The sleep health composite and chronotype among children and adolescents with type 1 diabetes compared to case-control peers without diabetes

Abstract

Study Objectives: Our objectives were to compare sleep health composite dimensions and chronotype in children and adolescents with and without type 1 diabetes (T1D) and to explore the relationship between sleep and glycemic variability in T1D. Methods: The study comprised 84 participants with T1D aged between 6 to 18 years and age- and sex-matched controls. The sleep health composite was measured using actigraphy, sleep diaries, and self or parental reports. Sleep disturbance was evaluated using the DSM-5 Level 2 Sleep Disorders Scale Short Form. Chronotype was determined using the Children’s Chronotype Questionnaire. Results: The median total sleep health composite score for both the T1D and control groups was 3.0 (3.0–4.0) (P = .485). Sleep quality was reported as good by 89.3% of participants with T1D and 96.4% of controls (P = .072). Objective data from actigraphy indicated poor sleep quality in 56% of participants with T1D and 59.5% of controls (P = .639). Additionally, 88% of participants with T1D and 84.5% of controls had inadequate total age-appropriate sleep duration (P = .501). Among participants with T1D, those with a stable glycemic variability (coefficient of variation < 36%) had an earlier midpoint sleep (P = .008). Conclusions: Our study indicates that there are no significant differences in the sleep health composite and chronotype between children and adolescents with and without T1D. Although most participants reported good sleep quality, objective assessments indicated poor sleep quality. These findings suggest that children and adolescents may overestimate their sleep quality. Copyright 2025 American Academy of Sleep Medicine. All rights reserved.