Quality of sleep in children and adolescents with type 1 diabetes

Czech version

Authors: M. Čiljaková ^1,2; J. Vojtková ¹; A. Šujanská ¹; M. Michalovičová ¹; K. Pozorčiaková ¹; Z. Sňahničanová ¹; M. Jančinová ¹; P. Ďurdík ¹; Peter Bánovčin ¹
Authors‘ workplace: Klinika detí a dorastu JLF UK a UNM, Martin ¹; Detské oddelenie NEDÚ, Ľubochňa ²
Published in: Čes-slov Pediat 2017; 72 (1): 25-32.
Category: Original Papers

Overview

Introduction:
In aspect of the influence of quantity and quality of sleep on metabolic control of type 1 diabetes (T1D) the works extended in last years, but data are limited in childhood. In 2016 meta-analysis revealed that children with type 1 diabetes slept shorter than their peers. Conclusions were not done in aspect of sleep quality and presence of sleep disordered breathing.

Goal:
The aim of work was to examine sleep quality by polysomnographic examination in the group of children with type 1 diabetes and to determine the influence of short-term and long-term metabolic compensation (HbA1c) on sleep quality in children with type 1 diabetes.

Methods:
44 children (28 girls and 16 boys) aged 10–18 years with type 1 diabetes were included to the study after exclusion of children with hypoglycemia before and during polysomnography. The group was divided into two subgroups, The first group (n=23) consisted from children with sub-optimal metabolic control of diabetes (HbA1c 7.5–9%), while children with non-optimal control of diabetes (HbA1c ≥9%) were included to the second group. The subgroups did not differ in aspect of anthropometric parameters and diabetes duration. Results of continuous glucose monitoring and polysomnographic examinations were analysed in subgroups.

Results:
We did not find significant difference in parameters of sleep latency, sleep effectivity, percentage of time spended in NREM N1, NREM N3, AHI and OAHI. Children with worse metabolic control of type 1 diabetes (HbA1c ≥9%) spent significantly more time in sleep stage of NREM N2 (51.352% vs. 45.565%, p=0.008), significantly less time in sleep stage of REM (15.990% vs. 19.052%, p=0.011) and had significantly lower effectivity of deep sleep (45.114% vs. 49.913%, p=0.028) comparing to children with long-term better metabolic control of diabetes. Obstructive sleep apnoe (OSA) was diagnosed in only one patient, 9 children had mild degree of central sleep disordered breathing.

Conclusion:
Children with non-optimal metabolic control of T1D spent more time in sleep stage of NREM N2 and had significantly decreased effectivity of deep sleep NREM N3. Approximatelly one fifth of children with T1D had mild central disordered breathing, the prevalence of OSA was comparable with general pediatric population. We did not find difference in the occurance of sleep disordered breathing in relation to compensation of T1D in children and adolescents.

Key words:
T1D, metabolic compensation, quality of sleep, effectivity of deep sleep, OSA

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