Sleep variability (variability in day-to-day sleep schedule) and insufficient sleep duration are increasingly recognized as important contributors to glycemic control in T1D. The purpose of this pilot trial was to evaluate the effects of a T1D-specific sleep optimization intervention (Sleep-Opt-In) on the outcomes of objectively measured sleep variability and duration; and glycemic parameters (glycemic control and variability) in working-age adults with T1D.
Six adults with T1D completed an 8-week T1D-Sleep-Opt-In intervention. A one-week run-in period was conducted to obtain baseline measures of sleep (actigraphy-derived duration, variability [sleep duration SD]), glycemic control (A1C, Quest®), and glucose variability (CGM-derived CV%, Abbott Libre®). T1D-Sleep-Opt-In entails a novel technology-assisted behavioral sleep intervention employing a wearable sleep tracker, didactic content, an interactive smartphone application, and brief telephone counseling. At completion (Week 8), baseline measures were repeated to determine post-intervention differences.
After the 8-week program there was a reduction in sleep variability, wakefulness after sleep onset and glycemic variability. Those with higher sleep variability (>60 min) responded better: mean sleep variability decreased 17 minutes; mean A1C decreased 0.26%, mean CV% decreased 5.7%.
This pilot study demonstrates proof of concept that those with high sleep variability may benefit from a sleep optimization intervention.