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Disclosures: The authors report no relevant financial disclosures.
May 18, 2020
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Pediatric CGM use improves sleep quality for children, not parents in type 1 diabetes

Source/Disclosures
Disclosures: The authors report no relevant financial disclosures.
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A small study of young children with type 1 diabetes and their parents suggests that continuous glucose monitoring technology may improve a child’s sleep by minimizing wake periods during the night for blood glucose monitoring, whereas a parent’s sleep may be more disrupted by frequent nighttime blood glucose checks when using CGM, according to findings published in Diabetes Technology & Therapeutics.

“Technology use for diabetes management can be beneficial for families of young children, but there are special considerations when deciding to use these technologies, such as the potential impact on parent’s sleep or health-related quality of life,” Randi Streisand, PhD, CDCES, chief of the division of psychology and behavioral health at the Center for Translational Research at Children’s National Hospital and the Gerard B. Lambert Foundation Professor at George Washington University in Washington, D.C., told Healio. “Providers should consider the potential impacts that diabetes devices may have on children and parents in order to adequately support families through their decision-making process and during their transition onto devices.”

Assessing sleep data

Streisand and colleagues analyzed data from 46 parents of children aged 2 to 5 years with type 1 diabetes, recruited to participate in a larger behavioral intervention on nutrition and physical activity among young children with type 1 diabetes (88.9% mothers; 66.7% white; 36.1% girls). Participants completed a series of psychosocial questionnaires; blood glucose values were collected via downloaded blood glucose monitors of CGMs.

“Providers should consider checking in about the impact of device use on children and parents.”
A small study of young children with type 1 diabetes and their parents suggests that continuous glucose monitoring technology may improve a child’s sleep by minimizing wake periods during the night for blood glucose monitoring, whereas a parent’s sleep may be more disrupted by frequent nighttime blood glucose checks when using CGM.

As a secondary analysis within the study, 11 families consented to wear accelerometers overnight for a minimum of 4 nights to track sleep patterns (100% CGM users).

Researchers asked parents about their child’s sleep schedule and their nighttime blood glucose monitoring routine. They reported their child’s average sleep and wake times and were asked about sleep disturbances related to nighttime blood glucose monitoring.

Within the cohort, parents reported their child’s total sleep time to be an average of 10.4 hours per night, with bedtimes ranging from 7 to 11 p.m. and wake times ranging from 6 to 10 a.m.

Within the accelerometry subset, parents also reported their child’s sleep duration as an average of 10.4 hours per night. Total sleep time as measured by accelerometry indicated that children slept for an average of 9.8 hours per night, about a half-hour less than what parents of these children reported. The average bedtime, as captured by accelerometer, was 9:10 p.m. The average wake time was 7:25 a.m.

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Among the full cohort, 63% of parents reported checking their child’s blood glucose levels at least a few nights per week. Parents of children using CGMs reported a higher frequency of nighttime blood glucose monitoring compared with parents of children without a CGM (P < .05).

Researchers found that 17% of parents reported that their child’s sleep was disrupted by nighttime blood glucose monitoring, whereas 78.3% of parents reported that their own sleep was disrupted by nighttime blood glucose monitoring. More than half of parents (n = 26) reported they felt that their child typically experienced at least some daytime tiredness.

Connection between sleep, health-related quality of life

In an independent samples t test conducted to compare parent and child sleep quality and health-related quality of life among CGM users and nonusers, the researchers observed differences in both parent and child sleep disturbances from nighttime blood glucose monitoring.

“Specifically, children who used CGM experienced fewer sleep disturbances than non-CGM users, per parent report ... P < .01,” the researchers wrote. “An inverse relationship was found in parent sleep disturbances from nighttime blood glucose monitoring, indicating that parents of children on CGM experienced greater sleep disturbances ... P < .01.”

Researchers did not observe between-group differences in parent or child health-related quality of life when comparing CGM users vs. nonusers.

Researchers also observed an association between child sleep disturbance from nighttime blood glucose monitoring and greater difficulties related to the child’s diabetes symptoms (P = .04) and treatment adherence (P = .01).

“During the transition to device use, providers should consider checking in about the impact of device use on children and parents and provide strategies to parents in need of additional support,” Streisand said. “Our study was based on a relatively small sample of young children and their parents, with data collected at one time point. Further research that is longitudinal and tracks changes in sleep and health-related quality of life across the transition to technology use could lead to further clinical implications.” – by Regina Schaffer

For more information:

Randi Streisand, PhD, CDCES, can be reached at Children’s National Hospital, Center for Translational Research, 6th Floor Main, CTR, 111 Michigan Ave. NW, Washington, DC 20010; email: rstreis@childrensnational.org.

Disclosures: The authors report no relevant financial disclosures.