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Variations in Sleep Characteristics and Glucose Regulation in Young Adults With Type 1 Diabetes

活动记录 就寝时间 内科学 睡眠开始 医学 内分泌学 2型糖尿病 糖尿病 睡眠剥夺 睡眠(系统调用) 昼夜节律 1型糖尿病 心理学 失眠症 精神科 操作系统 计算机科学
作者
Stephanie Griggs,Margaret Grey,Kingman P. Strohl,Sybil L. Crawford,Seunghee Margevicius,Sangeeta R. Kashyap,Chiang‐Shan R. Li,Sanjay Rajagopalan,Ronald L. Hickman
出处
期刊:The Journal of Clinical Endocrinology and Metabolism [The Endocrine Society]
卷期号:107 (3): e1085-e1095 被引量:14
标识
DOI:10.1210/clinem/dgab771
摘要

Short sleep duration and sleep disruptions are associated with impaired glucoregulation in type 1 diabetes (T1D). However, the mechanistic pathways between sleep and glucose variability remain unclear.To determine within- and between-person associations between objective sleep-wake characteristics and glucose variability indices.Multilevel models were used to analyze concurrent sleep and glucose patterns over 7 days in 42 young adults with T1D in their natural home environment. Young adults with T1D (mean age 22.2 ± 3.0 years, HbA1c 7.2%, 32.6% male) for at least 6 months with no other medical or major psychiatric comorbidity were included. Sleep-wake characteristics were measured via wrist actigraphy and glucose variability indices via a continuous glucose monitor (CGM).Lower sleep efficiency predicted higher glucose variability (less time in range β = 0.011 and more time in hyperglycemia β = -0.011) within-person. A longer wake after sleep onset and more sleep disruptions were associated with higher glucose variability between persons (β = 0.28 and 0.31). Higher glucose variability predicted poorer sleep within-person (delayed bedtime, waketime, mid-sleep time, and lower sleep efficiency), while higher glucose variability was associated with poorer sleep and more sleep disruptions between persons (lower sleep efficiency, longer wake after sleep onset, and a higher sleep fragmentation index).Clinicians can address the reciprocal nature of the sleep-glucose relationship by optimizing sleep and targeting efforts toward a euglycemic range overnight. Sleep habits are a modifiable personal target in diabetes care.
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