Sleep characteristics in type 1 diabetes and associations with glycemic control: systematic review and meta-analysis
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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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Sleep may be disrupted in people with type 1 diabetes as a result of both behavioral and physiological aspects of diabetes and its management.
“Sleep may be disrupted in people with type 1 diabetes as a result of both behavioral and physiological aspects of diabetes and its management (153).”
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 [436]
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 [436]
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- Authors
- Reutrakul, S., Thakkinstian, A., Anothaisintawee, T., Chontong, S., Borel, A.-L., Perfect, M. M., Janovsky, C. C. P. S., Kessler, R., Schultes, B., Harsch, I. A., van Dijk, M., Bouhassira, D., Matejko, B., Lipton, R. B., Suwannalai, P., Chirakalwasan, N., Schober, A.-K., & Knutson, K. L.
- Affiliations
- Mahidol University (TH)
- Inserm (FR)
- University of Arizona (US)
- Universidade Federal de São Paulo (BR)
- Hôpitaux Universitaires de Strasbourg (FR)
- eSwiss Medical and Surgical Center (CH)
- University of Chicago (US)
- Thai Red Cross Society (TH)
- Corresponding author
- Reutrakul, Sirimon
- ORCID
- Venue
- Sleep Medicine
- Publisher
- Elsevier BV
- Published
- 2016-07
- Volume
- 23
- Pages
- 26-45
- ISSN
- 1389-9457 (ISSN-L)
- PMC
- PMC9554893
- OpenAlex
- W2417840983
- Cited by
- 238
- References
- 66
- Citations by year
- 2026: 24 · 2025: 22 · 2024: 33 · 2023: 33 · 2022: 28 · 2021: 32 · 2020: 26 · 2019: 13 · 2018: 17 · 2017: 10
- FWCI
- 1.76
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Sleep Medicine (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion, cc-by-nc-nd)
- Jagiellonian University Repository (Jagiellonian University) (submittedVersion, other-oa)
- Homo Politicus (Academy of Humanities and Economics in Lodz) (submittedVersion, cc-by-nc-nd)
- HAL (submittedVersion)
- UNIFESP Institutional Repository (Universidade Federal de São Paulo) (submittedVersion, cc-by-nc-nd)
- Funders
- National Heart, Lung, and Blood Institute (R01HL062373)
- 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 › Physiology › Obstructive Sleep Apnea Research
- Keywords
- type 1 diabetes, sleep duration, sleep quality, glycemic control, HbA1c, obstructive sleep apnea, pediatric diabetes, adults with diabetes
- MeSH terms
- Diabetes Mellitus, Type 1, Glycated Hemoglobin, Humans, Sleep, Sleep Wake Disorders
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