Pediatric Hypoglycemia May Affect Sleep Quality Measures

Time spent in hypoglycemia may negatively affect sleep quality for children with type 1 diabetes, a new study presented at the American Diabetes Association (ADA) 81st Scientific Sessions suggests.

Angela Karami, BS, and a team at the Barbara Davis Center for Diabetes, Colorado, used objective measures to evaluate sleep quality in children with type 1 diabetes and their parents.

To do this, they used actigraphy watches on 26 children and 26 parents, who recorded about 7 nights of sleep results. Total sleep time in hours, sleep efficiency (ratio of total sleep time to time in bed), awakening after onset of sleep, and number of awakenings during sleep periods were all recorded.

Nighttime hours were defined as between noon and 6:00 am, while the total day was considered to be a 24-hour period. During both periods, the researchers collected glycemic data from the pediatric patients using Dexcom G6 continuous glucose monitor (CGM).

The team used mixed models to test the associations of sleep outcomes with both time-in-range and time in hypoglycemia.

The findings

The mean age of the pediatric population was 10.7 years with equal proportions of males and females. For the parent population, the mean age was 42.5 years, with the majority (84.6%) being female.

The mean duration of type 1 diabetes was 1.98 years and the mean HbA1c was 7.2.

“Significant associations were found between hypoglycemia and child awakening after sleep onset, awakening and total sleep time,” the researchers reported. However, no associations were observed between sleep measures and time in range.

Similarly, no associations were observed between time in sleep hypoglycemia and any of the sleep measures. In her presentation, Karami indicated that it is possible that the total time spent on hypoglycemia has more influence on sleep quality than the glycemic values ​​at night.

“Time spent in hypoglycemia was associated with more nighttime awakenings and long awakenings after the onset of sleep in young people with type 1 diabetes,” Karami and colleagues wrote.

They noted that the associations between the total time in hypoglycemia and the child’s total sleep time, as well as the child’s sleep efficiency and time in range during the nighttime hours were unexpected findings. As such, it is necessary to further evaluate these links.

In addition, a larger sample size would be needed to better assess these links between glycemic and sleep outcomes. Nevertheless, the researchers emphasized the importance of providing tools to reduce hypoglycemia to improve sleep quality in this pediatric population.

The study, “Association of Glycemic Ranges and Sleep Measures in Youth with T1D and their Parents,” was presented at ADA 2021.

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