Evaluating the influence of sleep quality and quantity on glycemic control in adults with Type 1 Diabetes

Abstract

Background: Sleep quality disturbances are frequent in adults with type 1 diabetes. However, the possible influence of sleep problems on glycemic variability has not been deeply studied in the past. This study aims to assess the impact of sleep quality and sleep quantity on glycemic control. Materials and Methods: Observational study in 25 adults with type 1 diabetes, simultaneous recording of continuous glucose monitoring (Abbott FreeStyle Libre system) for 14 days, and a sleep study by wrist actigraphy (Fitbit Ionic device). The study analyzes, using artificial intelligence techniques, the relationship between the quality and structure of sleep with time in normo-, hypo-, and hyperglycemia ranges and with glycemic variability. The patients are also studied as a group, comparing patients with good and poor sleep quality. Several cluster analyses and correlational studies are performed Results: A total of 243 days/nights were analyzed, of which 77% (n=189) were categorized as poor quality and 33% (n=54) as good quality. Linear regression methods find a correlation (r=0.8) between the variability of sleep efficiency and the variability of mean blood glucose. With clustering techniques, patients were grouped according to their sleep structure (characterizing this structure from the number of transitions between the different sleep phases). These clusters show a relationship between time in range and sleep structure. Conclusions: This study suggests that poor sleep quality is associated with lower time in range and greater glycemic variability, so improving sleep quality in patients with type 1 diabetes could improve their glycemic control.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

The Spanish Ministerio de Innovacion Ciencia y Universidad grant RTI2018095180-B-I00. Madrid Regional Goverment FEDER grants B2017/BMD3773 (GenObIA-CM) and Y2018/NMT-4668 (Micro-StressMAP-CM). Fundacion Eugenio Rodriguez Pascual 2019 grant: Development of adaptive and bioinspired systems for glycemic control with continuous subcutaneous insulin infusors and continuous glucose monitors.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethics Committee of the Hospital Principe de Asturias in Alcala de Henares, Spain, gave approval for this study. All patients signed a prior informed consent. The data acquisition was carried out by two nurses of the Endocrinology and Nutrition Service of the hospital

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.

Yes

Data Availability

All data produced in the present study are available upon reasonable request to the authors

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