Impact of Chronic Sleep Disturbance for People Living With T1 Diabetes

Abstract

Chronic sleep interruption is highly prevalent in adults with T1D and parents/carers of children with T1D with negative effects on daily functioning and well-being. Appropriate interventions are required to alleviate this burden of T1D, address modifiable risk factors for nocturnal hypoglycemia, and reduce the (perceived) need for nocturnal waking.

Sleep disturbance in people with diabetes: A concept analysis

“…() defined sleep disturbance as “self‐reported difficulty falling asleep or waking up in the night three or more times per week plus average sleep efficiency of <80% based on actigraphy” (p. 1172). Frequent nocturnal awakening was also identified in several studies (Barnard et al., ; Caruso et al., ; Chasens et al., ; Fritschi & Redeker, ; Han et al., ; Izci‐Balserak & Pien, ; Knutson et al., ; Reutrakul & Van Cauter, ). Different terms were used to express the same meaning of nocturnal awakening, such as arousal, sleep fragmentation or fragmented sleep.…”

“…Particularly, glycaemic excursions or poor glycaemic control in people with diabetes could lead to sleep disturbance. In this review, several studies supported that glucose control could potentially contribute to sleep disturbance (Barnard et al., ; Caruso et al., ; Cho et al., ; van Dijk et al., ; Happe et al., ; Sridhar & Madhu, ). This perspective can be traced back to 1994 when Sridhar and Madhu (Sridhar & Madhu, ) indicated “sleep disturbances may be due to … fluctuations in metabolic control and perhaps also hyperinsulinemia” (p. 183).…”

“…Although sleep disorder is a distinctly different term from sleep disturbance, it has been used to mean sleep disturbance in several studies (Bener & Al‐Hamaq, ; van Dijk et al., ; Keskin et al., ; Martins et al., ; Sridhar & Madhu, ; Voinescu et al., ). Other interchangeably used terms are sleep problem (Caruso et al., ; Cho et al., ; Olsson et al., ), sleep disruption (Barnard et al., ; Eshkoor, Hamid, Nudin, & Mun, ; Voinescu et al., ), disrupted sleep (Olsson et al., ; Sridhar & Putcha, ), abnormal sleep (Sridhar & Putcha, ), sleep complaint (Cho et al., ), sleep impairment (Martins et al., ) and impaired sleep (Chasens et al., ). Surprisingly, even in the same paper, different terms were used.…”

Sweet dreams or bitter nightmare: a narrative review of 25 years of research on the role of sleep in diabetes and the contributions of behavioural science

“…Suboptimal subjective sleep quality was associated with lower health status and diabetes‐related quality of life in adults with type 2 diabetes . Similarly, almost 80% of adults with type 1 diabetes believed waking in the night had a negative impact on their usual daily functioning, including mood and happiness, family relationships, work and the ability to exercise regularly and eat healthily . Suboptimal subjective sleep quality has been related to higher levels of daytime sleepiness, fatigue, symptoms of depression and anxiety, and diabetes‐specific distress in adults with type 1 or type 2 diabetes and higher worries about hypoglycaemia in adults with type 1 diabetes .…”

CGM, Pregnancy, and Remote Monitoring

“…61,65 Software and online programs have been used in remote or retrospective monitoring of glucose data in nonpregnant populations. [55][56][57][58][59][66][67][68] One CGM system was evaluated with concurrent remote monitoring at children's diabetes camps. On control nights of CGM use, subjects (n = 57) could hear hypoglycemia alarms, but on intervention nights, only medical personnel received alarms through remote monitoring.…”