Yale University, School of Nursing, United States.
Yale University, School of Nursing, United States.
Diabetes Res Clin Pract. 2019 Apr;150:17-26. doi: 10.1016/j.diabres.2019.02.012. Epub 2019 Feb 18.
Only 14% of young adults with Type 1 Diabetes (T1D) achieve targets for glycemic control (HbA1C < 7.0%), with deterioration over time. Complex cognitive processes required to manage glycemia are vulnerable to sleep deficiency. Using Whittemore and Knafl's approach, we conducted an integrative review of research literature on sleep characteristics and glycemia in these young adults. Quality was assessed using the Mixed Methods Appraisal Tool (v. 2011). Multiple databases were searched for articles published in English in peer-reviewed journals from 2003 to 2018, using search terms 'sleep' and 'T1D' with age limiters 18-40. Of 218 studies initially retrieved, 17 original studies met the inclusion criteria. The following themes were identified in young adults with T1D: (1) They had poorer objective and subjective sleep quality, more variability, and impaired awakening response to hypoglycemia compared with controls; (2) They had poorer glycemic control that was associated with shorter sleep duration, poorer sleep quality, and less time in deep sleep; and (3) Hypoglycemia negatively impacted diabetes management, sleep quality, and next day functioning. Sleep deficiency, as indicated by short sleep duration is associated with a range of negative health outcomes for people with T1D; therefore, optimizing sleep should be a priority in practice and research.
仅有 14%的 1 型糖尿病（T1D）青年患者达到血糖控制目标（HbA1C<7.0%），且随着时间推移病情不断恶化。管理血糖所需的复杂认知过程容易受到睡眠不足的影响。我们采用 Whittemore 和 Knafl 的方法，对该年龄段青年患者的睡眠特征与血糖关系的研究文献进行综合回顾。采用混合方法评估工具（2011 年版）评估质量。在 2003 年至 2018 年期间，我们在同行评审期刊上以“睡眠”和“T1D”为检索词，并以 18-40 岁为年龄限制，在多个数据库中搜索英文发表的文章，共检索到 218 篇文章，其中 17 项原始研究符合纳入标准。T1D 青年患者中存在以下主题：（1）与对照组相比，他们的客观和主观睡眠质量更差，睡眠波动性更大，对低血糖的觉醒反应受损；（2）他们的血糖控制更差，与睡眠时间更短、睡眠质量更差以及深度睡眠时间更短有关；（3）低血糖会对糖尿病管理、睡眠质量和次日功能产生负面影响。睡眠时间过短表明存在睡眠不足，这与 T1D 患者的一系列不良健康后果有关；因此，优化睡眠应成为实践和研究的重点。
