scholarly journals 0927 Variations in Sleep and Glucose in Adolescents with Type 1 Diabetes

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A352-A353
Author(s):  
S Griggs ◽  
N S Redeker ◽  
S Jeon ◽  
M Grey
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Sleep Duration ◽  
Sleep Onset ◽  
Glucose Variability ◽  
Poor Sleep ◽  
Short Sleep Duration ◽  
High Blood Glucose ◽  
Short Sleep

Abstract Introduction The association between short sleep duration and poorer glycemic control in adolescents ages 10-16 with type 1 diabetes (T1D) is well established. Researchers have used cross-sectional, between-subjects’ methods, with limited focus on the potential intraindividual variation among these variables. The purpose of this analysis was to examine the within person associations between glucose variability indices (J index, low/high blood glucose index, time in range) and sleep characteristics (bedtime, waketime, total sleep time, sleep efficiency, wake after sleep onset [WASO], awakenings, and sleep fragmentation index) in adolescents with T1D. Methods Adolescents monitored their sleep and glucose patterns concurrently for 3-7 days with a wrist actigraph on their non-dominant wrist and either their own continuous glucose monitor (CGM) or a provided blinded CGM. General linear mixed models (GLMM) were used to determine within-person and day level associations. Results The sample included 38 adolescents (M age 13.4±1.8; 37.8% male; M A1C 8.2±1.2%). Average glucose levels were controlled in all GLMMs. Adolescents had earlier waketimes on days when more time was spent in hypoglycemia <70mg/dL (β=-0.15, p<0.001). At the person level, adolescents had greater WASO with more % time spent in severe hypoglycemia <54mg/dL with more severe low blood glucose indices (β=0.35, p<0.01 and β=0.34, p<0.01 respectively). At the daily level, adolescents had greater WASO (β=0.20, p=0.01) and more awakenings (β=0.16, p=0.04) on the days they had more overall glucose variability (J index) and more severe high blood glucose indices (β=0.17, p=0.04), but were less likely to have more % time in hypoglycemia (β=-0.15, p=0.02). Conclusion Glucose variability was positively associated with poor sleep (e.g., WASO and awakenings) in adolescents with T1D both at the daily and intraindividual level. Monitoring over a longer period of time in subsequent studies would allow researchers to determine the within person associations between habitual short sleep duration and glucose variability. Support NINR T32NR0008346 & P20NR014126, Medtronic MiniMed provided CGMs at a discounted rate for the study.

scholarly journals Short Sleep Duration Measured by Wrist Actimetry Is Associated With Deteriorated Glycemic Control in Type 1 Diabetes

Diabetes Care ◽  
2013 ◽  
Vol 36 (10) ◽  
pp. 2902-2908 ◽  
Author(s):  
A.-L. Borel ◽  
J.-L. Pepin ◽  
L. Nasse ◽  
J.-P. Baguet ◽  
S. Netter ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Sleep Duration ◽  
Short Sleep Duration ◽  
Short Sleep

scholarly journals Short Sleep Duration Is Associated With a Blood Pressure Nondipping Pattern in Type 1 Diabetes: The DIAPASOM study

Diabetes Care ◽  
2009 ◽  
Vol 32 (9) ◽  
pp. 1713-1715 ◽  
Author(s):  
A.-L. Borel ◽  
P.-Y. Benhamou ◽  
J.-P. Baguet ◽  
I. Debaty ◽  
P. Levy ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 1 Diabetes ◽  
Sleep Duration ◽  
Short Sleep Duration ◽  
Short Sleep

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

2021 ◽  
Author(s):  
Stephanie Griggs ◽  
Margaret Grey ◽  
Kingman P Strohl ◽  
Sybil L Crawford ◽  
Seunghee Margevicius ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young Adults ◽  
Sleep Onset ◽  
Glucose Variability ◽  
Sleep Efficiency ◽  
Sleep Habits ◽  
Short Sleep Duration ◽  
Wrist Actigraphy ◽  
Wake Characteristics

Abstract Context 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. Objective To determine within-and between-person associations between objective sleep-wake characteristics and glucose variability indices. Design/Setting Multilevel models (MLMs) were used to analyze concurrent sleep and glucose patterns over seven days in 42 young adults with T1D in their natural home environment. Patients or Other Participants Young adults with T1D (mean age of 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. Main Outcome Measure(s) Sleep-wake characteristics via wrist actigraphy and glucose variability indices via a continuous glucose monitor (CGM). Results Lower sleep efficiency predicted higher glucose variability (less time in range β= .011 and more time in hyperglycemia β= -.011) within-person. A longer wake after sleep onset and more sleep disruptions were associated with higher glucose variability between persons (β= .28 - .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). Conclusions Clinicians can address the reciprocal nature of the sleep-glucose relationship by optimizing sleep and targeting efforts towards a euglycemic range overnight. Sleep habits are a modifiable personal target in diabetes care.

