Sleep-wake characteristics, daytime sleepiness, and glycemia in young adults with type 1 diabetes.

STUDY OBJECTIVES

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

CITATION

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.