Objective: Sleep disturbances occur frequently in youth with type 1 diabetes (T1D) with only 20% of adolescents meeting recommendations for sleep duration during the week. Few studies have directly evaluated the relationship between objectively measured sleep behaviors and mean blood glucose (BG) as measured by continuous glucose monitors (CGM).

Methods: Twenty adolescents with T1D (Age: M= 14.69, SD= 1.58, Sex= 50% female; Race= 80% Caucasian) participated. Youth’s average HbA1c was 9.0% (SD= 1.70), and all participants used an insulin pump. Youth wore an accelerometer on their non-dominant wrist and a CGM for seven consecutive days. We estimated multilevel models using SAS PROC MIXED and reverse-lagged nighttime sleep variables to specifically examined the impact of BG values on each sleep variable the following night. We examined total sleep time (TST), sleep efficiency (i.e., percentage of time spent asleep while in bed), and onset latency (i.e., minutes between going to bed and falling asleep) independently, as proxies for sleep behavior. We entered a dichotomous weekday/weekend variable in the model as a level 2 moderator. Results: Participants averaged 9.1 hours (SD= 84.9 minutes, range= 2.82-11.15 hours) of TST. Sleep variables did not differ on weekdays versus weekends. Our multilevel models did not reveal a significant association between sleep variables predicting mean BG. We did observe an association between within-person mean BG values significantly predicting sleep efficiency (β= -0.06802). This suggests an adolescent’s sleep efficiency may increase when their BG is lower than typical for themselves.

Conclusions: The results of the study add support to previous laboratory studies that indicate lower BG levels associate with better sleep efficiency in youth with T1D. Clinicians may consider assessing sleep patterns in youth with T1D as an additional treatment target for optimal T1D self-management.


A. Monzon: None. R. McDonough: None. M.A. Clements: Consultant; Self; Glooko, Inc. Other Relationship; Self; Glooko, Inc. S.R. Patton: None.

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