Background and Aims
There is a complex relationship between sleep and diabetes. Most research reported focuses on changes in insulin sensitivity and type 2 diabetes. Relationships between sleep and daytime glycemic control in people with type 1 diabetes (T1D) must be understood in a similar quantitative way to incorporate new modules into a multivariable artificial pancreas (mAP) to achieve better glycemic regulation.
Subjects with T1D ages 18-65 are monitored for the weekdays of three weeks. Each participant wore an at-home automatic sleep-staging device and a CGM. Participants maintained constant activity schedules and meal compositions across the study. Quantitative descriptive features, including insulin sensitivity, were developed with the meal, insulin and CGM data along with the corresponding previous night of sleep data. K-means clustering and linear regression was used to determine relationships between sleep characteristics and daytime glycemic control. Analysis was done across the entire group and on each individual participant.
When analyzed together, there were no common effects sleep characteristics had on daytime glycemic control. However, when analyzed individually, participants all had distinct clusters of data that showed sleep influenced their next day glycemic regulation. Furthermore, most individuals exhibited unique relationships with differing sleep quality characteristics including measures such as sleep efficiency, time in light sleep and total sleep time.
These results suggest that sleep has distinct individualized effects in people with T1D. These results show a potential need for personalized sleep effect models to be implemented in mAP systems to enhance daytime glycemic control.