Impact of Type 1 Diabetes Mellitus, glucose levels and glycaemic control on sleep in children and adolescents - a case-control study
Abstract
STUDY OBJECTIVES
To assess differences in habitual sleep patterns and sleep states between children and adolescents with Type 1 Diabetes Mellitus (T1DM) and control subjects, and to explore the relationships between sleep, glucose levels and glycaemic control.
METHODS
Participants included 82 children (5-18 years); 41 with T1DM (cases), and 41 healthy control subjects group matched for age and sex. Sleep was measured by 7-day actigraphy and single night home-based polysomnography (PSG) recordings. Haemoglobin A1c (HbA1c) and 7-days of continuous glucose monitoring (CGM) data were collected in cases. Regression analyses were used to model all within and between group comparisons adjusted for age, sex and BMI z-scores.
RESULTS
There were no significant differences in sleep duration, efficiency or awakenings as measured by actigraphy and PSG between cases and controls, nor sleep states measured by PSG. However, cases had significantly later sleep onset and offset than controls (both p <0.05), partially moderated by age. Cases with suboptimal glycaemic control (HbA1c ≥58 mmol/mol [≥7.5%]) had significantly shorter actigraphy-derived total sleep time (TST) (mean difference = -40 minutes; 95% CI = -77,-3), with similar differences in TST measured by PSG. Cases with mean CGM glucose levels ≥10 mmol/L (≥180mg/dL) on PSG night had significantly more stage N3 (%) sleep and less stage REM (%) sleep (both p <0.05).
CONCLUSIONS
Short- and long-term suboptimal glycaemic control in T1DM…
How strong is the evidence?
Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 82 participants or records.
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