Sleep and type 1 diabetes mellitus management among children, adolescents, and emerging young adults: a systematic review
Abstract
Background Type 1 diabetes mellitus (T1DM) is one of the most common chronic illnesses among the youth. Emerging evidence has suggested poor sleep as a risk factor for glycemic control. This review aimed to examine the associations between sleep characteristics and diabetes management in children, adolescents, and emerging young adults with T1DM.Methods Following PRISMA guidelines, the authors searched articles in PubMed, Web of Science, and Scopus from 2000 through August 2020. Using inclusion and exclusion criteria, observational studies and clinical trials that examined sleep and diabetes management among individuals with T1DM (up to 25 years old) were selected for review.Results Twenty-four articles met the review criteria. Most studies did not report differences in self-report sleep between individuals with and without T1DM. However, several studies using objective sleep measures (actigraph and PSG) suggested shorter sleep duration and worse sleep quality in individuals with T1DM. Higher A1C levels and undesirable T1DM self-care behaviors were associated with short and long sleep duration, poor sleep quality, sleep disturbances, and irregular sleep, particularly among adolescent boys, young men and those from immigrant families. Self-care behaviors mediated the associations between sleep and subsequent A1C levels.Conclusions Too much or too little sleep, poor sleep quality, sleep disturbances and sleep variability are associated with undesirable T1DM management. Although more research is needed, our findings indicate the importance of including sleep education in the plan of care for children, adolescents and emerging young adults with T1DM.
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Sleep disturbances are associated with less engagement in diabetes self-management among people with type 1 and type 2 diabetes.
“Moreover, sleep disturbances are associated with less engagement in diabetes self-management and may interfere with the achievement of glycemic targets among people with type 1 and type 2 diabetes (434-439).”
From 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:<i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [437]
Sleep disturbances may interfere with the achievement of glycemic targets among people with type 1 and type 2 diabetes.
“Moreover, sleep disturbances are associated with less engagement in diabetes self-management and may interfere with the achievement of glycemic targets among people with type 1 and type 2 diabetes (434-439).”
From 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes:<i>Standards of Care in Diabetes—2023</i> (2023) · cites this paper as [437]
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ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Hilliard, M. E., Isaacs, D., Johnson, E. L., et al. (2023) · Diabetes Care · doi:10.2337/dc23-s005 · Cited by 362 · see citing works
- Authors
- Ji, X., Wang, Y., & Saylor, J.
- Affiliations
- University of Delaware (US)
- University of Pennsylvania (US)
- Corresponding author
- Ji, Xiaopeng
- Saylor, Jennifer
- Venue
- Journal of Pediatric Nursing
- Publisher
- Elsevier BV
- Published
- 2021-11
- Volume
- 61
- Pages
- 245-253
- ISSN
- 0882-5963 (ISSN-L)
- OpenAlex
- W3175998576
- Cited by
- 57
- References
- 40
- Citations by year
- 2026: 13 · 2025: 18 · 2024: 8 · 2023: 13 · 2022: 4 · 2021: 1
- FWCI
- 1.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Journal of Pediatric Nursing (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Delaware
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- type 1 diabetes, sleep duration, sleep quality, sleep disorders, glycemic control, HbA1c, diabetes self-care behavior, children, adolescents, young adults, immigrant families, sleep education
- MeSH terms
- Sleep Quality, Adolescent, Blood Glucose, Child, Diabetes Mellitus, Type 1, Humans, Male, Self Care, Sleep, Young Adult
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