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Depressive and anxiety symptoms in relation to sleep architecture in children and adolescents with type 1 diabetes

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Authors: M. Jančinová 1;  M. Čiljaková 1;  J. Vojtková 1;  M. Kostková 1;  K. Pozorčiaková 1;  A. Šujanská 1;  Z. Sňahničanová 1,2;  A. Müllerová 1;  O. Chromá 1;  P. Ďurdík 1;  Peter Bánovčin 1
Authors‘ workplace: Klinika detí a dorastu JLF UK a UNM, Martin 1;  Divízia Onkológia, Martinské centrum pre biomedicínu (BioMed), JLF UK, Martin 2
Published in: Čes-slov Pediat 2019; 74 (1): 22-29.
Category:

Overview

Objectives:

Youth with type 1 diabetes (T1D) are more susceptible to develop depressive and anxiety symptoms. In combination with disturbed sleep, these conditions may significantly affect adherence to treatment. We investigated the depressive and anxiety symptoms, personality traits, sleep architecture, compensation, and duration of T1D and their possible intercorrelations in a sample of children and adolescents.

Methods:

The sample consisted of 50 subjects aged 10–18 years hospitalized at the time of research at the Pediatric Department. We used self-report validated scales for detecting depressive and anxiety symptoms. Sleep architecture was measured by single night polysomnography (PSG). The values of patients' glycated hemoglobin (HbA1c) reflecting glycemic control and disease duration was determined according to the data in the medical record.

Results:

The depressive and anxiety symptoms were detected in 28% and 27.91% subjects, respectively. The main differences between depressed and non-depressed groups included significantly longer central apnoeic events (12.24±1.69 vs 8.15±6.16, p=0.038) as well as apnoeic–hypopnoeic events (12.82±2.31 vs 8.71±5.77, p=0.045) despite the comparable HbA1c, age, and duration of T1D. In contrast to our expectations, no significant association between HbA1c and depressive (r=-0.02; p<0.05) nor anxiety (r=0.09; p<0.05) symptoms was found. Depressive and anxiety symptoms correlated on a statistically significant level (r=0.51; p<0.05). Personality trait of extraversion-introversion correlated on the moderate level with sleep parameters total sleep time (r=-0.40; p<0.05), deep sleep efficiency (r=-0.42; p<0.05), the percentage of total sleep time spent in sleep stages NREM N2 (r=0.52; p<0.05) and NREM N3 (r=-0,42; p<0.05).

Conclusion:

The longer duration of central apnoeic and apnoeic–hypopnoeic events found in youth with T1D and depressive symptoms, suggest possible role of depressive symptomatology between sleep disordered breathing and metabolic control. Further research in possible shared mechanisms underlying these conditions is needed.

Keywords:

