Facilitators and Barriers of Sleep in Young Type 1 Diabetes

A recent study found that young adult T1D reported feeling challenged at bedtime and overnight by the demands of a complex disease management regimen. General and diabetes specific barriers and facilitators to obtaining sufficient sleep were the themes in this study. The consequences of sleep deficiency are detrimental for young adults with T1D given the association with poorer glycemic control and poorer management of T1D.

Diabetes-Specific Facilitators of Sufficient Sleep

• Maintaining blood glucose (BG)within range so close to bedtime as possible was the most common facilitator of sleep (43.3%).
• Strategies to maintain BG in range included having a snack or light meal (13.3%) not eating 2 hours before bedtime (3.3%) or eating closer to bedtime (3.3%). But it all depends on whether the BG is elevated, in range or below range as to these tactics.

Diabetes-Specific Bedtime Delays or Disruptions in Sleep

• Delaying bedtime to manage their diabetes (60%), sometimes related to fear of hypoglycemia (13.3%), being awoken from hyper or hypoglycemia (66.7%) and being awoken by sensor/pump alarms (20%) which some reporting that they were sometimes false alarms. Delaying bedtime was also attributed to set up equipment for the night, ie, treat with insulin, replace an expired sensor, lower an insulin pump basal rate to a nighttime rat or check settings on pump, etc.
• In relation to this is that participants felt like they had to stay up to see if a treatment caused their BG to go in the right direction, such as treating a high BG and taking a lot longer to correct than low BG.

General Facilitators for Sleep

• Avoiding caffeine and alcohol or naps and avoiding or limiting electronic prior to bedtime. Other participants had a relaxing regular bedtime routine (73.3%), physical activity during the day (30%), a comfortable sleep environment, which is quiet, dark and cozy (26.7%) and being tired (23.3%).

Sourced from the American Diabetes Association Journal