Evaluation of sleep characteristics of children and adolescents with type 1 diabetes mellitus

Abstract

Objective: To evaluate sleep characteristics of children and adolescents with type 1 diabetes mellitus (T1DM) and their relationship with glycemic control. Methods: A cross-sectional study was conducted at a public hospital in São Paulo, Brazil. It included 86 patients with T1DM, aged between 10 and 18 years old, who were on insulin therapy, had performed at least three measurements of capillary blood glucose throughout the day, and had normal thyroid function. The clinical, anthropometric, and laboratory data of each patient were evaluated. The Pediatric Daytime Sleepiness Scale (PDSS) and the Munich Chronotype Questionnaire (MCTQ) were used to assess the sleep characteristics. Results: The mean level of glycated hemoglobin (HbA1c) was 9.2±2.1%, and it was higher in adolescents than in children. The mean score of PDSS was 13.9±4.7. Patients with HbA1c<7.5% had lower PDSS scores and longer sleep duration on weekdays than patients with HbA1c≥7.5%. HbA1c levels were negatively correlated with chronotype values and sleep duration on weekdays and positively correlated with social jet lag. Patients who had had T1DM for less than three years had a higher prevalence of daytime sleepiness. The regression analysis showed that higher HbA1c (≥7.5%) and shorter time since the diagnosis of T1DM increased the chance of daytime sleepiness, regardless of age and sex. Conclusions: Patients with higher HbA1c had more daytime sleepiness, a morning chronotype, shorter sleep duration on weekdays and a more significant social jet lag. The shorter diagnosis time for T1DM and greater levels of HbA1c increased the chance of daytime sleepiness.

Social jet lag and (changes in) glycemic and metabolic control in people with type 2 diabetes

“…Previous research has supported these findings, as our recent meta-analysis showed that social jet lag was significantly associated with higher BMI, waist circumference, HbA1c levels, and systolic blood pressure in general but also in people with diabetes [7]. This is also in agreement with findings in people with type 1 diabetes [8][9][10][11]. In this study, however, we only found cross-sectional associations among social jet lag and markers of glycemic and metabolic control, and not prospectively.…”

“…Our recent meta-analysis of the associations among social jet lag and parameters of the metabolic syndrome and T2D has shown that social jet lag is associated with increased levels of glycated hemoglobin (HbA1c), higher body mass index (BMI), higher waist circumference, and higher odds of obesity [7]. Social jet lag has also been associated with worse glycemic control, higher HbA1c levels, and higher insulin requirements in people with type 1 diabetes [8][9][10][11]. Few studies have assessed the effects of social jet lag in people with T2D.…”

Children and adolescents hospitalized with chronic conditions: sleep patterns, resilience and quality of life

“…In the present study, no violations of the null hypothesis were found for the sleep assessment variables according to age and gender. Similar results were found in a study of children and adolescents aged between 10 and 18 with type I diabetes mellitus, for whom age and gender were not predictors of a greater chance of daytime sleepiness (21) . There are also compatible results with children and adolescents with cancer, and age was also not a predictor of shorter sleep duration (6) .…”

“…In children and adolescents with type I diabetes mellitus, there was a higher prevalence of daytime sleepiness among patients with a diagnosis of less than 3 years when compared to those with a diagnosis of 3 years or more (57.1% versus 36.2%; p = 0.03). However, insulin treatment had no influence on daytime sleepiness (p = 0.80) (21) .…”

“…No estudo, não foram encontradas violações de hipótese nula para as variáveis de avaliação do sono, segundo idade e sexo. Resultados semelhantes foram encontrados em estudo com crianças e adolescentes entre 10 e 18 anos com diabetes mellitus tipo I, para as quais a idade e o sexo não foram preditores para uma maior chance de sonolência diurna (21) . Também existem resultados compatíveis com crianças e adolescentes com câncer, e a idade também não foi um preditor para menor duração do sono (6) .…”