It is known that sleep disturbances in healthy youth have negative effects on neurobehavioral functioning. Further, data support that individuals with diabetes have more sleep disturbances and compromised neurobehavioral functioning than individuals without diabetes. Unfortunately, sleep is not routinely addressed in standard clinical care for youth with diabetes. An experimental study is needed to verify the direct impact of sleep duration on glycemic control and neurobehavioral functioning in youth with type 1 diabetes. Therefore, our primary study aims are to (1) Test if lengthening sleep improves glycemic control and in youth with T1DM; (2) Assess if ?booster? sessions can contribute to sustained sleep length; and (3) Assess if ?booster? sessions can lead to statistically and clinically meaningful changes in HbA1c, the gold standard of glucose control. In the proposed randomized study, up to 175 youth (ages 10 through 16) with T1DM will be assigned to a Sleep Extension or a Control condition. The Sleep Extension lengthens youth's time in bed to allow for a healthy sleep duration, whereas the control condition does not impose a prescribed sleep schedule; it controls for time and attention. We will test the impact of sleep extension on key indices of glycemic control (average glucose levels and % time in range) and secondary benefits (e.g., quality of life, diabetes-related distress, and social-emotional functioning); examine the mediating role of adherence, and explore physiological pathways of effect (e.g., heart rate variability (HRV), cortisol levels) Once our aims are achieved and a causal link is established, the proposed Sleep Extension intervention will advance knowledge about the role of sleep in diabetes management and provide a beneficial intervention to help youth with T1DM.

Public Health Relevance

This research project will test a behavioral intervention to increase sleep duration in adolescents with type 1 diabetes, a developmental time period when sleep debt is abundance. A brief, cost-effective approach that can easily be infused with standards of care may lead to improvements in glycemic control, quality of life, and biomarkers that are implicated in both sleep and diabetes. If our sleep extension intervention is successful in improving outcomes in youth with T1DM, it could herald entirely new approaches in the management of this condition.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Research Project (R01)
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Biobehavioral Mechanisms of Emotion, Stress and Health Study Section (MESH)
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Linder, Barbara
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University of Arizona
Physical Medicine & Rehab
Schools of Education
United States
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Perfect, Michelle M; Beebe, Dean; Levine-Donnerstein, Deborah et al. (2016) The Development of a Clinically Relevant Sleep Modification Protocol for Youth with Type 1 Diabetes. Clin Pract Pediatr Psychol 4:227-240