetes: Does it matter?. Diab Vasc Dis Res 2017; 14 (05) 454-462
    CrossrefPubMedGoogle Scholar
  • 13 Anothaisintawee T, Reutrakul S, Van Cauter E, Thakkinstian A. Sleep disturbances compared to traditional risk factors for diabetes development: Systematic review and meta-analysis. Sleep Med Rev 2016; 30: 11-24
    CrossrefPubMedGoogle Scholar
  • 14 Chasens ER, Korytkowski M, Sereika SM, Burke LE. Effect of poor sleep quality and excessive daytime sleepiness on factors associated with diabetes self-management. Diabetes Educ 2013; 39 (01) 74-82
    CrossrefPubMedGoogle Scholar
  • 15 Kara B, Kılıç Ö. Predictors of poor sleep quality and excessive daytime sleepiness in Turkish adults with type 2 diabetes. J Clin Nurs 2015; 24 (9-10): 1436-1439
    CrossrefPubMedGoogle Scholar
  • 16 Khalil M, Power N, Graham E, Deschênes SS, Schmitz N. The association between sleep and diabetes outcomes - A systematic review. Diabetes Res Clin Pract 2020; 161: 108035
    CrossrefPubMedGoogle Scholar
  • 17 Zhu B, Hershberger PE, Kapella MC, Fritschi C. The relationship between sleep disturbance and glycaemic control in adults with type 2 diabetes: An integrative review. J Clin Nurs 2017; 26 (23-24): 4053-4064
    CrossrefPubMedGoogle Scholar
  • 18 AlAufi NS, Chan YM, Waly MI, Chin YS, Mohd Yusof B-N, Ahmad N. Application of Mediterranean Diet in Cardiovascular Diseases and Type 2 Diabetes Mellitus: Motivations and Challenges. Nutrients 2022; 14 (13) 2777
    CrossrefPubMedGoogle Scholar
  • 19 Bach-Faig A, Fuentes-Bol C, Ramos D. et al. The Mediterranean diet in Spain: adherence trends during the past two decades using the Mediterranean Adequacy Index. Public Health Nutr 2011; 14 (04) 622-628
    CrossrefPubMedGoogle Scholar
  • 20 Willett WC, Sacks F, Trichopoulou A. et al. Mediterranean diet pyramid: a cultural model for healthy eating. Am J Clin Nutr 1995; 61 (06) 1402S-1406S
    CrossrefPubMedGoogle Scholar
  • 21 Martínez-Gómez D, Guallar-Castillón P, León-Muñoz LM, López-García E, Rodríguez-Artalejo F. Combined impact of traditional and non-traditional health behaviors on mortality: a national prospective cohort study in Spanish older adults. BMC Med 2013; 11 (01) 47
    CrossrefPubMedGoogle Scholar
  • 22 Sofi F, Macchi C, Abbate R, Gensini GF, Casini A. Mediterranean diet and health status: an updated meta-analysis and a proposal for a literature-based adherence score. Public Health Nutr 2014; 17 (12) 2769-2782
    CrossrefPubMedGoogle Scholar
  • 23 Salim AN, Chan YM, Chin YS, Ahmad N, Mohd BN. Effectiveness of Mediterranean Diet on Diabetic Control and Cardiovascular Risk Modification Among Patients With Type 2 Diabetes Mellitus in Oman: A Study Protocol.
    Google Scholar
  • 24 Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. sleep. 1991; 14 (06) 540-5.
