Sleep and glycemic control in adolescents with type 1 diabetes

Schnurbein, Julia von; Boettcher, Claudia; Brandt, Stephanie; Karges, Beate; Dunstheimer, Desirée; Galler, Angela; Denzer, Christian; Denzer, Friederike; Vollbach, Heike; Wabitsch, Martin; Roenneberg, Till; Vetter, Céline

doi:10.1111/pedi.12538

Cited by 53 publications

(58 citation statements)

References 34 publications

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“…42,45,5 However, some data have supported that delays or disruptions in sleep may be linked to poor glycemic control, diabetes-related complications, and inconsistent diabetes management. 39,41,51,52 For instance, Pillar et al 39 found that a swift decline in glucose levels paralleled more PSG-recorded awakenings in children with T1DM. Supporting these findings, higher HbA1c, DKA, and more frequent hypoglycemic episodes were more likely to have been experienced by children with a higher severity of parent-reported sleep disturbances, but the number of fingersticks did not associate with sleep disturbance severity.…”

Section: Sleep Disturbancesmentioning

confidence: 99%

<p>Sleep-related disorders in patients with type 1 diabetes mellitus: current insights</p>

Perfect

2020

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Type 1 diabetes mellitus (T1DM) is an autoimmune condition that results from destruction of beta cells in the pancreas. Several reviews have concluded that sleep contributes to poor glycemic control, diabetes management, and diabetes-related complications in individuals with T1DM and represents an untapped opportunity for intervention. However, at the current juncture, the American Diabetes Association's Standards of Medical Care are devoid of recommendations about how to address sleep in the management of T1DM. This article summarizes reviews of sleep in youth and adults with T1DM and empirical studies that have examined various sleep parameters ranging from sleep disturbances (general, perceived sleep quality, sleepiness, awakenings, and sleep efficiency), sleep duration, sleep consistency, sleep-disordered breathing (SDB), and sleep architecture. The data show that many individuals with T1DM sleep less than recommendations; individuals with the poorest sleep have difficulties with diabetes management; and sleep deficiency including SDB often corresponds to several disease morbidities (neuropathy, nephropathy, etc). Mixed findings exist regarding direct associations of various sleep parameters and glycemic control. SDB appears to be just as prevalent, if not more, than other conditions that have been recommended for universal screening in individuals with T1DM. The article concludes with recommendations for collaborative research efforts to further elucidate the role of sleep in diabetes-related outcomes; investigations to test behavioral strategies to increase sleep quantity and consistency; and considerations for clinical care to address sleep.

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Section: Sleep Disturbancesmentioning

confidence: 99%

<p>Sleep-related disorders in patients with type 1 diabetes mellitus: current insights</p>

Perfect

2020

NSS

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“…Specifically, adults displaying frequent swings between insufficient sleep and sleep compensation had higher insulin requirements than those with lower sleep variability, highlighting the importance of sleep regularity in the management of diabetes, though behavioral substrates that may impact both sleep patterns and diabetes care, such as executive function, were not assessed [•18]. A separate study of sleep patterns in adolescents with T1D using questionnaire data revealed that the mean variability in weekday/weekend sleep timing was 2.5 hours, and this variability was significantly associated with increased insulin requirements, regardless of adherence to treatment [19]. These findings support that sleep variability has negative effects on glycemic control in both adults and adolescents with T1D.…”

Section: Sleep Patterns and Disturbances In T1dmentioning

confidence: 99%

Sleep in Type 1 Diabetes: Implications for Glycemic Control and Diabetes Management

et al. 2018

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Purpose of Review To highlight recent findings from studies of sleep in type 1 diabetes (T1D), with a focus on the role of sleep in self-management, the cognitive and psychosocial outcomes related to sleep disturbances, and factors associated with sleep disturbances specific to T1D. Recent Findings People with T1D experience higher rates of sleep disturbances than people without diabetes, and these disturbances have negative implications for glycemic control and diabetes management, as well as psychosocial and cognitive outcomes. Inconsistent sleep timing (bedtime and wake time) has emerged as a potential target for interventions, as inconsistent sleep has been linked with poorer glycemic control and adherence to treatment. Sleep-promoting interventions and new diabetes technology have the potential to improve sleep in people with T1D. Summary Sleep is increasingly considered a critical factor in diabetes management, but more multi-method and longitudinal research is needed. We emphasize the importance of sufficient and consistent sleep for people with T1D, and the need for providers to routinely assess sleep among patients with T1D.

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“…To date, the T1D literature has provided some support for a general sleep pathway affecting executive function and T1D adherence in the short term, and health complications in the long term, such as diabetic ketoacidosis (DKA) and higher HbA1C levels (Figure ). Some research suggests that adolescents with greater sleep disturbances and lower sleep quality, have poorer T1D management and higher HbA1C levels . Moreover, one study has shown that the additive effect of poor self‐reported sleep relates to higher HbA1c levels, more episodes of severe hypoglycemia, and more episodes of DKA in youth …”

Section: Conceptual Modelsmentioning

confidence: 99%

“…31 The emerging literature examining sleep and T1D warrants a Figure 1). Some research suggests that adolescents with greater sleep disturbances and lower sleep quality, 33 have poorer T1D management and higher HbA1C levels. 34 Moreover, one study has shown that the additive effect of poor self-reported sleep relates to higher HbA1c levels, more episodes of severe hypoglycemia, and more episodes of DKA in youth.…”

Section: Type 1 Diabetes and Sleepmentioning

confidence: 99%

Sleep and type 1 diabetes in children and adolescents: Proposed theoretical model and clinical implications

Monzon

McDonough²,

Meltzer

et al. 2018

Pediatr Diabetes

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Youth with type 1 diabetes mellitus (T1D) experience more sleep disturbances and shorter sleep durations compared to their healthy peers. Researchers have now uncovered the negative mental health and physical health outcomes associated with poor sleep in youth with T1D. The field of T1D sleep research currently operates under the broad notion that sleep behaviors impact treatment adherence, which ultimately lead to worse long‐term health outcomes. This model however does not explain how behavior influences T1D management and sleep outcomes on a day‐to‐day basis, leading to difficulties in providing tailored treatment recommendations. In this review, we present a theoretical framework that describes the recursive cycle between sleep behaviors, T1D outcomes, and symptoms of negative affect/stress over a 24‐hour period. This model is guided by the sleep literature, showing a clear relationship between poor sleep and negative affect, and the T1D literature demonstrating a link between poor sleep and disease management for youth with T1D. Further, emerging literature indicates a need for additional parent sleep assessment considering that T1D management and fear of hypoglycemia negatively impact parent sleep behaviors. Recommendations are provided to move the field toward effective intervention studies and new areas of research to evaluate and modify the proposed model.

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Sleep and glycemic control in adolescents with type 1 diabetes

Cited by 53 publications

References 34 publications

<p>Sleep-related disorders in patients with type 1 diabetes mellitus: current insights</p>

<p>Sleep-related disorders in patients with type 1 diabetes mellitus: current insights</p>

Sleep in Type 1 Diabetes: Implications for Glycemic Control and Diabetes Management

Sleep and type 1 diabetes in children and adolescents: Proposed theoretical model and clinical implications

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