Abstract
BACKGROUND: Type 2 diabetes mellitus (T2DM) is a growing global health crisis, affecting hundreds of millions worldwide. Poor sleep quality-often under-recognized-impairs glycemic control and accelerates diabetes-related complications. Despite its clinical relevance, data on sleep quality among T2DM patients in Somalia are virtually nonexistent. This study aimed to evaluate the prevalence and determinants of poor sleep quality among T2DM patients in Mogadishu, Somalia. METHODS: A hospital-based cross-sectional study was conducted between November 2024 and January 2025 at Mogadishu Somali-Turkiye Recep Tayyip Erdogan Training and Research Hospital. A total of 311 adults with T2DM were selected using systematic sampling. Data were collected using structured questionnaires and validated instruments including the Pittsburgh Sleep Quality Index (PSQI), Patient Health Questionnaire-9 (PHQ-9), and Oslo Social Support Scale (OSSS-3). Logistic regression analysis was employed to identify variables independently associated with suboptimal sleep quality. RESULTS: Overall, 54.0% of participants reported poor sleep quality (95% CI: 48.3-59.7). Multivariable analysis identified several significant predictors, including female gender, unemployment, low income, substance use, physical inactivity, and depressive symptoms. Clinical factors such as comorbidities, poor glycemic control, and diabetes-related complications were also independently associated with suboptimal sleep quality. CONCLUSION: Over half of T2DM patients in Mogadishu experience poor sleep quality, influenced by sociodemographic, behavioral, psychological, and clinical factors. The findings highlight the need to incorporate sleep evaluation and targeted interventions-focusing on mental health, lifestyle, and metabolic control-into routine diabetes care.