Vol. 1 No. 1 (2026): August 2026
Articles

The relationship between anxiety levels and sleep quality in patients with type 2 Diabetes Mellitus at the Bulu Lor community health center in Semarang City

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  • Feti Setyowati,
  • Dwi Nur Aini
Feti Setyowati
Widya Husada University, Semarang
Dwi Nur Aini
Widya Husada University, Semarang
volume 1 no 2 (2026)

Published 2026-08-03

Keywords

  • anxiety level,
  • diabetes mellitus type 2,
  • sleep quality

Copyright (c) 2026 Feti Setyowati, Dwi Nur Aini (Author)

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Background: Type 2 diabetes mellitus (DM) is a chronic disease that often triggers psychological problems such as anxiety, which in turn affects patients’ sleep quality. 

Objective: This study aims to determine the relationship between anxiety levels and sleep quality in patients with type 2 DM in the service area of the Bulu Lor Community Health Center in Semarang City.

Methods: This study employed a quantitative design with a cross-sectional analytical approach. The sample consisted of 76 respondents selected using purposive sampling. The instruments used were the Zung Self-Rating Anxiety Scale (ZRAS) to measure anxiety and the Pittsburgh Sleep Quality Index (PSQI) to measure sleep quality.

Results: The study found that the majority of respondents experienced severe anxiety (38 individuals, 50%) and poor sleep quality (69 individuals, 90.8%). The bivariate statistical test yielded a p-value of 0.006 (< 0.05) with a correlation coefficient of 0.311.

Conclusion: This study demonstrates a significant, positive, but weak association between anxiety levels and sleep quality. The higher the anxiety level, the poorer the patient’s sleep quality. Healthcare professionals are encouraged to provide education on stress management and relaxation techniques to improve the quality of life for patients with type 2 diabetes.

