Concordance Between Subjective and Actigraphy‐Measured Sleep and Factors Associated With Discrepancies in Adults With Type 2 Diabetes

The relationship between sleep and glucose metabolism underscores the importance of evaluating sleep, especially given the high prevalence of sleep disturbances in individuals with Type 2 diabetes (T2D). Objective sleep measurements like actigraphy may not always align with subjective assessments, such as the Pittsburgh Sleep Quality Index (PSQI). Although discrepancies between objectively measured sleep and subjectively measured sleep have been highlighted in healthy populations and other clinical populations, the relationship has not been well studied in individuals with T2D. We aimed to assess the discrepancies and correlations between actigraphy-measured and self-reported sleep parameters in individuals with T2D, and to identify demographic, psychological, and clinical factors contributing to these discrepancies. Adults (n = 134) with T2D wore actigraphy devices for 14 days and completed study surveys assessing subjective sleep (PSQI), demographics, and psychological and clinical factors. Findings indicated significant discrepancies in total sleep time (TST) and sleep efficiency between the two measurement methods, with self-reported TST being higher. Discrepancy levels varied by sex, depressive symptoms, and perceived stress. After adjusting for covariates, sex and depressive symptoms remained significant factors of greater discrepancies in TST and sleep efficiency. Age, marital status, housing stability, and sleep quality were also associated with discrepancies in sleep efficiency. Employment status and housing stability were factors associated with discrepancies in sleep midpoint. Discrepancies between subjective and objective sleep assessments suggest that integrating both methods could provide a more comprehensive understanding of sleep health. The findings also emphasize the need to consider individual psychological and demographic factors when interpreting sleep measurements.