depressive symptoms – anxiety symptoms – Personality traits – sleep

Sources
  1. Kovacs M, Goldston O, Obrosky DS, Bonar LK. Psychiatric disorders in youth with IDDM: Rates and risk factors. Diabetes Care 1997; 20 (1): 36–44.
  2. Holt RI, de Groot M, Lucki I, et al. NIDDK international conference report on diabetes and depression: current understanding and future directions. Diabetes Care 2014; 37 (8): 2067–2077.
  3. Johnson B, Eiser C, Young V, et al. Prevalence of depression among young people with type 1 diabetes: A systematic review. Diabet Med 2013; 30 (2): 199–208.
  4. Šumník Z. Novinky v dětské diabetologii. Pediatr prax 2013; 14 (6): 249–251.
  5. van Dijk M, Donga E, van Dijk JG, et al. Disturbed subjective sleep characteristics in adult patients with long-standing type 1 diabetes mellitus. Diabetologia 2011; 54 (8): 1967–1976.
  6. Alfano A, Gamble AL. The role of sleep in childhood psychiatric disorders. Child Youth Care Forum 2009; 38 (6): 327–340.
  7. Snoek FJ, Bremmer MA, Hermanns N. Constructs of depression and distress in diabetes: time for an appraisal. Lancet Diabetes Endocrinol 2015; 3 (6): 450–460.
  8. Reutrakul S, Thakkinstian A, Anothaisintawee T, et al. Sleep characteristics in type 1 diabetes and associations with glycemic control: systematic review and meta-analysis. Sleep Med 2016; 23: 26–45.
  9. Barone MT, Menna-Barreto L. Diabetes and sleep: A complex cause-and-effect relationship. Diabetes Res Clin Pract 2011; 91 (2): 129–137.
  10. van Dijk DJ. Slow-wave sleep, diabetes, and the sympathetic nervous system. Proc Natl Acad Sci U S A 2008; 105 (4): 1107–1108.
  11. Perfect MM, Patel PG, Scott RE, et al. Sleep, glucose, and daytime functioning in youth with type 1 diabetes. Sleep 2012; 35 (1): 81–88.
  12. Rewers MJ, Pillay K, de Beaufort C, et al. Assessment and monitoring of glycemic control in children and adolescents with diabetes. Pediatr Diabetes 2014; 15 (20):102–114.
  13. Rechtshaffen A, Kales A. A manual of standardized terminology and scoring system for sleep stages of human subjects. Washington, DC: National Institutes of Health, 1968: 1–57.
  14. Beck S, Marcus LC. Pediatric polysomnography. Sleep Med Clin 2009; 4 (3): 393–406.
  15. Berry RB, Budhiraja R, Gottlieb DJ, et al. Rules for scoring respiratory events in sleep: update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Deliberations of the Sleep Apnea Definitions Task Force of the American Academy of Sleep Medicine. J Clin Sleep Med 2012; 8 (5): 597–619.
  16. Kovacs M. Children‘s depression inventory CDI. In: Preiss M. Sebaposudzovacia škála depresivity pre deti CDI. Bratislava: Psychodiagnostika, 1998: 1–33.
  17. Ruisel I, Snopková N. Škála zjavnej anxiety pre deti. Bratislava: Psychodiagnostické a didaktické testy, 1975: 1–39.
  18. Müllner J, Ruisel I, Farkaš G. Dotazník na meranie úzkosti a úzkostlivosti. Bratislava: Psychodiagnostické a didaktické testy, 1980: 1–95.
  19. Senka J. B-JEPI – Eysenckov dotazník extraverzie, neuroticizmu a psychoticizmu. Bratislava: Psychodiagnostika, 1994: 1–60.
  20. Ruisel I, Müllner J. DOPEN. Bratislava: Psychodiagnostické a didaktické testy, 1982: 1–72.
  21. Evans JD. Straightforward statistics for the behavioral sciences. Pacific Grove, CA: Brooks/Cole Publishing, 1996: 1–600.
  22. Příhodová I. Poruchy spánku u dětí a dospívajících. Praha: Maxdorf, 2013: 1–152.
  23. Buchberger B, Huppertz H, Krabbe L, et al. Symptoms of depression and anxiety in youth with type 1 diabetes: A systematic review and meta-analysis. Psychoneuroendocrinology 2016; 70 (8): 70–84.
  24. Silverstein J, Klingensmith G, Copeland K, et al. Care of children and adolescents with type 1 diabetes: a statement of the American Diabetes Association. Diabetes Care 2005; 28 (1): 186–212.
  25. Sacco WP, Bykowski CA. Depression and hemoglobin A1c in type 1 and type 2 diabetes: The role of self-efficacy. Diabetes Res Clin Pract 2010; 90 (2): 141–146.
  26. Hilliard ME, Herzer M, Dolan LM, et al. Psychological screening in adolescents with type 1 diabetes predicts outcomes one year later. Diabetes Res Clin Pract 2011; 94 (1): 39–44.
  27. Pillar G, Schuscheim G, Weiss R, et al. Interactions between hypoglycemia and sleep architecture in children with type 1 diabetes mellitus. J Pediatr 2003; 142 (2): 163–168.
  28. Matyka KA, Crawford C, Wiggs L, et al. Alterations in sleep physiology in young children with insulin-dependent diabetes mellitus: Relationship to nocturnal hypoglycemia. J Pediatr 2000; 137 (2): 233–238.
  29. Caruso NC, Radovanovic B, Kennedy JD, et al. Sleep, executive functioning and behaviour in children and adolescents with type 1 diabetes. Sleep Med 2014; 15 (12): 1490–1499.
  30. Rao U. Sleep disturbances in pediatric depression. Asian J Psychiatr 2011; 4 (4): 234–247.
  31. Čiljaková M, Vojtková J, Šujanská A, et al. Kvalita spánku detí a adolescentov s diabetes mellitus 1. typu. Čes-slov Pediat 2017; 72 (1): 25–32.
  32. Estrada CL, Danielson KK, Drum ML, et al. Insufficient sleep in young patients with diabetes and their families. Biol Res Nurs 2012; 14 (1): 48–54.
  33. Villa MP, Multari G, Montesano M, et al. Sleep apnoea in children with diabetes mellitus: effect of glycaemic control. Diabetologia 2000; 43 (6): 696–702.
  34. Kostková M, Ďurdík P, Čiljaková M, et al. Short-term metabolic control and sleep in children and adolescents with type 1 diabetes mellitus. J Diabetes Complications 2018; March 22. doi: https://doi.org/10.1016/j.jdiacomp.2018.03.010 [in press].
  35. Lumeng JC, Chervin RD. Epidemiology of pediatric obstructive sleep apnoea. Proc Am Thorac Soc 2008; 5: 242–252.
  36. Bottini P, Dottorini ML, Cordoni MC, et al. Sleep-disordered breathing in nonobese diabetic subjects with autonomic neuropathy. Eur Respir J 2003; 22: 654–660.
  37. Lawson VL, Bundy C, Belcher J, et al. Mediation by illness perceptions of the effect of personality and health threat communication on coping with the diagnosis of diabetes. Br J Health Psychol 2010; 15 (3): 623–642.
  38. Wheeler K, Wagaman A, McCord D. Personality traits as predictors of adherence in adolescents with type 1 diabetes. J Child Adolesc Psychiatr Nurs 2012; 25 (2): 66–74.
  39. Rassart J, Luyckx K, Moons P, et al. Personality and self-esteem in emerging adults with type 1 diabetes. J Psychosom Res 2014; 76 (2): 139–145.
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Czech-Slovak Pediatrics

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2019 Issue 1
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