Sleep-wake characteristics, daytime sleepiness, and glycemia in young adults with type 1 diabetes
Graduate School of Nursing
Endocrine System Diseases | Endocrinology, Diabetes, and Metabolism | Nutritional and Metabolic Diseases | Sleep Medicine
STUDY OBJECTIVES: The purpose of this study was to describe objective sleep-wake characteristics and glycemia over 7-14 days in young adults with type 1 diabetes. In addition, person-level associations among objective sleep-wake characteristics (total sleep time, sleep variability, and sleep fragmentation index), daytime sleepiness, and glycemia (glycemic control and glucose variability) were examined.
METHODS: In this cross-sectional study, objective sleep-wake characteristics were measured via actigraphy and glucose variability via continuous glucose monitoring over 6-14 days. At baseline, participants completed the Psychomotor Vigilance Test, the Trail Making Test, and questionnaires on daytime sleepiness, sleep quality, and sleep disturbance including sleep diaries.
RESULTS: Forty-six participants (mean age, 22.3 +/- 3.2 years) wore a wrist actigraph and underwent continuous glucose monitoring concurrently for 6-14 days. Greater sleep variability was directly associated with greater glucose variability (mean of daily differences; r = .33, P = .036). Higher daytime sleepiness was directly associated with greater glucose variability (mean of daily differences; r = .50, P = .001). The association between sleep variability and glucose variability (mean of daily differences) was no longer significant when accounting for daytime sleepiness and controlling for type 1 diabetes duration (P > .05). A higher sleep fragmentation index was associated with greater glucose variability (B = 1.27, P = .010, pr2 = 0.40) after controlling for type 1 diabetes duration and accounting for higher daytime sleepiness.
CONCLUSIONS: Sleep-wake variability, sleep fragmentation, daytime sleepiness, and the associations with glycemia are new dimensions to consider in young adults with type 1 diabetes. Sleep habits in this population may explain higher glucose variability, and optimizing sleep may improve overall diabetes management.
glucose variability, glycemic control, neurocognitive function, psychomotor vigilance, self-management, sleep, type 1 diabetes
DOI of Published Version
Griggs S, Hickman RL, Strohl KP, Redeker NS, Crawford SL, Grey M. Sleep-wake characteristics, daytime sleepiness, and glycemia in young adults with type 1 diabetes. J Clin Sleep Med. 2021 Sep 1;17(9):1865-1874. doi: 10.5664/jcsm.9402. PMID: 33949941; PMCID: PMC8636341. Link to article on publisher's site
Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
Griggs S, Hickman RL, Strohl KP, Redeker NS, Crawford SL, Grey M. (2021). Sleep-wake characteristics, daytime sleepiness, and glycemia in young adults with type 1 diabetes. Tan Chingfen Graduate School of Nursing Publications. https://doi.org/10.5664/jcsm.9402. Retrieved from https://escholarship.umassmed.edu/gsn_pp/171