Impact of Sleep Disturbance

on daytime function for

Parents and Children with
Type 1 Diabetes
ISPAD, Toronto, September 2014

MD PhD Peter Adolfsson, Prof Julia Lawton, Prof Roman Hovorka,

Dr David Rankin, Dr Cathy Hill, Prof Katharine Barnard

Disclosures
Great interest in technology as CSII and CGM!
Ongoing research including devices from Animas,
DANA, Dexcom, Medtronic, Omnipod and Roche
Ongoing clinical work including devices from Abbot,
Animas, DANA, Dexcom, Medtronic, Omnipod and
Roche we use all system!
One of the founders and board member of Diasend
since the start of this company

Sleep Disturbance
Sleep problems impact on a childs
physical and mental well-being as well as
that of their parent/carer
Anxiety and depression are independently
associated with poor sleep quality
Improved sleep can improve child and
family functioning essential for optimal
diabetes self-management

Impact
Poor quality or insufficient sleep in childhood
is associated with:
Increased risk of daytime behavioural
problems
Impaired learning and school performance
Emotional regulation
Immune health
Obesity risk

Objective and Methods

To explore the extent and impact of sleep
disturbance on parents of, and children
with T1DM
Systematic literature review and in-depth
interviews were conducted to explore the
experiences of parents (n=67) and
children with T1DM (n=56) across two
independent research studies; these
experiences were also compared.

Objective and Methods

The database of Diasend was used to
detect the frequency of night time
monitoring of SMBG.
Diasend is used regularly to download
meters and pumps in 98% of the pediatric
departments in Sweden

Results
Fear of nocturnal hypoglycaemia common
Parents commonly set alarms / wake
spontaneously each night to monitor bg
Parenting a child with T1DM = increased
risk of psychological stress and poor
physical health
Maternal sleep quality = mediator of effect

Results
Poor sleep in children impacts daily
function and school performance
CGM and artificial pancreas technologies
are associated with improved sleep for
some children and parents
Downsides of technology include false
alarms, size of device, lack of trust in
readings

Results
We analyzed data from Diasend
Data from pediatric units in Sweden
including 5040 children

Inclusion criteria: >200 days of data from a

glucose meter

Diasend: Frequency of families

measuring at night time 00-06
Percentage of nights per month
when SMBG was measured

0
1-9
10-19
20-29
30-39

40-49
50-59
60-69
70-79
80-89

90-100
0

10

Percentage of families

15

20

25

Diasend: Frequency of families

measuring at night time 00-06
Percentage of nights per month
when SMBG was measured

0
1-9
10-19
20-29
30-39

40-49
50-59
60-69

Only 1% of the families do not

measure SMBG at night
as the families with no diabetes

70-79
80-89

90-100
0

10

Percentage of families

15

20

25

Diasend: Frequency of families

measuring at night time 00-06
Percentage of nights per month
when SMBG was measured

0
1-9
10-19
20-29
30-39

40-49
50-59
60-69

24% of the families measure

SMBG 10-19% of the days
during a month (3-6 days)

70-79
80-89

90-100
0

10

Percentage of families

15

20

25

Diasend: Frequency of families

measuring at night time 00-06
Percentage of nights per month
when SMBG was measured

0
1-9
10-19
20-29
30-39

40-49
50-59
60-69

15% of the families is awake

measuring SMBG during 50%
of the nights

70-79
80-89

90-100
0

10

Percentage of families

15

20

25

Conclusions
Parental anxiety is common
Fear of nocturnal hypo leads to chronic
sleep disturbance
New technologies, eg CGM and artificial
pancreas have potential to reduce sleep
disturbance and improve daily functioning
Prevalence of sleep disturbance, its
impact on HbA1c, QoL and psychosocial
functioning is unclear and should be
explored

Questions?