scholarly journals Nightly sleep duration, fragmentation, and quality and daily risk of migraine

Neurology ◽  
2019 ◽  
Vol 94 (5) ◽  
pp. e489-e496 ◽  
Author(s):  
Suzanne M. Bertisch ◽  
Wenyuan Li ◽  
Catherine Buettner ◽  
Elizabeth Mostofsky ◽  
Michael Rueschman ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Sleep Duration ◽  
Conditional Logistic Regression ◽  
Sleep Onset ◽  
Sleep Fragmentation ◽  
Caffeine Intake ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Short Sleep Duration ◽  
Short Sleep

ObjectiveTo test the hypotheses that insufficient duration, high fragmentation, and poor sleep quality are temporally associated with migraine onset on the day immediately following the sleep period (day 0) and the following day (day 1).MethodsIn this prospective cohort study of 98 adults with episodic migraine, participants completed twice-daily electronic diaries on sleep, headaches, and other health habits, and wore wrist actigraphs for 6 weeks. We estimated the incidence of migraine following nights with short sleep duration, high fragmentation, or low quality compared to nights with adequate sleep with conditional logistic regression models stratified by participant and adjusted for caffeine intake, alcohol intake, physical activity, stress, and day of week.ResultsParticipants were a mean age of 35.1 ± 12.1 years. We collected 4,406 days of data, with 870 headaches reported. Sleep duration ≤6.5 hours and poor sleep quality were not associated with migraine on day 0 or day 1. Diary-reported low efficiency was associated with 39% higher odds of headache on day 1 (odds ratio [OR] 1.39, 95% confidence interval [CI] 1.06–1.81). Actigraphic-assessed high fragmentation was associated with lower odds of migraine on day 0 (wake after sleep onset >53 minutes, OR 0.64, 95% CI 0.48–0.86; efficiency ≤88%, OR 0.74, 95% CI 0.56–0.99).ConclusionShort sleep duration and low sleep quality were not temporally associated with migraine. Sleep fragmentation, defined by low sleep efficiency, was associated with higher odds of migraine on day 1. Further research is needed to understand the clinical and neurobiologic implications of sleep fragmentation and risk of migraine.

scholarly journals Associations Between Objective Sleep Behaviors and Blood Glucose Variability in Young Children With Type 1 Diabetes

2020 ◽  
Author(s):  
Alexandra D Monzon ◽  
Arwen M Marker ◽  
Amy E Noser ◽  
Mark A Clements ◽  
Susana R Patton
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Young Children ◽  
Sleep Onset ◽  
Glycemic Variability ◽  
Glucose Variability ◽  
Sleep Onset Latency ◽  
Onset Latency ◽  
Blood Glucose Variability

Abstract Background Young children with Type 1 diabetes (T1D) are at risk for extreme blood glucose variability, a risk factor for suboptimal glycated hemoglobin A1c (HbA1c) and long-term health complications. We know that a reciprocal relationship exists between sleep and glycemic outcomes in older youth with T1D; however, little research has examined objective sleep in young children (<7 years) with T1D. Purpose This study examines bidirectional associations between sleep behaviors and glycemic variability in young children with T1D. Methods Thirty-nine young children with T1D (Mage 4.33 ± 1.46 years; MHbA1c 8.10 ± 1.06%) provided accelerometry data to objectively measure sleep onset latency, number of nighttime awakenings, and total sleep time. We also assessed HbA1c, average blood glucose, and glycemic variability (i.e., standard deviation of blood glucose from device downloads). We evaluated bidirectional relationships using multilevel modeling in SAS, with weekday/weekend as a Level 2 moderator. Results Children averaged 8.5 ± 1.44 hr of sleep per night, but only 12.8% met current sleep recommendations. Children experienced more nighttime awakenings, higher blood glucose, and more glycemic variability on weekends. Sleep onset latency and nighttime awakenings predicted greater glycemic variability on weekends, and weekend glycemic variability predicted increased nighttime awakenings. Conclusions Most young children with T1D did not meet sleep recommendations. Young children experienced more nighttime awakenings, higher blood glucose, and increased glycemic variability on weekends only, when routines may be less predictable. Findings suggest that one way families of young children with T1D may be able to decrease glycemic variability is to keep consistent routines on weekdays and weekends.

