Sleep characteristics in young adults with type 1 diabetes

Abstract

Only 14% of young adults with Type 1 Diabetes (T1D) achieve targets for glycemic control (HbA1C < 7.0%), with deterioration over time. Complex cognitive processes required to manage glycemia are vulnerable to sleep deficiency. Using Whittemore and Knafl's approach, we conducted an integrative review of research literature on sleep characteristics and glycemia in these young adults. Quality was assessed using the Mixed Methods Appraisal Tool (v. 2011). Multiple databases were searched for articles published in English in peer-reviewed journals from 2003 to 2018, using search terms 'sleep' and 'T1D' with age limiters 18-40. Of 218 studies initially retrieved, 17 original studies met the inclusion criteria. The following themes were identified in young adults with T1D: (1) They had poorer objective and subjective sleep quality, more variability, and impaired awakening response to hypoglycemia compared with controls; (2) They had poorer glycemic control that was associated with shorter sleep duration, poorer sleep quality, and less time in deep sleep; and (3) Hypoglycemia negatively impacted diabetes management, sleep quality, and next day functioning. Sleep deficiency, as indicated by short sleep duration is associated with a range of negative health outcomes for people with T1D; therefore, optimizing sleep should be a priority in practice and research.

The impact of strict COVID-19 lockdown in Spain on glycemic profiles in patients with type 1 Diabetes prone to hypoglycemia using standalone continuous glucose monitoring

“…The parameters most commonly analyzed in the assessment of lifestyle influence include physical activity and nutrition, including monitoring carbohydrate intake. However, other parameters that have to be taken into account include exposure to stressful life events at work and at home, sleep duration, and specific unhealthy behaviors [5] , [6] .…”

Management of glucose profile throughout strict COVID-19 lockdown by patients with type 1 diabetes prone to hypoglycaemia using sensor-augmented pump

“…The parameters most commonly analysed in the assessment of lifestyle influence include physical activity and nutrition, with a focus on monitoring carbohydrate intake [ 3 ]. However, other parameters that have to be considered include exposure to stressful life events at work and at home, sleep duration, specific unhealthy behaviours, among others [ 4 , 5 ].…”

Assessing Diabetes Distress and Sleep Quality in Young Adults with Type 1 Diabetes Using FreeStyle Libre: A Prospective Cohort Study

“…This is likely due to sleep disturbances unique to T1DM, which include recurrent nocturnal hypoglycemia as well as alterations in sleep architecture caused by rapid fluctuations in glucose levels [17], the need to treat low blood glucose levels overnight [18,19], and alarms from diabetes monitoring or treatment devices [19]. A recent integrative review of 17 original studies on sleep and T1DM reported that young adults with T1DM have large variations in sleep duration, poor quality of sleep, and sleep deficiency [20]. An improvement in sleep quality has been observed in young children (2-5 years) using continuous glucose monitoring; however, continuous glucose monitoring negatively impacted parents' sleep [21].…”