    PubMedGoogle Scholar
  • 25 Kendzerska TB, Smith PM, Brignardello-Petersen R, Leung RS, Tomlinson GA. Evaluation of the measurement properties of the Epworth sleepiness scale: a systematic review. Sleep Med Rev 2014; 18 (04) 321-331
    CrossrefPubMedGoogle Scholar
  • 26 Al-Abri M, Al-Hamhami A, Al-Nabhani H, Al-Zakwani I. Validation of the arabic version of the epworth sleepiness scale in oman. Oman Med J 2013; 28 (06) 454-456
    CrossrefPubMedGoogle Scholar
  • 27 Isac C, Abraham J. Daytime sleepiness among Omani nursing students: Estimate of its determinants and impact on perceived stress. Clin Epidemiol Glob Health 2020; 8 (03) 739-743
    CrossrefGoogle Scholar
  • 28 Sewell DA, Hammersley VS, Robertson A. et al. A pilot randomised controlled trial investigating a Mediterranean diet intervention in pregnant women for the primary prevention of allergic diseases in infants. J Hum Nutr Diet 2017; 30 (05) 604-614
    CrossrefPubMedGoogle Scholar
  • 29 Skouroliakou M, Grosomanidis D, Massara P. et al. Serum antioxidant capacity, biochemical profile and body composition of breast cancer survivors in a randomized Mediterranean dietary intervention study. Eur J Nutr 2018; 57 (06) 2133-2145
    CrossrefPubMedGoogle Scholar
  • 30 Alzaheb RA, Altemani AH. The prevalence and determinants of poor glycemic control among adults with type 2 diabetes mellitus in Saudi Arabia. Diabetes Metab Syndr Obes 2018; 11: 15-21
    CrossrefPubMedGoogle Scholar
  • 31 George ES, Kucianski T, Mayr HL, Moschonis G, Tierney AC, Itsiopoulos C. A Mediterranean diet model in Australia: strategies for translating the traditional Mediterranean diet into a multicultural setting. Nutrients 2018; 10 (04) 465
    CrossrefPubMedGoogle Scholar
  • 32 Al-Sahouri A, Merrell J, Snelgrove S. Barriers to good glycemic control levels and adherence to diabetes management plan in adults with Type-2 diabetes in Jordan: a literature review. Patient Prefer Adherence 2019; 13: 675-693
    CrossrefPubMedGoogle Scholar
  • 33 Gillibrand R, Stevenson J. The extended health belief model applied to the experience of diabetes in young people. Br J Health Psychol 2006; 11 (Pt 1): 155-169
    CrossrefPubMedGoogle Scholar
  • 34 Kuo C-P, Lu S-H, Huang C-N, Liao W-C, Lee M-C. Sleep quality and associated factors in adults with type 2 diabetes: a retrospective cohort study. Int J Environ Res Public Health 2021; 18 (06) 3025
    CrossrefPubMedGoogle Scholar
  • 35 Vasconcelos JP, Daniele TMdC, Bruin PFCd, Forti AC, Bruin VMSd. Daytime sleepiness in patients with type 2 diabetes mellitus: A prospective cohort study. 2016
    PubMedGoogle Scholar
  • 36 Dong D, Lou P, Wang J. et al. Interaction of sleep quality and anxiety on quality of life in individuals with type 2 diabetes mellitus. Health Qual Life Outcomes 2020; 18 (01) 150
    CrossrefPubMedGoogle Scholar
  • 37 Sakamoto R, Yamakawa T, Takahashi K. et al; Sleep and Food Registry in Kanagawa (SOREKA). Association of usual sleep quality and glycemic control in type 2 diabetes in Japanese: A cross sectional study. PLoS One 2018; 13 (01) e0191771
    CrossrefPubMedGoogle Scholar
  • 38 Mirghani H. Restless legs syndrome among Sudanese patients with type 2 diabetes mellitus: a case-control study. Cureus 2020; 12 (08) e9635
    PubMedGoogle Scholar
  • 39 Ning P, Mu X, Yang X, Li T, Xu Y. Prevalence of restless legs syndrome in people with diabetes mellitus: A pooling analysis of observational studies. EClinicalMedicine 2022; 46: 101357
    CrossrefPubMedGoogle Scholar
  • 40 Gore M, Brandenburg NA, Dukes E, Hoffman DL, Tai K-S, Stacey B. Pain severity in diabetic peripheral neuropathy is associated with patient functioning, symptom levels of anxiety and depression, and sleep. J Pain Symptom Manage 2005; 30 (04) 374-385
    CrossrefPubMedGoogle Scholar
  • 41 Jaussent I, Dauvilliers Y, Ancelin M-L. et al. Insomnia symptoms in older adults: associated factors and gender differences. Am J Geriatr Psychiatry 2011; 19 (01) 88-97
    CrossrefPubMedGoogle Scholar
  • 42 Godos J, Ferri R, Caraci F. et al. Adherence to the mediterranean diet is associated with better sleep quality in Italian adults. Nutrients 2019; 11 (05) 976
    CrossrefPubMedGoogle Scholar
  • 43 Campanini MZ, Guallar-Castillón P, Rodríguez-Artalejo F, Lopez-Garcia E. Mediterranean diet and changes in sleep duration and indicators of sleep quality in older adults. Sleep 2017;40(03):
    Google Scholar
  • 44 Castro-Diehl C, Wood AC, Redline S. et al. Mediterranean diet pattern and sleep duration and insomnia symptoms in the Multi-Ethnic Study of Atherosclerosis. Sleep 2018; 41 (11) zsy158
    CrossrefPubMedGoogle Scholar