Sleep Patterns in Adults and Children with Less Common Forms of Diabetes

MARILYN AROSEMENA^1*Maria Salguero²Siri Greeley³Rochelle Naylor³Esra Tasali³Louis H Philipson³

• ¹The University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
• ²Advocate Christ Medical Center, Oak Lawn, Illinois, United States
• ³The University of Chicago, Chicago, Illinois, United States

Objective: To review the current evidence on sleep patterns in relation to glucose control in adults and children with type 1 diabetes (T1DM) and monogenic diabetes. Methods: We searched for the literature pertaining T1DM and monogenic diabetes with reported sleep patterns along with glycemic control in Pubmed. This review aimed to examine the current evidence on the relationship between sleep patterns and diabetes management and possible mediating mechanisms for this relationship in adults and children with T1DM and monogenic diabetes. We reviewed articles published from inception until 2023. Results: Twenty-five clinical studies met the eligibility criteria and were included. Children with T1DM with higher sleep variability had higher glucose levels and those with higher glucose variability had more sleep disruption. Comparing children with suboptimal (HbA1c ≥7.5%) to optimal glucose control, those with suboptimal control had shorter sleep duration. There was not a higher prevalence of obstructive sleep apnea (OSA) in children with T1DM compared to controls but within T1DM, those who had OSA had higher glucose levels. Adults with T1DM had a high prevalence of poor sleep quality and were also sleeping less than the recommended hours for their age. Poor sleep quality and short sleep duration correlated with higher glycemic variability. First generation automated insulin delivery systems did not improve sleep patterns in T1DM but other strategies including coaching and counseling proved to be effective. In Monogenic diabetes data also suggests poor sleep quality, short sleep and high rates of sleep apnea. Conclusion: T1DM subjects seem to have worse sleep patterns, especially those with suboptimal glucose control. Monogenic diabetes data is limited but also suggests poor sleep patterns. Rigorous interventional studies are needed to further elucidate the sleep-diabetes relationship. Future research could provide insights into strategies that could effectively improve sleep in people living with diabetes.