Poor Sleep Quality is Associated with Nocturnal Glycemic Variability and Fear of Hypoglycemia in Adults with Type 1 Diabetes.

Aims: To examine sleep quality and its associations with glycaemic control, glycaemic variability (GV), and fear of hypoglycaemia (FOH) in adults with type 1 diabetes. Background: Poor sleep quality has negative health consequences and is a frequent complaint among adults with type 1 diabetes. Sleep quality in adults with type 1 diabetes is likely affected by glucose levels as well as stressors associated with managing a chronic condition. Design: A retrospective secondary analysis of pooled data from two previous cross-sectional studies was conducted. Methods: We examined subjective sleep quality, FOH; objective measures of glycaemic control (HbA1c); and GV (3-day continuous glucose monitoring) in 48 men and women aged 18-45 years with type 1 diabetes. The data were collected over 3 years in 2013-2016. Results/Findings: Poor sleep quality was reported by 46% of patients. Those with poor sleep quality had significantly greater nocturnal GV and FOH. Nocturnal GV and FOH were significantly associated with poor sleep quality. The interaction effect of GV and FOH was significant. Conclusion: These findings suggest that glycaemic control and FOH are targets for intervention to improve sleep quality in those with type 1 diabetes.