Poor sleep quality linked to higher type 1 diabetes distress in young adults
Click Here to Manage Email Alerts
Young adults with type 1 diabetes have more diabetes distress symptoms with shorter sleep time, lower sleep efficiency and higher sleep variability, according to a study published in The Science of Diabetes Self-Management and Care.
“When an individual has inadequate sleep quantity or quality, a functional deficit occurs between the amygdala and ventral anterior cingulate cortex, resulting in decreased mood, a heightened response to negative stimuli and altered inhibitory function,” Stephanie Griggs, PhD, RN, assistant professor at the Frances Payne Bolton School of Nursing and faculty associate at the Schubert Center for Child Studies at Case Western Reserve University, told Healio. “Sleep extension has restorative benefits, normalizes inhibitory function and suppresses amygdala hyperactivity, thereby resulting in fewer or no emotional or physical symptoms.”
Griggs and colleagues conducted a cross-sectional study enrolling 46 young adults aged 18 to 30 years with type 1 diabetes for at least 6 months and no other major health problems (mean age, 22.3 years; 67.4% women; 84.8% non-Hispanic white). Participants with obstructive sleep apnea or working night shift were excluded. Adults wore the Spectrum Plus device on their wrist to measure sleep-wake data. Sleep quality was assessed through the 19-item Pittsburgh Sleep Quality Index. The 17-item Diabetes Distress Scale measured diabetes emotional stress, and diabetes symptoms were measured with the 34-item Diabetes Symptom Checklist – Revised. The 8-item PROMIS version 1.0 questionnaire measured general emotional distress. Each participant wore a Dexcom G4 continuous glucose monitor or shared data from their own device during the study. Clinical and demographic data were collected through electronic medical records.
Of the study cohort, 54.3% slept fewer than 7 hours per night. The cohort had a mean sleep quality score of 5.91, with a score of greater than 5 signifying poor sleep quality.
Moderate emotional distress was reported by 30.4% of the cohort, and 41.3% met the criteria for moderate diabetes distress. Females reported having more hypoglycemia symptoms (P = .001) and fatigue symptoms (P =.008) compared with males.
Having a shorter total sleep time (r = –.32; P = .032), longer sleep onset latency (r = .36; P = .014) and worse sleep efficiency (r = –.35; P = .018) were associated with greater diabetes emotional distress. The associations remained significant after adjusting for sex and BMI. High sleep variability was associated with more neurologic pain symptoms (r = .32; P = .028). Longer sleep onset latency was associated with more psychological cognitive symptoms (r = .37; P = .012), more hyperglycemia symptoms (r = .33; P = .024) and a higher total symptom burden (r = .3 P = .042).
“Promoting sleep through extension and decreasing variability may help mitigate diabetes symptoms,” Griggs said. “Diabetes and primary care providers should routinely assess sleep health and address diabetes management issues that may be interfering with nocturnal sleep, such as nocturnal hyperglycemia or hypoglycemia.”
Griggs said future researchers should clarify the directionality of the associations between sleep duration and the timing of symptoms, and whether promoting sleep mitigates diabetes symptoms over time.
For more information:
Stephanie Griggs, PhD, RN, can be reached at sag153@case.edu.
Collapse
Click Here to Manage Email Alerts