653-P: Do Specific Fears or General Anxiety Mediate the Relationship between Child Nighttime Glucose Levels and Parent Sleep Quality?

Introduction: Many caregivers of youth with type 1 diabetes (T1D) report reduced sleep at night and sleep disruptions due to overnight diabetes care and fear of nighttime hypoglycemia (FoNH). Data suggests that child nighttime glycemic variability is associated with increased FoNH, and increased nighttime caregiving due to out-of-range glucose levels may also impact parent sleep, but no studies have examined relations among these variables in a single model. The current study examines if parent FoNH or general anxiety mediates the relationship between child nighttime glycemic variability and parent sleep quality.

Methods: We recruited 165 parents/caregivers of youth with T1D. We administered the Pittsburg Sleep Quality Scale, State-Trait Anxiety Inventory, and the Hypoglycemia Fear Survey for Parents, along with new items that assessed additional nighttime fears more comprehensively. Youth provided 14 days of glucose data from their personal continuous glucose monitor. We conducted mediation analysis in R using the Lavaan package.

Results: Most caregivers (89%) self-identified as mothers with a M_age= 41.76+6.52 years. For youth, 49% were female, M_age= 13.41+2.59 years, M_{T1D duration}= 3.97+3.14 years, and M_HbA1C= 7.81 + 1.43. Mediation analyses revealed a direct effect of glycemic variability on parent sleep quality (b=0.04, p>0.05), and parent FoNH mediated this effect (b=2.9, p>0.05). Neither state (p=0.29) nor trait anxiety (p=0.28) mediated this effect.

Conclusions: It is important to consider how child glucose levels at night relate to parents' sleep quality to reduce the risk that parental fatigue may impact their functioning the following day. The results of this study suggest that parental FoNH is an important factor that relates to parent sleep quality. Clinicians may consider providing strategies that may help parents manage their specific worries related to hypoglycemia to potentially help parents improve sleep.