title: Short sleep duration measured by wrist actimetry is associated with deteriorated glycemic control in type 1 diabetes.
abstract: OBJECTIVE
  Sleep restriction has been associated with deteriorated insulin sensitivity. The effects of short sleep duration have been explored little in patients with type 1 diabetes. This study addresses the question of whether sleep curtailment affects HbA1c levels in patients with type 1 diabetes.
  
  
  METHODS
  Seventy-nine adult patients with type 1 diabetes (median age 40 years [IQR 23-49]; 47% men) were recruited to wear a wrist actimetry sensor during 3 consecutive days to assess mean sleep duration during normal daily life. A subsample of 37 patients also performed 24-h ambulatory blood pressure monitoring (ABPM). Medical history, sleep questionnaires, and diabetes-related quality of life (DQOL) were assessed.
  
  
  RESULTS
  Patients having shorter sleep duration--less than 6.5 h (n=21)--had higher levels of HbA1c (P=0.01) than patients with longer sleep duration, above 6.5 h (n=58). In a multivariable regression model including shorter versus longer sleep duration, diabetes duration, DQOL score, and daily activity, sleep duration was the only variable independently associated with HbA1c (R2=10%). In patients who performed 24-h ABPM, patients with a nondipping pattern of blood pressure exhibited shorter sleep duration than patients with a dipping pattern of blood pressure.
  
  
  CONCLUSIONS
  Shorter sleep duration is associated with higher HbA1c levels in patients with type 1 diabetes, as well as with a nondipping pattern of blood pressure, anticipating a long-term deleterious impact on the risk of microvascular complications. Further studies should test whether extending the duration of sleep may improve both HbA1c and blood pressure in type 1 diabetes.
authors.affiliation: Corresponding author: Anne-Laure Borel, alborel@chu-grenoble.fr.
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Borel
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Pépin
authors.forename: Laure
authors.initials: L
authors.lastname: Nasse
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Baguet
authors.forename: Sophie
authors.initials: S
authors.lastname: Netter
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Benhamou
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure / Q000502:physiology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D012890:Sleep / Q000502:physiology*; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin