Impact Of High-Risk Glycemic Control On Habitual Sleep Patterns And Sleep Quality Among Youth (13-20 Years) With Type 1 Diabetes Mellitus Compared To Controls Without Diabetes

Background In type 1 diabetes mellitus (T1D), glycemic control and sleep have a bidirectional relationship, with unhealthy glycemic control impacting sleep, and inadequate sleep impacting diabetes management. Youth are at risk for poor quality sleep; however, little is known about sleep among youth with high-risk glycemic control.Objective To assess differences in habitual sleep timing, duration, and quality among youth with T1D and controls.Subjects Two-hundred-thirty youth (13-20 years): 64 with T1D (mean age 16.6 +/- 2.1 years, 48% female, diabetes duration 7.5 +/- 3.8 years, HbA1c 96 +/- 18.0 mmol/mol [10.9 +/- 1.7%]), and 166 controls (mean age 15.3 +/- 1.5, 58% female).Methods Comparison of data from two concurrent studies (from the same community) using subjective and objective methods to assess sleep in youth: Pittsburgh Sleep Quality Index evaluating sleep timing and quality; 7-day actigraphy measuring habitual sleep patterns. Regression analyses were used to compare groups.Results When adjusted for various confounding factors, youth with T1D reported later bedtimes (+36 min; p < 0.05) and shorter sleep duration (-53 min; p < 0.05) than controls, and were more likely to rate subjective sleep duration (OR 3.57; 95% CI 1.41-9.01), efficiency (OR 4.03; 95% CI 1.43-11.40), and quality (OR 2.59; 95% CI 1.16-5.76) as "poor" (p < 0.05). However, objectively measured sleep patterns were similar between the two groups.Conclusions Youth with high-risk T1D experience sleep difficulties, with later bedtimes contributing to sleep deficit. Despite a lack of objective differences, they perceive their sleep quality to be worse than peers without diabetes.