Introduction: Many children with Type 1 Diabetes (T1D) and their parents/carers anecdotally report poor sleep quality. This is particularly problematic in patients experiencing frequent hypoglycaemia despite intensive blood glucose monitoring (BGM). Continuous glucose monitoring (CGM) overcomes some of the burdens of BGM and can reduce overnight hypoglycaemia.
Objectives: This pilot study explored the impact of CGM on sleep quality in children and adolescents with T1D experiencing labile glycaemic control and frequent hypoglycaemia. Impact of CGM use on parental sleep quality was also investigated.
Methods: Actigraphy was used to measure sleep quality in children and adolescents aged 218 with T1D (n=10) and their parent(s) (n=18). Sleep quality was measured one week prior to the patient starting CGM and during week 5 of CGM use. Additionally, all participants recorded a sleep diary during each sleep monitoring week.
Results: Sleep efficiency improved by 7.03% in children and adolescents (95% CI 3.09 to 10.99; P = 0.003), and 4.14% in parents (2.21 to 6.06; P < 0.001). This was accompanied by a significant reduction in nocturnal wakening. In children and adolescents, mean reduction in nocturnal wakening was 42.5 minutes (−66.5 to −18.4; P = 0.003), and in parents, 18.5 min (−28.6 to −8.4; P < 0.001).
Conclusions: This was the first study that objectively explored sleep quality in both children and adolescents with T1D, and their parents, before and during the use of CGM. The improvements in sleep efficiency and nocturnal wakening may be clinically significant for both patients and parents with regards to functioning, quality of life and neurocognition. Reasons for improved sleep quality may include reduced overnight disturbance from BGM, reduced hypoglycaemia and reduced anxiety related to hypoglycaemia. These factors may directly and indirectly impact upon an individuals T1D self-management and consequently, may affect a patients glycaemic control. This area warrants further research.
27 - 29 Nov 2019
British Society for Paediatric Endocrinology and Diabetes