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

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

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Objectives The association between inadequate sleep and type 2 diabetes has garnered much attention, but little is known about sleep and type 1 diabetes (T1D). Our objectives were 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. Methods Studies 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. Results A 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 who 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). Conclusion T1D 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.

Original languageEnglish (US)
Pages (from-to)26-45
Number of pages20
JournalSleep Medicine
Volume23
DOIs
StatePublished - Jul 1 2016

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Type 1 Diabetes Mellitus
Meta-Analysis
Sleep
Obstructive Sleep Apnea
Confidence Intervals
Hemoglobins
Quality Control
Type 2 Diabetes Mellitus

Keywords

  • Glycemic control
  • Meta-analysis
  • Obstructive sleep apnea
  • Sleep duration
  • Sleep quality
  • Type 1 diabetes

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Sleep characteristics in type 1 diabetes and associations with glycemic control : systematic review and meta-analysis. / Reutrakul, Sirimon; Thakkinstian, Ammarin; Anothaisintawee, Thunyarat; Chontong, Sasipas; Borel, Anne Laure; Perfect, Michelle M; Janovsky, Carolina Castro Porto Silva; Kessler, Romain; Schultes, Bernd; Harsch, Igor Alexander; van Dijk, Marieke; Bouhassira, Didier; Matejko, Bartlomiej; Lipton, Rebecca B.; Suwannalai, Parawee; Chirakalwasan, Naricha; Schober, Anne Katrin; Knutson, Kristen L.

In: Sleep Medicine, Vol. 23, 01.07.2016, p. 26-45.

Research output: Contribution to journalArticle

Reutrakul, S, Thakkinstian, A, Anothaisintawee, T, Chontong, S, Borel, AL, Perfect, MM, Janovsky, CCPS, Kessler, R, Schultes, B, Harsch, IA, van Dijk, M, Bouhassira, D, Matejko, B, Lipton, RB, Suwannalai, P, Chirakalwasan, N, Schober, AK & Knutson, KL 2016, 'Sleep characteristics in type 1 diabetes and associations with glycemic control: systematic review and meta-analysis', Sleep Medicine, vol. 23, pp. 26-45. https://doi.org/10.1016/j.sleep.2016.03.019
Reutrakul, Sirimon ; Thakkinstian, Ammarin ; Anothaisintawee, Thunyarat ; Chontong, Sasipas ; Borel, Anne Laure ; Perfect, Michelle M ; Janovsky, Carolina Castro Porto Silva ; Kessler, Romain ; Schultes, Bernd ; Harsch, Igor Alexander ; van Dijk, Marieke ; Bouhassira, Didier ; Matejko, Bartlomiej ; Lipton, Rebecca B. ; Suwannalai, Parawee ; Chirakalwasan, Naricha ; Schober, Anne Katrin ; Knutson, Kristen L. / Sleep characteristics in type 1 diabetes and associations with glycemic control : systematic review and meta-analysis. In: Sleep Medicine. 2016 ; Vol. 23. pp. 26-45.
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abstract = "Objectives The association between inadequate sleep and type 2 diabetes has garnered much attention, but little is known about sleep and type 1 diabetes (T1D). Our objectives were 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. Methods Studies 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. Results A 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 who 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). Conclusion T1D 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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T1 - Sleep characteristics in type 1 diabetes and associations with glycemic control

T2 - systematic review and meta-analysis

AU - Reutrakul, Sirimon

AU - Thakkinstian, Ammarin

AU - Anothaisintawee, Thunyarat

AU - Chontong, Sasipas

AU - Borel, Anne Laure

AU - Perfect, Michelle M

AU - Janovsky, Carolina Castro Porto Silva

AU - Kessler, Romain

AU - Schultes, Bernd

AU - Harsch, Igor Alexander

AU - van Dijk, Marieke

AU - Bouhassira, Didier

AU - Matejko, Bartlomiej

AU - Lipton, Rebecca B.

AU - Suwannalai, Parawee

AU - Chirakalwasan, Naricha

AU - Schober, Anne Katrin

AU - Knutson, Kristen L.

PY - 2016/7/1

Y1 - 2016/7/1

N2 - Objectives The association between inadequate sleep and type 2 diabetes has garnered much attention, but little is known about sleep and type 1 diabetes (T1D). Our objectives were 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. Methods Studies 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. Results A 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 who 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). Conclusion T1D 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.

AB - Objectives The association between inadequate sleep and type 2 diabetes has garnered much attention, but little is known about sleep and type 1 diabetes (T1D). Our objectives were 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. Methods Studies 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. Results A 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 who 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). Conclusion T1D 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.

KW - Glycemic control

KW - Meta-analysis

KW - Obstructive sleep apnea

KW - Sleep duration

KW - Sleep quality

KW - Type 1 diabetes

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