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Young children with type 1 diabetes (T1D): Sleep, health-related quality of life, and continuous glucose monitor use.

BACKGROUND
While children with T1D and their parents report significant sleep problems, few studies have focused on young children nor included health-related quality of life (HRQOL) as an outcome of sleep disturbance. Additionally, relatively little is known about the use of diabetes devices, such as continuous glucose monitors (CGM), in young children and their link with sleep disturbances. This brief report examines the relationship between sleep quality and HRQOL, and explores sleep disturbances related to CGM use in a sample of young children with T1D.


METHODS
Data are from the baseline of a behavioral intervention pilot for 46 parents of children ages 2-5 years with T1D. Parents reported on their child's sleep disturbances as a result of nighttime blood glucose monitoring (NBGM). Sleep was measured objectively in a subset of children (N=11) who wore accelerometers for a 5-day period. All parents completed measures of pediatric and parental HRQOL.


RESULTS
Greater child sleep disturbance due to NBGM was associated with lower pediatric HRQOL. Child sleep disturbances were negatively associated with parental life satisfaction. Additionally, children who used CGM experienced fewer sleep disturbances than those who did not. However, parents of children who used CGM experienced greater sleep disturbances related to a higher frequency of NBGM.


CONCLUSIONS
Pediatric and parental HRQOL were most related to child sleep disturbances by NBGM. CGM use may be associated with better child sleep, as parents are less likely to wake their child for NBGM, although CGM use may also be associated with greater sleep difficulties in parents.Future studies should further explore the relationship between sleep and technology use and impact on clinical outcomes in young children with T1D and their parents.