Sleep duration and its impact on adherence in adolescents with type 1 diabetes mellitus

McDonough RJ, Clements MA, DeLurgio SA, Patton SR. Sleep duration and its impact on adherence in adolescents with type 1 diabetes mellitus. Pediatric Diabetes 2017: 18: 262-270. Background: Adherence to the type 1 diabetes (T1D) regimen, while predictive of glycemic control, decreases during adolescence. For adolescents, attaining adequate sleep is an additional challenge. This study evaluates the impact of sleep on adherence in teens with T1D. Subjects: Forty-five adolescents aged 12-18 yr, with T1D for at least 6 months while on insulin pump therapy. Methods: Adolescents logged their sleep on a written diary for 2 wk. Corresponding insulin pump/glucometer downloads as well as sleep habit questionnaires were also obtained. Results: Data from 20 girls and 25 boys, with a mean age of 15 +/- 1.6 yr and mean glycated hemoglobin of 8.7 +/- 1.1% (72 mmol/mol), were analyzed. Overall, average sleep was 8.6 +/- 0.9 h per night. Sleep durations were compared to the next day's frequency of self-monitored blood glucose (SMBG) and total daily insulin bolus frequency. Associations were found between sleep duration and youths' SMBG and insulin bolus frequencies (p<0.03 and p<0.001, respectively). Specifically, a 15- and 20-min increase in sleep was associated with one additional SMBG check and one additional insulin bolus, respectively. Conclusion: Analyses suggest an associated increase in T1D self-management behaviors in youths with increased sleep duration. These findings highlight the importance of assessing sleep in clinical practice, and encourage further research to examine effective strategies to address sleep hygiene as part of routine diabetes management.