1847-LB: Fear of Hypoglycemia and Sleep among Parents of Young Children with Type 1 Diabetes

Background: Parents’ fear of hypoglycemia (FH) is common and associated with increased parental anxiety and stress. We examined the associations among FH and parental sleep in a sample of parents of young children with type 1 diabetes (T1D). We additionally explored whether FH and parental sleep differed by insulin modality or associated with child age and T1D duration.

Methods: One hundred and eighty-four parents completed the Hypoglycemia Fear Survey-Parent (HFS-PYC), the PROMIS Sleep Disturbance Short Form, and reported on their child’s T1D, insulin pump usage, and frequency of hypoglycemia.

Results: Parents were 92% mothers (M age=36.43±6.11) and children were 45% female (M child age=4.40±1.23; M HbA1c=7.54%±1.15). Children included 49% on a hybrid closed loop pump (HCL), 29% on an open loop pump (OLP), and 23% on multiple daily injections (MDI). Parent-reported FH (M=76.66±16.58) was associated with greater parental sleep disturbance and greater frequency of hypoglycemic events (>2/week). Parents of youth on HCL reported greater difficulty staying asleep compared to parents of youth on MDI (p<.05), but not compared to parents of youth on OLP (p>.05). FH did not differ based on insulin modality. FH and sleep disruption were not associated with T1D duration or child age.

Conclusions: FH may contribute to disrupted sleep among parents of young children with T1D regardless of insulin modality, tT1D duration, or child age. Parents who reported greater FH were more likely to report greater frequency of hypoglycemic events; however, it is unclear whether parent-reported hypoglycemic events occurred during the night, contributing to disrupted sleep. Further, HCL usage was associated with sleep disruption, but not FH. Future research that incorporates continuous glucose monitoring and assesses parental FH specifically at night will help identify factors that may contribute to disrupted parental sleep and thereby help inform future sleep-promoting interventions for these parents.