Let Sleeping Teens Lie

Sleep deprived teens with diabetes have more trouble with blood sugar school and behavior

(RxWiki News) Teenagers with Type 1 diabetes may not be getting enough quality sleep, leading to higher blood sugar levels and academic and behavior problems.

A recent study revealed that diabetic teens generally don't get as much good, deep sleep compared to teenagers without diabetes.

This poorer sleep was associated with less control over their blood sugar levels, poorer performance on standardized tests, symptoms of depression and an overall lower quality of life, according to the study results.

"Diabetic teens especially need a good night's sleep."

Lead investigator Michelle Perfect, PhD, from the Department of Disability and Psychoeducational Studies at the University of Arizona - Tucson, and her coauthors recommend in the paper that doctors ask young diabetics about their sleeping habits and help ensure they are getting enough good quality sleep.

Almost a third of the youth exhibited mild or moderate symptoms of sleep apnea, but even these mild conditions were associated with higher blood sugar levels and increased emotional and behavioral difficulties based on the reports of the teens' parents.

"This study substantiates what has been found in adults as far as sleep apnea being associated with elevated insulin resistance," said William Kohler, MD, director of the Florida Sleep Institute and director of Pediatric Sleep Services at Florida Hospital, Tampa, in speaking with dailyRx.

"The more we look into the adverse effects of sleep, the more we realize it affects all our bodily systems and significant medical problems such as diabetes," Kohler said.

Perfect and her colleagues used in-home sleep study equipment readings and questionnaires to compare the sleep patterns, sleeping habits, school records, emotional health and daytime behavior of two groups of teens, aged 10 to 16.

The characteristics and sleeping data from a group of 50 youths with Type 1 diabetes were compared to a control group with similar age, sex and weight demographics.

The researchers did not control for race or ethnicity across the two groups, and they did not control for insulin dosage among those in the diabetic group.

The diabetic teens spent more time in the first and second stages of sleep and less time in the third, deeper stage of sleep than the nondiabetic teens did.

More time in the second stage of sleep was "related to hyperglycemia, behavioral difficulties, reduced quality of life, lower grades, depression, sleep-wake behavior problems, poor sleep quality, sleepiness and lower state standardized math scores," according to the paper.

The researchers also established a correlation between sleepiness or poor sleep habits and lower grades, lower reading scores, a depressed mood and a reduced quality of life using a standard quality of life diagnostic survey.

Because diabetic children are already at-risk for school-related problems, the researchers pointed out in the paper, more research should be done to determine how sleep is affecting young diabetics' ability to perform well in school.

Kohler echoed one of the conclusions of the study, saying that both children and adults with diabetes should be screened for potential sleeping problems.

The study, which was funded by the Father's Day Council in Tuscon, Arizona, and the University of Arizona Foundation Faculty Small Grants Program, appears in the January issue of the journal Sleep.

Johnson and Johnson donated some of the equipment used in the study, and three doctors in the study have received research support from Dyomid Corporation and Lilly. One has received research support from Phillips/Respironics. The authors have indicated no financial conflicts of interest.

Review Date: 
January 3, 2012