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Daily variations in sleep and glucose in adolescents with type 1 diabetes
Author(s) -
Griggs Stephanie,
Redeker Nancy S.,
Jeon Sangchoon,
Grey Margaret
Publication year - 2020
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.13117
Subject(s) - medicine , bedtime , sleep (system call) , sleep onset , hypoglycemia , type 1 diabetes , type 2 diabetes , diabetes mellitus , glycemic , sleep stages , polysomnography , endocrinology , insomnia , psychiatry , apnea , computer science , operating system
Objective We used multilevel models (MLMs) to determine person (between‐persons) and day level (within‐person) associations between glucose variability indices and sleep characteristics in adolescents with type 1 diabetes (T1D). Methods Adolescents with T1D (Mean age 13.4 ± 1.8 years; 37.8% male; mean HbA1c 8.2 ± 1.2%, 66 mmol/mol) monitored their sleep and glucose patterns concurrently for 3‐7 days with a wrist actigraph on their non‐dominant wrist and a continuous glucose monitor (CGM) (their own or a provided, blinded CGM). Glucose variability indices included J index, coefficient of variation, low and high blood glucose risk indices (LBGI and HBGI), time in range, and sleep characteristics, including bedtime, wake time, total sleep time, sleep efficiency, wake after sleep onset, awakenings, and sleep fragmentation index. Results More overall glucose variability was associated within person, more sleep disruptions (more awakenings and more fragmentation) or poorer sleep in our study (earlier wake time or longer wake after sleep onset). Also, more time spent in hypoglycemia <70 mg/dL and a higher LBGI was associated within person with earlier wake time indicating poorer sleep. However, a lower LBGI was associated with a later between‐persons wake time. Conclusions Monitoring over a longer period of time in subsequent studies would allow researchers to determine the within person association between habitual short sleep duration and glucose variability. Providers should regularly assess sleep habits in adolescents as a way to improve glycemic control. Targeting a euglycemic range overnight is also important to promote better sleep and to decrease sleep disruptions.