Insufficient Sleep in Young Patients With Diabetes and Their Families

Abstract

Objective We examined sleep in families of individuals with type 1 diabetes and the relationship of sleep with obesity, diabetes, and insulin resistance. Methods Probands with type 1 diabetes diagnosed before age 18 and 1st and 2nd degree relatives were included (n = 323). Demographic, anthropometric and clinical variables and self-reported sleep duration and napping were assessed. Results On average, adults (≥ 20 years) slept 7.5 (SD 1.5) hr, whereas children (5–11 years) and adolescents (12–19 years) slept 9.8 (SD 1.1) and 8.5 (SD 1.9) hr, respectively (p < .01). Based on national recommendations, 40.9% of participants slept insufficiently, particularly young people (vs. adults, p < .01). In age-group stratified analysis, there were no significant associations of insufficient sleep or sleep duration with obesity, diabetes status, or insulin resistance after adjustment for age, race/ethnicity, and gender. 42% of participants reported napping regularly (≥ 1/week), with adolescents significantly more likely to do so (vs. adults, OR = 1.95, p < .01). Non-Hispanic Blacks and Hispanics also had higher odds of regular napping (vs. Non-Hispanic Whites, OR = 3.74, p < .01, and OR = 2.52, p = .03, respectively). In adjusted analysis, leaner (vs. obese) adolescents, whether measured by body mass index, percent body fat, or waist circumference, were significantly more likely to nap regularly. Conclusions We found that insufficient sleep was significantly more likely in children and adolescents compared with adults in families with type 1 diabetes. Lower adiposity was associated with regular napping in adolescents. The high prevalence of insufficient sleep in young patients with type 1 diabetes and their relatives detected in the current study may have significant health consequences.

Overweight and Obesity in Youth With Type 1 Diabetes

“…After employing inclusion and exclusion criteria to the full manuscripts, 13 studies were excluded because of lack of findings related to overweight or obesity and/or physical activity or lifestyle, and one was excluded because the study focused on eating disorders. In total, seven manuscripts met inclusion criteria for our review, including the one publication from a nursing journal (Estrada, Danielson, Drum, & Lipton, 2012). No additional manuscripts were identified from reviewing the reference lists of the articles included in this review.…”

“…The age range varied from 4 to 18 years, but for those studies that reported the mean age, most focused on the preadolescent to adolescent years of 11–16 years. In only one study was a diverse sample in terms of race/ethnicity reported (Estrada et al, 2012). Diabetes duration ranged from an average of 3.7 to 7.4 years, and mean HbA1c levels ranged from to 7.5% to 13.1%, whereas the American Diabetes Association recommends levels <8.0% in this age group (Silverstein et al, 2005).…”

“…More than one-third of the participants in this study were found to be overweight or obese, the highest prevalence found across the studies in this review. Using a self-report questionnaire, the authors established that regular napping was significantly and inversely associated with characteristics of overweight, including high BMI, high percentage of body fat, and high waist circumference (Estrada et al, 2012). …”

Cardiovascular Disease Risk Factors in Youth With Diabetes Mellitus

“…385,386 In the general adult population and in healthy children and adolescents, sleep alterations may adversely influence glucose regulation, 385 C-reactive protein, 387 and lipids 388 and increase the risk for hypertension, T2DM, heart attack, and stroke. 389,390 Reports of reduced sleep times of up to 64% 391 have been documented for children and adolescents with diabetes mellitus who confront additional challenges with sleep as a result of diabetes mellitus management 392,393 that may further disrupt sleep and add to adverse cardiovascular outcomes.…”

Validation of the Behavioral Risk Factor Surveillance System Sleep Questions

“…Insufficient sleep is associated with cancer, weight gain, anxiety, depression, suicide, cardiovascular disease, 25 and immune dysfunction, and thus is an important health issue in the population at large. [26][27][28][29][30][31][32] As individual's sleep need is unique, screening for insufficient sleep requires direct questioning about sleep need in comparison to total sleep achieved and/or inquiring about the presence of the consequences of inadequate sleep as opposed to just asking how much sleep the person obtains. BRFSS#1 attempts to screening for non-restorative sleep or perhaps just not feeling rested, but is not specific for detecting either sleep disorders or lack of sleep opportunity.…”