title: Sleep, executive functioning and behaviour in children and adolescents with type 1 diabetes.
abstract: OBJECTIVE
  The aim of the study was to examine sleep, neurocognitive and behavioural functioning in children and adolescents with type 1 diabetes (T1D) compared to controls and to test whether sleep quality mediates the relationship between diabetes and neurocognitive and behavioural deficits.
  
  
  METHODS
  Participants include 49 children and adolescents with T1D (recruited from a hospital clinic) and 36 healthy controls (age range = 6-16 years). Parents completed a survey consisting of the Sleep Disturbances Scale for Children, the Behavior Rating Inventory of Executive Functions, and the Behavior Assessment System for Children-2. Diabetic and demographic parameters were collated from medical records. The survey was posted to participants.
  
  
  RESULTS
  Children with T1D compared to controls reported a higher frequency of sleep problems, and mild deficits in executive and behavioural functioning. Mediational analyses revealed that sleep quality fully mediated metacognitive functioning, externalised problematic behaviour, and internalised problematic behaviour, but not behavioural regulation.
  
  
  CONCLUSIONS
  Rather than the direct impact of T1D on daytime functioning, it is the consequent impact of T1D on sleep and the resulting sleep disruption which can explain much of the neurocognitive and behavioural deficits reported in children with T1D. Maintaining good nocturnal glycaemic control may play a much larger role than previously thought in regulating daytime functioning in children with T1D.
authors.affiliation: School of Psychology, Social Work and Social Policy, University of South Australia, St Bernards Road, Adelaide, 5000, SA, Australia.
authors.forename: Nicole C
authors.initials: NC
authors.lastname: Caruso
authors.affiliation: School of Psychology, Social Work and Social Policy, University of South Australia, St Bernards Road, Adelaide, 5000, SA, Australia.
authors.forename: Branka
authors.initials: B
authors.lastname: Radovanovic
authors.affiliation: Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, King William Road, Adelaide, 5000, SA, Australia; Department of Respiratory and Sleep Medicine, Women's & Children's Hospital, King William Road, North Adelaide, 5006, SA, Australia.
authors.forename: J Declan
authors.initials: JD
authors.lastname: Kennedy
authors.affiliation: Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, King William Road, Adelaide, 5000, SA, Australia; Department of Endocrinology, Women's & Children's Hospital, King William Road, North Adelaide, 5006, SA, Australia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Couper
authors.affiliation: School of Psychology, Social Work and Social Policy, University of South Australia, St Bernards Road, Adelaide, 5000, SA, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Kohler
authors.affiliation: School of Psychology, Social Work and Social Policy, University of South Australia, St Bernards Road, Adelaide, 5000, SA, Australia.
authors.forename: Phillip S
authors.initials: PS
authors.lastname: Kavanagh
authors.affiliation: Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, King William Road, Adelaide, 5000, SA, Australia; Department of Respiratory and Sleep Medicine, Women's & Children's Hospital, King William Road, North Adelaide, 5006, SA, Australia.
authors.forename: A James
authors.initials: AJ
authors.lastname: Martin
authors.affiliation: School of Psychology, Social Work and Social Policy, University of South Australia, St Bernards Road, Adelaide, 5000, SA, Australia. Electronic address: kurt.lushington@unisa.edu.au.
authors.forename: Kurt
authors.initials: K
authors.lastname: Lushington
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002652:Child Behavior / Q000502:physiology / Q000523:psychology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000523:psychology*; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011581:Psychological Tests; D012893:Sleep Wake Disorders / Q000209:etiology* / Q000523:psychology
keywords: Behaviour problems; Children; Executive functioning; Mediational analysis; Sleep; Type 1 diabetes