0921 Pilot Cognitive Behavioral Sleep Health Randomized Controlled Trial for Young Adults with Type 1 Diabetes

Abstract Introduction Short sleep duration and inconsistent timing have been linked to poor glycemic target achievement and greater comorbidities in individuals with type 1 diabetes (T1D), particularly adults aged 18-26 years who achieve glycemic targets at the lowest rates (only 14%). Preliminary evidence supports cognitive behavioral sleep interventions (sleep extension + timing consistency) in improving the achievement of sleep and glycemic targets. The purpose of this pilot randomized controlled trial (RCT) was to determine the preliminary effects of a cognitive behavioral sleep health self-management intervention (CB-Sleep Health - sleep extension + timing consistency) on self-report and objectively derived sleep health dimensions (satisfaction, alertness, timing, efficiency, and duration) in young adults with T1D. Methods Young adults with T1D for at least 6 months with a hemoglobin A1C ≥ 7% or ≤ 80% time in glucose range were randomly assigned 1:1 stratified by sex at birth to a 12-week CB-Sleep Health (n = 21) or time balanced attention control (AC) condition (n = 18). Participants completed the Pittsburgh Sleep Quality Index (sleep satisfaction) and trail making test (daytime alertness) while concurrently wearing continuous glucose monitors and research grade actigraphy (timing, efficiency, and duration) for 14 days at baseline, post-intervention, and a 3-month follow up. Results Thirty-nine young adults (mean age 21, BMI 25.9 kg/m2, A1C 8.5% and 44% time in glucose range, 59% male, 26% Non-White - 18% Black/8% other race) participated. Baseline sleep health dimension values (mean + sd) were 5.4 + 0.7 vs. 5.3 + 0.5 score (satisfaction), 18.4 + 1.4 vs. 20.3 + 1.3 seconds (daytime alertness), 16:07 + 0.4 vs. 15:95 + 0.4 hours (timing), 85.6 + 4.1% vs. 84.7 + 4.5% (efficiency), and 6.4 + 1.0, vs. 6.9 + 1.0 hours (duration) for CB-Sleep Health vs. AC respectively. Sleep duration and alertness improved for CB-Sleep Health compared to AC post intervention (+18 minute vs. -25.8 minutes, p = .01 and -3.92 seconds vs. +0.71, p = .005) and were sustained at the 3-month follow up. Conclusion Preliminary effects of a CB-Sleep Health intervention on sleep duration and alertness without impairing efficiency for young adults with T1D are encouraging. Support (if any) National Institute of Nursing Research (R00NR018886)