Abstract P336: The Association Between Goal-Striving Stress, Sleep Duration and Sleep Quality in the Jackson Heart Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Loretta Cain ◽  
LáShauntá Glover ◽  
Dayna Johnson ◽  
Mario Sims
Keyword(s):  
Sleep Quality ◽  
Sleep Duration ◽  
Poor Sleep ◽  
Jackson Heart Study ◽  
Poor Sleep Quality ◽  
Short Sleep Duration ◽  
Logistic Regression Models ◽  
Short Sleep ◽  
Goal Striving ◽  
Heart Study

Introduction: Research shows that compared to non-Hispanic whites, African Americans (AAs) have poorer sleep quality, lower mean sleep duration, and a higher prevalence of sleep-disordered breathing. AAs also report more frequent exposures to certain stressors over the life course, which may impact physiological processes that may impair sleep. Goal-striving-stress (GSS), the discrepancy between aspiration and achievement, weighted by the subjective probability of success, and the level of disappointment experienced if goals are not reached, may be an important stressor among AA’s that may influence sleep; however this has yet to be explored. The objective of this study was to assess the relationship between GSS and sleep duration and sleep quality in AAs. Hypothesis: We assessed the hypothesis that high (versus low) GSS would be associated with short or long sleep duration and poor sleep quality. Methods: We utilized data from the baseline exam of the Jackson Heart Study (JHS; n=5306), an AA sample of women and men, 35-84 years old. There were a total of 5082 participants in the sample; 63.34% female with a mean age of 55.30 (± 12.75) and mean sleep duration of 6.43 hours (±1.51). The sample was categorized into GSS tertiles: low (n=2121), moderate (n=1716), high (n=1296). Participants self-reported sleep duration (hours) and rated their sleep quality. Sleep duration was categorized as short ( < 6 hours), normal (7 or 8 hours) and long ( > 9 hours). Sleep quality was categorized as high (good/very good/excellent) and low (fair/poor). Logistic regression models were used to obtain odds ratios (OR, 95% confidence interval-CI) to assess the associations of GSS levels with sleep duration and sleep quality categories. Models were adjusted for sex, age, socioeconomic status, health behaviors, discrimination, and health outcomes. Results: Significant results showed that participants who reported high (versus low) GSS had a 29% increased odds [1.29 (1.10, 1.52)] of short (versus normal) sleep after full adjustment. Participants who reported high (versus low) GSS had a 42% increased odds [1.42 (1.20, 1.67)] of low (versus high) sleep quality after full adjustment. Conclusion In conclusion, the deficit between goal aspiration and achievement is associated with short sleep duration and poor sleep quality. Potential interventions should consider the extent to which GSS may contribute to the development of short sleep duration and poor sleep quality.

scholarly journals 0176 Short Sleep Duration and Poor Sleep Quality Predict Blunted Weight Loss in a Behavioral Weight Loss Intervention

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A70-A70
Author(s):  
C E Kline ◽  
M J Lambiase ◽  
M B Conroy ◽  
M M Brooks ◽  
A M Kriska ◽  
...  
Keyword(s):  
Weight Loss ◽  
Sleep Quality ◽  
Sleep Duration ◽  
Poor Sleep ◽  
Weight Loss Intervention ◽  
Behavioral Weight Loss ◽  
Poor Sleep Quality ◽  
Short Sleep Duration ◽  
Short Sleep ◽  
Behavioral Weight Loss Intervention

Abstract Introduction Short sleep duration and poor sleep quality have each been associated with obesity and weight gain. However, less is known regarding how sleep may impact attempted weight loss. The purpose of this study was to investigate the associations between sleep duration and sleep quality, both independently and in combination, with weight loss in a 12-month behavioral weight loss intervention. Methods Young to middle-aged adults who were overweight or obese (N=296) completed a 12-month behavioral weight loss intervention, with weight assessed at baseline, 6 and 12 months. Sleep duration and quality were derived from the Pittsburgh Sleep Quality Index. Analyses examined the change in sleep over time and the association between baseline sleep and changes in sleep with 6- and 12-month weight loss following adjustment for relevant covariates including age, gender, race, education, baseline body mass index, and baseline risk for sleep apnea. Results Participants (with an average baseline weight of 97.0±1.0 kg) lost 6.6±1.1 kg (6.8%) and 6.7±1.2 kg (6.9%) at 6 and 12 months relative to baseline, respectively. Global sleep quality significantly improved over the 12-month intervention (P=.03), but average sleep duration and the prevalence of short sleep duration (&lt;6 h) or poor sleep quality did not change significantly (each P≥.45). Adults with short sleep duration at baseline lost 3.3±0.9% less weight than those with ≥6 h sleep duration (P&lt;.001). Adults with poor sleep quality at baseline lost 1.6±0.8% less weight than those with good sleep quality (P=.04). When considered together, adults with both short sleep duration and poor sleep quality lost at least 5.0% less weight compared with all other sleep duration/quality group combinations (P&lt;.001). Conclusion Our findings highlight the importance of both sleep duration and sleep quality as predictors of behavioral weight loss and suggest that screening for sleep disturbance may be useful to determine who may benefit from additional counseling and resources. Support R01HL077525, K23HL118318

74-LB: Impact of Mild and Moderate High Blood Glucose Excursions on Daily Living in Adults with Type 1 Diabetes

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 74-LB
Author(s):  
ALLYSON HUGHES ◽  
JEOFFREY BISPHAM ◽  
COLLEEN GAREY ◽  
JINGWEN LIU ◽  
LILY FULLER ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Daily Living ◽  
High Blood Glucose
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