Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio.
School of Medicine, Case Western Reserve University, Cleveland, Ohio.
J Clin Sleep Med. 2021 Sep 1;17(9):1865-1874. doi: 10.5664/jcsm.9402.
The purpose of this study was to describe objective sleep-wake characteristics and glycemia over 7-14 days in young adults with type 1 diabetes. In addition, person-level associations among objective sleep-wake characteristics (total sleep time, sleep variability, and sleep fragmentation index), daytime sleepiness, and glycemia (glycemic control and glucose variability) were examined.
In this cross-sectional study, objective sleep-wake characteristics were measured via actigraphy and glucose variability via continuous glucose monitoring over 6-14 days. At baseline, participants completed the Psychomotor Vigilance Test, the Trail Making Test, and questionnaires on daytime sleepiness, sleep quality, and sleep disturbance including sleep diaries.
Forty-six participants (mean age, 22.3 ± 3.2 years) wore a wrist actigraph and underwent continuous glucose monitoring concurrently for 6-14 days. Greater sleep variability was directly associated with greater glucose variability (mean of daily differences; = .33, = .036). Higher daytime sleepiness was directly associated with greater glucose variability (mean of daily differences; = .50, = .001). The association between sleep variability and glucose variability (mean of daily differences) was no longer significant when accounting for daytime sleepiness and controlling for type 1 diabetes duration ( > .05). A higher sleep fragmentation index was associated with greater glucose variability ( = 1.27, = .010, 2 = 0.40) after controlling for type 1 diabetes duration and accounting for higher daytime sleepiness.
Sleep-wake variability, sleep fragmentation, daytime sleepiness, and the associations with glycemia are new dimensions to consider in young adults with type 1 diabetes. Sleep habits in this population may explain higher glucose variability, and optimizing sleep may improve overall diabetes management.
Griggs S, Hickman RL Jr, Strohl KP, Redeker NS, Crawford SL, Grey M. Sleep-wake characteristics, daytime sleepiness, and glycemia in young adults with type 1 diabetes. 2021;17(9):1865-1874.
本研究旨在描述 1 型糖尿病年轻患者 7-14 天的客观睡眠-觉醒特征和血糖。此外，还研究了客观睡眠-觉醒特征（总睡眠时间、睡眠变异性和睡眠碎片化指数）、日间嗜睡与血糖（血糖控制和血糖变异性）之间的个体水平关联。
在这项横断面研究中，通过活动记录仪测量客观睡眠-觉醒特征，通过连续血糖监测测量血糖变异性。在基线时，参与者完成了精神运动警觉测试、连线测试和关于日间嗜睡、睡眠质量以及包括睡眠日记在内的睡眠障碍的问卷。
46 名参与者（平均年龄 22.3 ± 3.2 岁）佩戴腕部活动记录仪并同时进行 6-14 天的连续血糖监测。更大的睡眠变异性与更大的血糖变异性直接相关（每日差异的平均值； =.33， =.036）。更高的日间嗜睡与更大的血糖变异性直接相关（每日差异的平均值； =.50， =.001）。当考虑到日间嗜睡并控制 1 型糖尿病持续时间时，睡眠变异性与血糖变异性（每日差异的平均值）之间的关联不再显著（>.05）。在控制 1 型糖尿病持续时间并考虑到更高的日间嗜睡后，更高的睡眠碎片化指数与更大的血糖变异性相关（ = 1.27， =.010，2 = 0.40）。
睡眠-觉醒变异性、睡眠碎片化、日间嗜睡以及与血糖的关联是 1 型糖尿病年轻患者中需要考虑的新维度。该人群的睡眠习惯可能解释了更高的血糖变异性，优化睡眠可能改善整体糖尿病管理。
Griggs S, Hickman RL Jr, Strohl KP, Redeker NS, Crawford SL, Grey M. Sleep-wake characteristics, daytime sleepiness, and glycemia in young adults with type 1 diabetes. 2021;17(9):1865-1874.
