Variations in Sleep Characteristics and Glucose Regulation in Young Adults With Type 1 Diabetes

Publication Date


UMMS Affiliation

Graduate School of Nursing

Document Type



Endocrine System Diseases | Endocrinology, Diabetes, and Metabolism | Nutritional and Metabolic Diseases | Sleep Medicine


CONTEXT: Short sleep duration and sleep disruptions are associated with impaired glucoregulation in type 1 diabetes (T1D). However, the mechanistic pathways between sleep and glucose variability remain unclear.

OBJECTIVE: To determine within- and between-person associations between objective sleep-wake characteristics and glucose variability indices.

METHODS: Multilevel models were used to analyze concurrent sleep and glucose patterns over 7 days in 42 young adults with T1D in their natural home environment. Young adults with T1D (mean age 22.2 +/- 3.0 years, HbA1c 7.2%, 32.6% male) for at least 6 months with no other medical or major psychiatric comorbidity were included. Sleep-wake characteristics were measured via wrist actigraphy and glucose variability indices via a continuous glucose monitor (CGM).

RESULTS: Lower sleep efficiency predicted higher glucose variability (less time in range beta = 0.011 and more time in hyperglycemia beta = -0.011) within-person. A longer wake after sleep onset and more sleep disruptions were associated with higher glucose variability between persons (beta = 0.28 and 0.31). Higher glucose variability predicted poorer sleep within-person (delayed bedtime, waketime, mid-sleep time, and lower sleep efficiency), while higher glucose variability was associated with poorer sleep and more sleep disruptions between persons (lower sleep efficiency, longer wake after sleep onset, and a higher sleep fragmentation index).

CONCLUSION: Clinicians can address the reciprocal nature of the sleep-glucose relationship by optimizing sleep and targeting efforts toward a euglycemic range overnight. Sleep habits are a modifiable personal target in diabetes care.


actigraphy, glucose variability, multilevel model, sleep, type 1 diabetes, young adult

DOI of Published Version



Griggs S, Grey M, Strohl KP, Crawford SL, Margevicius S, Kashyap SR, Li CR, Rajagopalan S, Hickman RL. Variations in Sleep Characteristics and Glucose Regulation in Young Adults With Type 1 Diabetes. J Clin Endocrinol Metab. 2022 Feb 17;107(3):e1085-e1095. doi: 10.1210/clinem/dgab771. PMID: 34698348; PMCID: PMC8852208. Link to article on publisher's site

Journal/Book/Conference Title

The Journal of clinical endocrinology and metabolism

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