Sleep, glucose, and daytime functioning in youth with type 1 diabetes.
STUDY HYPOTHESES: 1) Youth with evidence of SDB (total apnea-hypopnea index [Total-AHI] ≥ 1.5) would have significantly worse glucose control than those without SDB; 2) Elevated self-reported sleepiness in youth with T1DM would be related to compromised psychosocial functioning; and 3) Youth with T1DM would have significantly less slow wave sleep (SWS) than controls.


METHODS
The study utilized home-based polysomnography, actigraphy, and questionnaires to assess sleep, and continuous glucose monitors and hemoglobin A1C (HbA1C) values to assess glucose control in youth with T1DM. We compared sleep of youth with T1DM to sleep of a matched control sample.


METHODS
Diabetic participants were recruited in a pediatric endocrinology clinic.


METHODS
Participants were youth (10 through 16 years) with T1DM. Controls, matched for sex, age, and BMI percentile, were from the Tucson Children's Assessment of Sleep Apnea study.


RESULTS
Participants with a Total-AHI ≥ 1.5 had higher glucose levels. Sleepiness and/or poor sleep habits correlated with reduced quality of life, depressed mood, lower grades, and lower state standardized reading scores. Diabetic youth spent more time (%) in stage N2 and less time in stage N3. Findings related to sleep architecture included associations between reduced SWS and higher HbA1C, worse quality of life, and sleepiness. More time (%) spent in stage N2 related to higher glucose levels/hyperglycemia, behavioral difficulties, reduced quality of life, lower grades, depression, sleep-wake behavior problems, poor sleep quality, sleepiness, and lower state standardized math scores.
Department of Disability and Psychoeducational Studies, University of Arizona, 1430 E.2nd St., Tucson, AZ 85721, USA. mperfect@email.arizona.edu
Michelle M
MM
Perfect
Priti G
PG
Patel
Roxanne E
RE
Scott
Mark D
MD
Wheeler
Chetanbabu
C
Patel
Kurt
K
Griffin
Seth T
ST
Sorensen
James L
JL
Goodwin
Stuart F
SF
Quan
D056044:Actigraphy; D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis* / Q000502:physiology; D016022:Case-Control Studies; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D017286:Polysomnography; D011788:Quality of Life / Q000523:psychology; D012890:Sleep / Q000502:physiology*; D012891:Sleep Apnea Syndromes / Q000209:etiology / Q000503:physiopathology; D011795:Surveys and Questionnaires; D014851:Wakefulness / Q000502:physiology*
D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human