Sleep Health and Barriers in Adolescents with Type 1 Diabetes: A Mixed-Methods Study.

IF 3.8 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM
Erin C Cobry, Emily Fivekiller, Laura Pyle, Lisa J Meltzer, Sarah S Jaser, Kasserine Taylor, Cristy Geno Rasmussen, Bennett Stewart, R Paul Wadwa
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Abstract

Introduction: Sleep health is critical for physical and mental well-being, yet adolescents with type 1 diabetes (T1D) often experience sleep disruptions due to nocturnal glucose management, fear of hypoglycemia, and device alarms. Despite evidence linking poor sleep to adverse diabetes outcomes, sleep assessment is rarely integrated into routine care.

Methods: This mixed-methods observational study evaluated sleep patterns and barriers to sleep in adolescents with T1D (ages 11-17 years) recruited from a pediatric diabetes clinic. Participants completed 7 days of actigraphy and sleep diaries, surveys assessing sleep and psychosocial factors, and diabetes device downloads. A subset completed qualitative interviews exploring sleep experiences and perceived facilitators and barriers. Quantitative analyses examined sleep duration, efficiency, and glycemic metrics; qualitative data were coded for themes.

Results: Among 70 participants, 54% did not meet American Academy of Sleep Medicine recommendations for sleep duration. The mean actigraphic sleep duration was 7.1 ± 0.9 h, with older adolescents sleeping less than younger peers (p = 0.002). Lower sleep efficiency was observed in those not achieving sufficient sleep (p = 0.011). No significant differences in glycemic outcomes were found by sleep sufficiency. Qualitative interviews (n = 31) revealed school and extracurricular demands as the most common barriers, with diabetes-related factors (e.g., nocturnal alarms) contributing to awakenings. Most adolescents reported good perceived sleep quality but expressed interest in receiving recommendations to improve sleep health.

Conclusions: Over half of adolescents with T1D fail to achieve recommended sleep duration, and qualitative findings highlight modifiable behavioral and diabetes-related barriers. Routine sleep screening and tailored interventions should be developed in efforts to address overall health in adolescents with T1D.

青少年1型糖尿病患者的睡眠健康与障碍:一项混合方法研究
背景:睡眠健康对身心健康至关重要,然而青少年1型糖尿病(T1D)患者经常由于夜间血糖管理、对低血糖的恐惧和设备警报而经历睡眠中断。尽管有证据表明睡眠不足与糖尿病的不良结局有关,但睡眠评估很少被纳入日常护理。方法:这项混合方法的观察性研究评估了从儿童糖尿病诊所招募的T1D青少年(11-17岁)的睡眠模式和睡眠障碍。参与者完成了为期7天的活动记录和睡眠日记,评估睡眠和心理因素的调查,以及糖尿病设备的下载。一部分人完成了关于睡眠经历和感知到的促进因素和障碍的定性访谈。定量分析检查了睡眠时间、效率和血糖指标;对主题进行定性数据编码。结果:在70名参与者中,54%的人没有达到美国睡眠医学学会关于睡眠时间的建议。平均活动图睡眠时间为7.1±0.9小时,年龄较大的青少年睡眠时间少于年龄较小的青少年(p=0.002)。睡眠不足者睡眠效率较低(p=0.011)。睡眠充足对血糖结果没有显著影响。定性访谈(n=31)显示,学校和课外需求是最常见的障碍,与糖尿病相关的因素(如夜间警报)也会导致醒来。大多数青少年报告了良好的睡眠质量,但表示有兴趣接受改善睡眠健康的建议。结论:超过一半的青少年糖尿病患者未能达到建议的睡眠时间,定性研究结果强调了可改变的行为和糖尿病相关障碍。应制定常规睡眠筛查和量身定制的干预措施,努力解决青少年T1D的整体健康问题。
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来源期刊
Hormone Research in Paediatrics
Hormone Research in Paediatrics ENDOCRINOLOGY & METABOLISM-PEDIATRICS
CiteScore
4.90
自引率
6.20%
发文量
88
审稿时长
4-8 weeks
期刊介绍: The mission of ''Hormone Research in Paediatrics'' is to improve the care of children with endocrine disorders by promoting basic and clinical knowledge. The journal facilitates the dissemination of information through original papers, mini reviews, clinical guidelines and papers on novel insights from clinical practice. Periodic editorials from outstanding paediatric endocrinologists address the main published novelties by critically reviewing the major strengths and weaknesses of the studies.
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