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References

  1. Basri, M., Rahmatia, S., Dillah, R., 2020. The Relationship Between Sleep Quality and Fasting Blood Glucose Levels in Type II Diabetes Mellitus Patients at the Kassi-Kassi Community Health Center in Makassar. Jurnal Ilmiah Kesehatan Diagnosis 15, 46–50.
  2. Donkor, F.K., Mitoulis, S.-A., Argyroudis, S., Aboelkhair, H., Canovas, J.A.B., Bashir, A., Cuaton, G.P., Diatta, S., Habibi, M., Hölbling, D., Manuel, L., Pregnolato, M., Ribeiro, R.R.R., Sfetsos, A., Shahzad, N., Werner, C., 2022. SDGs: The Final Decade of Action—Resilient Pathways to Build Back Better from High-Impact, Low-Probability (HILP) Events. Sustainability 14, 15401. https://doi.org/10.3390/su142215401
  3. Dwi Nugroho, K., Asih, H.M., Widyaatmadja, S.T., 2022. Phenomenological Study: Overview of Palliative Care Management in the Pre-Hospital Setting of Semarang City. Jurnal Keperawatan Malang 7, 43–54.
  4. Dwi Nugroho, K., Kristiyawati, P., Wika, & Prihatiningtias, B., N.D. The Relationship Between Self-Acceptance and Family Support on the Quality of Life of Post-Stroke Patients at K.R.M.T. Wongsonegoro General Hospital, Semarang, Indonesian Journal of Health Research.
  5. Fridda, A., Sharon, A., Ayu, B., Anggita, N., Dewi, S., N.D. Appropriate Technology Innovation: Utilization of Binahong Plant Extract (Anredera cordifolia) as a Tulle Swab Dressing and Diabetes Self-Management Education on Wound Healing in Patients with Diabetes Mellitus.
  6. Fuadah, F., Saragih, B.D., Harun, I., Purnasari, H., Sinaga, H., 2024. The Influence of Health Education on the Elderly’s Knowledge of Healthy Lifestyle Patterns in RW 08, Jayagiri, Lembang Village. International Journal of Pharmaceutical and Biomedical Science 04. https://doi.org/10.47191/IJPBMS/V4-I6-08
  7. Guldemir, O., Hizli-Guldemir, H., 2025. Energy and Nutrient Content of a Disaster Kitchen Menu and Experience in Coordinating Nutrition Services: The Kahramanmaraş Earthquake, Türkiye. Food Nutr. Bull. 46, 123–128. https://doi.org/10.1177/03795721251345181
  8. Hidayat, B., Ramadani, R., Rudijanto, A., Soewondo, P., Suastika, K., Ng, J.Y.S., 2021. Direct Medical Costs of Type 2 Diabetes Mellitus and Its Associated Complications in Indonesia. Value Health Reg. Issues 28, 82–89. https://doi.org/10.1016/j.vhri.2021.04.006
  9. Hooke, M.C., Linder, L.A., 2019. Symptoms in Children Receiving Treatment for Cancer—Part I: Fatigue, Sleep Disturbance, and Nausea/Vomiting. Journal of Pediatric Oncology Nursing 36, 244–261. https://doi.org/10.1177/1043454219849576
  10. Imelda, S.I., 2019. Factors Influencing the Incidence of Diabetes Mellitus at the Harapan Raya Community Health Center in 2018. Scientia Journal 8, 28–38.
  11. Koracevic, G., Lovic, D., Zdravkovic, M., Stojanovic, M., Djordjevic, D., 2020. How Should We Treat Very High Blood Pressure Until We Distinguish Between Hypertensive Emergency and Urgency? Hypertension Research 43, 470–472. https://doi.org/10.1038/S41440-019-0393-5
  12. Made, N., Febriyanti, A., Primatanti, P.A., Luh, N., Eka, P., Sari, K., 2023a. The Relationship Between Anxiety Levels and Sleep Quality Among Pre-Clinical Medical Students Facing Block Exams at the Faculty of Medicine and Health Sciences, Warmadewa University. Aesculapius Medical Journal 3, 164–170.
  13. Made, N., Febriyanti, A., Primatanti, P.A., Luh, N., Eka, P., Sari, K., Ilmu, B., Jiwa, K., Kedokteran, F., 2023b. The Relationship Between Anxiety Levels and Sleep Quality Among Pre-Clinical Students Facing Block Exams at the Faculty of Medicine and Health Sciences, Warmadewa University. Aesculapius Medical Journal 3, 164–170.
  14. Metwally El-Sayed, M., Salihu, D., Hendy, A., Sharif, L., Sharif, K., 2026. Stabilizing Sleep–Wake Cycles and Social Functioning in Bipolar Disorders: Effect of Interpersonal and Social Rhythm Therapy. J. Clin. Med. 15. https://doi.org/10.3390/jcm15031071
  15. Mulyanto, J., Wibowo, Y., Ernawati, D.A., Lestari, D.W.D., Kringos, D., 2023. Exploring Inequalities in the Use, Quality, and Outcomes of the Diabetes Management Program of the Indonesian National Health Insurance. Health Equity 7, 644–652. https://doi.org/10.1089/heq.2023.0025
  16. Nugroho, K., Auliya, N.I., 2024. Relationship Between Nurses’ Therapeutic Communication and Family Anxiety Levels of Patients Experiencing Emergency Conditions. Babali Nursing Research 5, 423–432. https://doi.org/10.37363/BNR.2024.52303
  17. Nugroho, K.D., Sucipto, U., 2022. Introduction to Disaster Potential and Mitigation for Volunteers in the Southern Malang Beach Tourism Area. Kasih Stikes Dirgahayu Samarinda Journal of Community Service 1, 17–32.
  18. Rahmawati, F., Rizona, F., 2021. The Effect of Sleep Hygiene on Sleep Quality in Patients with Type 2 Diabetes Mellitus. ‘Aisyiyah Nursing Journal 8, 17–24. https://doi.org/https://doi.org/10.33867/JKA.V8i1.236
  19. Respati, T., Irasanti, S.N., Sartika, D., Akbar, I.B., Marzo, R.R., 2021. A Nationwide Survey of Psychological Distress Among Indonesian Residents During the COVID-19 Pandemic. Int. J. Publ. Health Sci. 10, 119–126. https://doi.org/10.11591/IJPHs.V10i1.20609
  20. Rizani, K., Kholik, S., Permadi, M.B., 2018. Nurses’ Educational Level and Years of Experience in Relation to Their Knowledge of Cardiopulmonary Resuscitation in the Emergency Department of Dr. Moch. Ansari Saleh General Hospital, Banjarmasin. Jurnal Citra Keperawatan 6, 78–88.
  21. Sulana, I.O.P., Sekeon, S.A.S., Mantjoro, E.M., Health, F., University, M., Ratulangi, S., Abstract, M., 2020. The Relationship Between Stress Levels and Sleep Quality Among Senior Students in the Faculty of Public Health at Sam Ratulangi University, Journal of Public Health.
  22. Superdock, A.K., Trejo, M., Yang, Y., Torres, C., Blazin, L.J., Baker, J.N., Spraker-Perlman, H.L., Kaye, E.C., 2024. “Understanding Why She Had to Leave Me”: The Roles of Religion and Spirituality in Narratives of Parents Grieving the Loss of a Child to Cancer. Death Studies 1–12. https://doi.org/10.1080/07481187.2024.2348059
  23. Sutanegara, D., Budhiarta, A.A.G., 2000. The Epidemiology and Management of Diabetes Mellitus in Indonesia. Diabetes Res. Clin. Pract. 50 Suppl. 2. https://doi.org/10.1016/S0168-8227(00)00173-X
  24. Tang, X., Pakarinen, E., Lerkkanen, M.-K., Muotka, J., Nurmi, J.-E., 2019. Longitudinal Associations of First-Grade Teaching with Reading in Early Primary School. J. Appl. Dev. Psychol. 63, 23–32. https://doi.org/10.1016/j.appdev.2019.05.002
  25. Tri Anggoro, W., Aeni, Q., 2018. The Relationship Between Nurses’ Characteristics and Caring Behavior. Journal of Mental Health Nursing 6, 98–105.
  26. Wahid, A., Manek, N., Nichols, M., Kelly, P., Foster, C., Webster, P., Kaur, A., Friedemann Smith, C., Wilkins, E., Rayner, M., Roberts, N., Scarborough, P., 2016. Quantifying the Association Between Physical Activity and Cardiovascular Disease and Diabetes: A Systematic Review and Meta-Analysis. J. Am. Heart Assoc. 5. https://doi.org/10.1161/Jaha.115.002495