Publication: Tip 1 diyabetli çocuk ve ergenlerde uyku düzeni, diyabet olmayan kontrol akranlarıyla karşılaştıran vaka-kontrol çalışması
Abstract
Amaç: Bu çalışmanın amacı, tip 1 diyabeti (T1D) olan ve olmayan sağlıklı kontrol akranlarıyla uyku sağlığı bileşenlerini ve kronotipi karşılaştırmak ve bu uyku parametreleri ile T1D'deki glisemik değişkenlik arasındaki ilişkiyi incelemektir. Gereç ve Yöntem: Çalışmaya yaşları 6-18 yıl arasında değişen 84 T1D’si olan katılımcı ile yaş ve cinsiyete göre eşleştirilmiş 84 sağlıklı katılımcı dahil edildi. Uyku sağlığı bileşenleri aktigrafi cihazı, uyku günlükleri ve öz veya ebeveyn beyanı kullanılarak ölçüldü. Uyku bozukluğu DSM-5 Düzey-2 Uyku Bozuklukları Ölçeği Kısa Formu ile değerlendirildi. Sirkadiyen tercih Çocukluk Dönemi Kronotipi Anketi ile belirlendi. Glisemik değişkenlik sürekli glukoz izlem (SGİ) parametreleri ile değerlendirildi. Bulgular: T1D ve kontrol grubunun uyku sağlığı bileşenleri ortanca toplam puanı 3,0 (3,0-4,0) olup iki grup arasında anlamlı bir fark görülmedi (p=0,485). Uyku kalitesi, T1D’si olan katılımcıların %89,3’ünde ve kontrol grubunun ise %96,4’ünde iyi olarak beyan edildi (p=0,072). Aktigrafiden elde edilen objektif verilere göre ise T1D’si olan katılımcıların %56’sının ve kontrol grubunun %59,5’inin kötü uyku kalitesine sahip olduğu saptandı (p=0,639). T1D’si olan katılımcıların %88,1'inin (n=74) ve sağlıklı katılımcıların %84,5'inin (n=71) yaşa göre önerilen sürenin altında uyuduğu tespit edildi (p=0,501). Sirkadiyen tercih her iki grubun yaklaşık %50'sinde ara formda gözlendi (p=0,121). T1D’si olan katılımcılar arasında, stabil glisemik değişkenliğe (glisemik dalgalanma katsayısı [CV] <%36) sahip olanlar daha erken bir orta nokta uykusuna sahipti (p=0,008). Ayrıca, glisemik değişkenliğin (CV) ara forma kıyasla akşamcıllarda daha yüksek olduğu gözlendi (p=0,024). Sonuç: Bulgularımız, tip 1 diyabeti olan ve olmayan çocuk ve ergenlerde uyku sağlığı bileşenlerinin ve sirkadiyen tercihin farklı olmadığını göstermektedir. Uyku kalitesi, katılımcıların çoğunda subjektif olarak iyi olarak beyan edilmesine rağmen, objektif kriterlere göre incelendiğinde çoğunlukla kötü olduğu saptanmıştır. Bu tutarsızlık, çocukların ve ergenlerin kötü uyku kalitesi düzeylerini gerçekte olduğundan daha hafife alabileceklerini düşündürmektedir.
Objective: Our objectives were to compare sleep health composite dimensions and chronotype in children and adolescents with and without type 1 diabetes (T1D) and to explore the relationship between sleep and glycemic variability in T1D. Materials and Methods: The study comprised 84 participants with T1D aged between 6 and 18 years, matched by age and sex with 84 healthy participants. The sleep health composite was measured using actigraphy, sleep diaries, and self or parental reports. Sleep disturbance was evaluated using the DSM-5 Level 2 Sleep Disorders Scale Short Form. Chronotype was determined using the Children’s Chronotype Questionnaire. Glycemic variability was assessed using continuous glucose monitoring (CGM). Results: The median total sleep health composite score for both the T1D and control groups was 3.0 (3.0-4.0), with no significant difference between the two groups (p=0.485). Sleep quality was reported as good by 89.3% of participants with T1D and 96.4% of controls (p=0.072). Objective data from actigraphy indicated poor sleep quality in 56% of participants with T1D and 59.5% of controls (p=0.639). Additionally, 88% (n=74) of participants with T1D and 84.5% (n=71) of controls had inadequate total age-appropriate sleep duration (p=0.501). Approximately 50% of both groups exhibited an intermediate circadian preference (p=0.121). Among participants with T1D, those with a stable glycemic variability (coefficient of variation [CV] <%36) had an earlier midpoint sleep (p=0.008). Furthermore, CV was higher in the evening types compared to the intermediate types (p=0.024). Conclusion: Our study indicates that there are no significant differences in the sleep health composite and chronotype between children and adolescents with and without T1D. Although most participants reported good sleep quality, objective assessments indicated poor sleep quality. These findings suggest that children and adolescents may overestimate their sleep quality.
Objective: Our objectives were to compare sleep health composite dimensions and chronotype in children and adolescents with and without type 1 diabetes (T1D) and to explore the relationship between sleep and glycemic variability in T1D. Materials and Methods: The study comprised 84 participants with T1D aged between 6 and 18 years, matched by age and sex with 84 healthy participants. The sleep health composite was measured using actigraphy, sleep diaries, and self or parental reports. Sleep disturbance was evaluated using the DSM-5 Level 2 Sleep Disorders Scale Short Form. Chronotype was determined using the Children’s Chronotype Questionnaire. Glycemic variability was assessed using continuous glucose monitoring (CGM). Results: The median total sleep health composite score for both the T1D and control groups was 3.0 (3.0-4.0), with no significant difference between the two groups (p=0.485). Sleep quality was reported as good by 89.3% of participants with T1D and 96.4% of controls (p=0.072). Objective data from actigraphy indicated poor sleep quality in 56% of participants with T1D and 59.5% of controls (p=0.639). Additionally, 88% (n=74) of participants with T1D and 84.5% (n=71) of controls had inadequate total age-appropriate sleep duration (p=0.501). Approximately 50% of both groups exhibited an intermediate circadian preference (p=0.121). Among participants with T1D, those with a stable glycemic variability (coefficient of variation [CV] <%36) had an earlier midpoint sleep (p=0.008). Furthermore, CV was higher in the evening types compared to the intermediate types (p=0.024). Conclusion: Our study indicates that there are no significant differences in the sleep health composite and chronotype between children and adolescents with and without T1D. Although most participants reported good sleep quality, objective assessments indicated poor sleep quality. These findings suggest that children and adolescents may overestimate their sleep quality.