Adler Avital, Gavan Michal-Yackobovitz, Tauman Riva, Phillip Moshe, Shalitin Shlomit
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
The Jesse Z and Lea Shafer Institute of Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
Pediatr Diabetes. 2017 Sep;18(6):450-458. doi: 10.1111/pedi.12419. Epub 2016 Aug 3.
Sleep has been shown to impact glucose regulation, and may be altered in persons with type 1 diabetes (T1D).
To assess sleep characteristics in T1D patients and the possible association between sleep disturbances and diabetes-related variables.
In a cross-sectional study in 154 young patients with T1D and 154 age-range-matched nondiabetic controls subjective sleep characteristics were assessed using validated questionnaires: Sleep Disturbance Scale for Children (SDSC), Adolescent Sleep-Wake Scale (ASWS), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS). Clinical and disease-related variables were obtained from medical charts.
Sleep disorders were frequent in all age groups, with no significant difference in prevalence or total scores of the SDSC, ASWS, PSQI, or ESS between the patients and the controls. In T1D children, SDSC score was significantly higher in those using continuous glucose monitoring (CGM) vs glucose meters (P = .042). The score of disorders related to "initiating and maintaining sleep" was significantly higher in those treated with pumps vs patients treated with injections (P = .014), in those using CGM vs glucose meters (P = .02), and in those with nocturnal hypoglycemia vs those without (P = .023). The percentage of children with excessive daytime sleepiness was significantly lower in patients vs controls (P = .035). No significant differences were found in the other two age groups.
CONCLUSIONS/INTERPRETATION: The prevalence of sleep disorders among most of the young T1D patients was no higher than in the nondiabetic population. Studies using objective sleep measures are warranted to further assess sleep quality in T1D patients.
睡眠已被证明会影响血糖调节，1型糖尿病（T1D）患者的睡眠可能会发生改变。
评估T1D患者的睡眠特征以及睡眠障碍与糖尿病相关变量之间的可能关联。
在一项横断面研究中，对154例年轻T1D患者和154例年龄匹配的非糖尿病对照者，使用经过验证的问卷评估主观睡眠特征：儿童睡眠障碍量表（SDSC）、青少年睡眠-觉醒量表（ASWS）、匹兹堡睡眠质量指数（PSQI）、爱泼华嗜睡量表（ESS）。从病历中获取临床和疾病相关变量。
所有年龄组中睡眠障碍都很常见，患者和对照者在SDSC、ASWS、PSQI或ESS的患病率或总分上无显著差异。在T1D儿童中，使用持续葡萄糖监测（CGM）的患儿SDSC评分显著高于使用血糖仪的患儿（P = 0.042）。与“入睡和维持睡眠”相关的障碍评分在使用胰岛素泵治疗的患儿中显著高于注射治疗的患儿（P = 0.014），在使用CGM的患儿中高于使用血糖仪的患儿（P = 0.02），在有夜间低血糖的患儿中高于无夜间低血糖的患儿（P = 0.023）。与对照者相比，患者中白天过度嗜睡儿童的百分比显著更低（P = 0.035）。在其他两个年龄组中未发现显著差异。
结论/解读：大多数年轻T1D患者的睡眠障碍患病率并不高于非糖尿病人群。有必要开展使用客观睡眠指标的研究，以进一步评估T1D患者的睡眠质量。
