Sleep characteristics in type 1 diabetes and associations with glycemic control: systematic review and meta-analysis

Publication date: Available online 8 June 2016
Source:Sleep Medicine
Author(s): Sirimon Reutrakul, Ammarin Thakkinstian, Thunyarat Anothaisintawee, Sasipas Chontong, Anne-Laure Borel, Michelle M. Perfect, Carolina Castro Porto Silva Janovsky, Romain Kessler, Bernd Schultes, Igor Alexander Harsch, Marieke van Dijk, Didier Bouhassira, Bartlomiej Matejko, Rebecca B. Lipton, Parawee Suwannalai, Naricha Chirakalwasan, Anne-Katrin Schober, Kristen L. Knutson
ObjectiveThe association between inadequate sleep and type 2 diabetes has garnered much attention, but little is known about sleep and type 1 diabetes (T1D). Our objective was to conduct a systematic review and meta-analysis comparing sleep in persons with and without T1D, and to explore relationships between sleep and glycemic control in T1D.MethodsStudies were identified from Medline and Scopus. Studies reporting measures of sleep in T1D patients and controls, and/or associations between sleep and glycemic control, were selected.ResultsA total of 22 studies were eligible for the meta-analysis. Children with T1D had shorter sleep duration (mean difference [MD] = −26.4 minutes; 95% confidence interval [CI] = −35.4, −17.7) than controls. Adults with T1D reported poorer sleep quality (MD in standardized sleep quality score = 0.51; 95% CI = 0.33, 0.70), with higher scores reflecting worse sleep quality) than controls, but there was no difference in self-reported sleep duration. Adults with TID reported sleeping >6 hours had lower hemoglobin A1c (HbA1c) levels than those sleeping ≤6 hours (MD = −0.24%; 95% CI = − 0.47, −0.02), and participants reporting good sleep quality had lower HbA1c than those with poor sleep quality (MD = −0.19%; 95% CI = − 0.30, −0.08). The estimated prevalence of obstructive sleep apnea (OSA) in adults with TID was 51.9% (95% CI = 31.2, 72.6). Patients with moderate-to-severe OSA had a trend toward higher HbA1c (MD = 0.39%, 95% CI = −0.08, 0.87).ConclusionT1D was associated with poorer sleep and high prevalence of OSA. Poor sleep quality, shorter sleep duration, and OSA were associated with suboptimal glycemic control in T1D patients.



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