Sleep assessment as part of routine care of your patients with diabetes

Could sleep problems help explain why even adherent young patients with type 1 diabetes may have trouble maintaining blood glucose control? A new study suggests that poor sleep not only worsens blood glucose control but also quality of life (QOL) in youth with diabetes.

Previous studies have suggested an association between sleep and diabetes, but they have focused on adults with type 2 diabetes. In the current study, researchers evaluated the effect of sleep-disordered breathing (≥1.5 apnea-hypopnea index events per hour) on blood glucose control in 50 children and adolescents aged 10 to 16 years with type 1 diabetes. They also assessed the effect of sleep patterns on daytime functioning and compared the sleep of patients with type 1 diabetes to that of matched controls.

Nearly a third of the diabetic youths had sleep apnea. Those who experienced sleep apnea had significantly higher glucose levels and a greater percentage of time experiencing hyperglycemia. Compared with nondiabetic controls, youths with diabetes spent less time in deep sleep (stage N3) and more time in light sleep (stage N2). Less time spent in deep sleep was associated with higher hemoglobin A1C values. Also, more time spent in light sleep was associated with higher average glucose levels on continuous monitoring and more time in hyperglycemia.

Self-reported daytime sleepiness adversely affected psychosocial functioning. Specifically, youths reporting daytime sleepiness or poor sleep habits had worse grades in school, lower scores on standardized tests, poorer disease-related QOL, more diabetes-related worries, and more depression.

Health and education professionals should be aware that daytime sleepiness, disrupted sleep, and poor sleep habits affect patients’ diabetes care, QOL, and school performance, the researchers write, and they recommend including sleep assessment in the routine clinical care of youth with type 1 diabetes.

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