Abu Irsheed Ghada, Steffen Alana, Martyn-Nemeth Pamela, Park Minsun, Quinn Laurie, Duffecy Jennifer, Baron Kelly Glazer, Saleh Adam Hussain, Takgbajouah Mary, Bimbi Olivia, Kessler Justine, Mihailescu Dan, Reutrakul Sirimon
College of Nursing, Department of Biobehavioral Nursing Science, University of Illinois Chicago, Chicago, Illinois.
College of Nursing, Department of Population Health Nursing Science, University of Illinois Chicago, Chicago, Illinois.
J Clin Endocrinol Metab. 2025 Jan 16. doi: 10.1210/clinem/dgaf032.
Sleep health is multidimensional. While studies have shown associations between certain sleep dimensions and health in type 1 diabetes (T1D), global sleep health has rarely been considered.
To examine the associations between individual sleep dimensions and multidimensional sleep health (MSH) on glycemic control and self-reported outcomes in T1D.
Data from 116 adults with T1D participating in a sleep study (NCT04506151) were analyzed. Sleep satisfaction and alertness were assessed by questionnaires. Sleep timing, efficiency, duration, and regularity were derived from 7-day actigraphy. A composite MSH score was created by counting "healthy sleep" across these six measures. Glycemic control was assessed by 7-day continuous glucose monitoring and A1C. Self-reported outcomes were collected through questionnaires.
After adjusting for covariates, greater sleep irregularity was associated with higher glycemic variability (b=5.048, p<0.01), less time in range (TIR) (b=-10.806, p<0.01), higher time above range (TAR) (b=7.40, p<0.05), and higher A1C (b=0.365, p<0.05)]. Poor sleep satisfaction was associated with higher diabetes distress and depression (b=0.29, p<0.05, b=3.59, p<0.05), respectively. Later sleep timing was associated with higher depression (b=1.545, p<0.05), while lower sleep efficiency was associated with higher depression (b=1.545, p<0.01). Worse MSH was significantly associated with lower TIR (b=2.376, p<0.05), higher TAR, A1C, and depression (b=-2.38, p<0.05; b=-0.177, p<0.01; b=-1.275, p<0.05, respectively).
Sleep irregularity likely drives the association between MSH and glycemic control, while poor sleep satisfaction, lower efficiency, and later timing contribute to the association between MSH and depression. These results highlight the importance of comprehensive sleep health evaluation in T1D.
睡眠健康具有多维度性。虽然研究表明1型糖尿病（T1D）的某些睡眠维度与健康之间存在关联，但很少有人考虑整体睡眠健康。
研究T1D患者个体睡眠维度与多维度睡眠健康（MSH）对血糖控制和自我报告结果的关联。
分析了116名参与睡眠研究（NCT04506151）的成年T1D患者的数据。通过问卷调查评估睡眠满意度和警觉性。睡眠时间、效率、时长和规律性由7天的活动记录仪得出。通过计算这六项指标中的“健康睡眠”来创建综合MSH评分。通过7天连续血糖监测和糖化血红蛋白评估血糖控制情况。通过问卷调查收集自我报告结果。
在调整协变量后，更高的睡眠不规律性与更高的血糖变异性（b = 5.048，p < 0.01）、更低的血糖达标时间（TIR）（b = -10.806，p < 0.01）、更高的血糖高于目标范围时间（TAR）（b = 7.40，p < 0.05）以及更高的糖化血红蛋白（b = 0.365，p < 0.05）相关。睡眠满意度差分别与更高的糖尿病困扰和抑郁相关（b = 0.29，p < 0.05；b = 3.59，p < 0.05）。更晚的睡眠时间与更高的抑郁相关（b = 1.545，p < 0.05），而更低的睡眠效率与更高的抑郁相关（b = 1.545，p < 0.01）。更差的MSH与更低的TIR（b = 2.376，p < 0.05）、更高的TAR、糖化血红蛋白和抑郁显著相关（分别为b = -2.38，p < 0.05；b = -0.177，p < 0.01；b = -1.275，p < 0.05）。
睡眠不规律性可能导致MSH与血糖控制之间的关联，而睡眠满意度差、效率低和时间晚则导致MSH与抑郁之间的关联。这些结果凸显了T1D患者综合睡眠健康评估的重要性。
