Aims: To date, few objective or subjectively measured data exist to describe the impact of continuous glucose monitoring (CGM) technology on sleep timing, duration, and quality in young people with type 1 diabetes (T1D). This study aims to evaluate the impact of first-generation intermittently scanned CGM (isCGM) on habitual sleep patterns, including sleep onset and offset timing, sleep duration, disturbances (frequency and duration of night-time awakenings), sleep efficiency and perceived sleep quality in youth with high-risk glycaemic control.
Methods: We recruited 64 youth aged 13-20 years (mean age 16.6 ± 2.1 years, 48% female, diabetes duration 7.5 ± 3.8 years, 41% Māori or Pacific ethnicity, HbA1c 96 ± 18 mmol/mol [10.9 ± 3.8%]). Thirty three participants were allocated to the 6-month intervention group (isCGM plus self-monitoring blood glucose [SMBG]), while the remaining 31 participants were allocated to the SMBG control group. At baseline and 6 months, participants completed seven days of actigraphy to objectively measure sleep timing and duration. They were also asked to complete the Pittsburgh Sleep Quality Index (PSQI) to assess perceptions of sleep timing and quality over the prior month.
Results: At six months, subjective measures for overall sleep quality, time taken to get to sleep, sleep duration, sleep efficiency, night-time disturbances, use of sleep medications, and daytime dysfunction were similar between the groups. Although participants using isCGM reported later average bedtimes over the prior month compared to controls, regression analyses of the actigraphy data found no strong/substantial evidence for differences in objectively measured sleep patterns between the groups after adjusting for age, school term time, and baseline sleep values.
Conclusions: Access to isCGM in addition to SMBG was not sufficient to impact on either objective or subjective measures of sleep outcomes in youth with T1D and high-risk glycaemic control and highly variable sleep patterns.