The Effects of a Sleep Extension Intervention on Glucose Control in Youth with Type 1 Diabetes

Although the 2017 Standard of Diabetes Care introduced recommendations to assess sleep patterns in individuals with type 2 diabetes, they do not contain such recommendations for individuals with type 1 diabetes (T1DM). We conducted a randomized clinical trial (RCT) to examine whether increasing sleep duration over a one-week period in youth’s natural environment improved glucose control and neurobehavioral performance. The primary outcomes of glycemic control (percent time in target range and average glucose levels) were assessed via a continuous glucose monitor (CGM) before and after being randomized to a sleep extension condition or a fixed sleep duration condition. Participants between the ages of 10 and 16 were 111 youth with almost half female; 35% were Latino/a, 51% Caucasian, and 14% mixed raced. The majority (80%) increased their sleep by more than 15 minutes; one-third achieved an increase of one hour of additional of sleep. Using actigraphy (wrist-like device that measures movement to estimate sleep) and a sleep diary, the average increase in sleep duration is 43.0 minutes vs. .30 minutes. Comparatively, research has noted that medications are considered to have a benefit to improve sleep if the individual increases sleep by 15 or more minutes. Controlling for baseline, extension participants differed from the fixed sleep duration group by 17mg/dl points, F(1, 102) = 9.55, p = .003, η2 = .39. During the Sleep Modification week, those in the Sleep Extension condition showed a 7.4% improvement in glucose levels, accounting for 11 hours more in the target range than those in the Fixed Sleep condition. These data will contribute to the long-term goal of establishing research evidence that sleep contributes to diabetes clinical care.