Introduction and Objective: The aim was to analyze which glycemic parameters predict sleep quality and whether sleep quality predicts psychosocial well-being.Methods: People with type 1 and type 2 diabetes rated their sleep quality daily for 17 days (range: 0-10) on a ecological momentary assessment (EMA) app. CGM was used to calculate %<70 mg/dl (TBR), %>180 mg/dl (TAR) and coefficient of variation (CV). At the 3-month follow-up, elevated depressive symptoms were assessed via the Center for Epidemiology Studies – Depression (CES-D; Cut-off: 22), and elevated distress via the Problem Areas in Diabetes (PAID) scale (Cut-off: 40). Glycemic predictors of next-night sleep quality were analyzed with multilevel regression, controlled for age, sex, diabetes type, BMI. Logistic regression analyses were calculated with elevated CES-D and PAID as dependent variables, respectively, and sleep quality as independent variable, controlled for age, sex, BMI, diabetes type and respective baseline value.Results: Data from 390 participants were analyzed (50.6% type 1 diabetes). During the EMA phase, higher TAR (-0.35; p=0.03) and higher glucose CV (-0.84; p=0.04) on the previous day significantly predicted worse sleep quality. Each point increase in mean sleep quality was associated with a 35% reduced risk of having elevated depressive symptoms at follow-up (OR=0.65, p<.001) and a 31% reduced risk of having elevated diabetes distress (OR=0.69, p<.001). Increased fluctuations in sleep quality were also predictive of elevated depressive symptoms (10% increase: OR=1.23, p=.004) and distress (OR=1.21, p=.009).Conclusion: Hyperglycemic values and fluctuations were predictive of sleep quality. Mean sleep quality and fluctuations of sleep quality were indicative of an elevated risk for worse psychosocial well-being. This highlights the importance of sleep quality for people with type 1 and type 2 diabetes.
D. Ehrmann: Advisory Panel; Dexcom, Inc. Speaker’s Bureau; Dexcom, Inc. Consultant; Roche Diabetes Care. Speaker’s Bureau; Roche Diabetes Care, Sanofi, Eli Lilly and Company, Boehringer-Ingelheim. A.J. Schmitt: None. L.Y. Klinker: None. B. Kulzer: Advisory Panel; Abbott, Dexcom, Inc. Consultant; Becton, Dickinson and Company. Other Relationship; Insulet Corporation, AstraZeneca. Board Member; Sanofi-Aventis Deutschland GmbH. Advisory Panel; Roche Diabetes Care, Novo Nordisk. N. Hermanns: Advisory Panel; Dexcom, Inc., Abbott Diagnostics. Speaker’s Bureau; Abbott Diagnostics. Advisory Panel; Roche Diabetes Care.
German Center for Diabetes Research (DZD) (FKZ 82DZD01102, FKZ 82DZD11E03)
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