Characterizing Subjective Sleep Quality and Sleep Apnea Risk in Adults With Type 1 Diabetes

Area of Science:

• Endocrinology
• Sleep Medicine
• Cardiology

Background:

• Type 1 diabetes (T1D) is associated with increased risks of poor sleep quality and obstructive sleep apnea (OSA).
• The specific diabetes-related factors influencing these sleep disturbances remain incompletely understood.
• Understanding these associations is crucial for developing targeted interventions in T1D management.

Purpose of the Study:

• To investigate the associations between diabetes characteristics, affect, and subjective sleep quality and OSA risk in adults with T1D.
• To determine if specific diabetes complications or glycemic control metrics correlate with sleep disturbances.
• To explore the role of psychological factors like anxiety and stress in T1D-related sleep issues.

Main Methods:

• A cohort of 210 adults with T1D completed validated questionnaires for sleep quality (PSQI) and OSA risk (STOP-Bang).
• Psychological well-being was assessed using measures for generalized anxiety, perceived stress, and depression.
• Continuous glucose monitoring (CGM) data were collected for up to 20 days to evaluate glycemic variability.
• Bivariate correlations and hierarchical regressions were employed to analyze relationships between variables.

Main Results:

• Nearly half (47%) of participants reported poor sleep quality, and 37% were at elevated risk for OSA.
• Microvascular complications were significantly associated with poorer subjective sleep quality (β=.13, p=.03).
• Both microvascular (β=.15, p=.002) and cardiovascular disease (β=.14, p=.004) were linked to higher OSA risk.
• Continuous glucose monitoring (CGM) metrics did not show significant associations with sleep quality or OSA risk.

Conclusions:

• A substantial proportion of adults with T1D experience poor sleep quality and elevated OSA risk.
• Microvascular complications are a key factor associated with poorer sleep quality in T1D.
• The presence of microvascular and cardiovascular complications independently increases the risk for OSA in this population.
• Current aggregate glycemic control metrics do not appear to be directly associated with sleep outcomes in T1D, warranting further investigation into dynamic glucose patterns.