Sleep for Caregivers and Children with Type 1 Diabetes impacted!

What is life like for both Parent and Child – if Child has Type 1 Diabetes and sleep is disrupted?

Research suggests that parental sleep is disrupted by daily diabetes care, including checking BG levels to prevent nocturnal hypoglycemia, co-sleeping, and stress and anxiety related to children’s health . Child sleep may also be directly impacted by nighttime BG monitoring and treatment of hypoglycemic or hyperglycemic episodes.  In addition to nighttime caregiving, other correlates related to sleep and diabetes care should be explored. For example, more intensive regimens (such as multiple daily injections/basal-bolus) and tighter glycemic control increase the risk for frequent and prolonged nocturnal hypoglycemia in young children and, therefore, may be associated with sleep disruption.

Sufficient sleep is critical for young children’s healthy development, and chronic sleep disturbances have been associated with increased emotional, behavioral, and academic problems.  Estimates suggest that up to 40% of typically developing young children. Children with chronic illness may be at particular risk for sleep disruptions due to exacerbation of symptoms (e.g. epilepsy, asthma), increased pain and discomfort (e.g. atopic dermatitis), or nighttime caregiving behaviors related to illness management (e.g. ventilator-dependent. As discussed, young children with type 1 diabetes may experience acute complications at night and parents may perform related nighttime caregiving, including checking BG levels and treating hypoglycemia; however, child sleep habits in this population have not been explored to date.

Additionally, child sleep and parent sleep are likely interrelated. In a typically developing population, child sleep disruptions are a significant predictor of maternal sleepiness and stress, and increased maternal stress is predictive of increased child sleep problems. However, less is known about the relationships among child sleep, parent sleep, and parent psychosocial functioning in young children with type 1 diabetes.

It is predicted that parents and their children with type 1 diabetes would experience significant sleep problems, and that more frequent child sleep problems would be associated with greater parental stress, anxiety, and depressive symptoms. It was also predicted that increased child sleep problems, including behavioral insomnia and bedtime resistance, would be related to better glycemic control (i.e., lower hemoglobin A1c) and a more intensive insulin regimen.