Sleep and Type 1 Diabetes Mellitus Management Among Children, Adolescents, and Emerging Young Adults: A Systematic Review

Abstract

Background

Type 1 diabetes mellitus (T1DM) is one of the most common chronic illnesses among the youth. Emerging evidence has suggested poor sleep as a risk factor for glycemic control. This review aimed to examine the associations between sleep characteristics and diabetes management in children, adolescents, and emerging young adults with T1DM.

Methods

Following PRISMA guidelines, the authors searched articles in PubMed, Web of Science, and Scopus from 2000 through August 2020. Using inclusion and exclusion criteria, observational studies and clinical trials that examined sleep and diabetes management among individuals with T1DM (up to 25 years old) were selected for review.

Results

Twenty-four articles met the review criteria. Most studies did not report differences in self-report sleep between individuals with and without T1DM. However, several studies using objective sleep measures (actigraph and PSG) suggested shorter sleep duration and worse sleep quality in individuals with T1DM. Higher A1C levels and undesirable T1DM self-care behaviors were associated with short and long sleep duration, poor sleep quality, sleep disturbances, and irregular sleep, particularly among adolescent boys, young men and those from immigrant families. Self-care behaviors mediated the associations between sleep and subsequent A1C levels.

Conclusions

Too much or too little sleep, poor sleep quality, sleep disturbances and sleep variability are associated with undesirable T1DM management. Although more research is needed, our findings indicate the importance of including sleep education in the plan of care for children, adolescents and emerging young adults with T1DM.