Diabetes Forecast

More Sleep Improves Kids' Type 1 Management

By Andrew Curry , ,

Michelle Perfect, PhD
University of Arizona College of Education

Michelle Perfect, PhD

Associate professor and associate program director at the University of Arizona College of Education School of Psychology

Type 1 diabetes

American Diabetes Association Research Funding
Clinical Translational Research

Kids—especially those with type 1 diabetes—need sleep. And lots of it. Doctors recommend 9 to 11 hours of sleep a night through age 13; teenagers should get between 8 and 10 hours of shut-eye a night.

But most of them aren’t getting the sleep they need. Research shows that two-thirds of American children with and without diabetes sleep less than the recommended amount, whether because of early school start times, too much homework, distractions such as cell phones and TV, or something else.

For kids with type 1 diabetes, waking up in the middle of the night to check or adjust blood glucose levels presents another barrier to sound sleep. In a 2012 study, University of Arizona researcher Michelle Perfect, PhD, found that children between the ages of 10 and 16 with type 1 diabetes were sleeping just seven hours a night on average.

The consequences could be serious. In kids and adults with diabetes, research has shown that sufficient sleep is needed to help stabilize metabolic and mental processes. 

And then there are the behavioral effects of sleep-deprived brains. In addition to lower test scores and feelings of anxiety or depression in children, “sleep duration relates to their ability to engage in self-management,” Perfect says. Studies have shown, for example, that kids who aren’t getting enough sleep are less likely to do finger-stick blood glucose checks throughout the day, leading to off-target A1C numbers and an increased risk of complications.

With the help of a grant from the American Diabetes Association (ADA) and The Order of the Amaranth Diabetes Foundation, Perfect set out to see if it was possible to help kids with type 1 diabetes sleep better. Working with 111 kids with type 1 between ages 10 and 16, she used motion-sensitive bracelets for a week to track how, when, and how much they were sleeping.

The initial results surprised her. Most of the kids in her study were rarely getting eight hours of sleep on any given night. Instead, totals swung widely, from just four hours on some school nights to 14 hours on weekends. That was a red flag: The variability of sleep schedules doesn’t help kids get the deep sleep that they need.

The next step involved assessing whether more sleep was as good as a regular sleep schedule. Perfect divided the participants into two groups. The first group was told to get an hour more of sleep each night or spend 10 hours asleep, whichever was greater. The other group was told to sleep their average number of hours, but on a regular schedule—always going to bed by 10:30 p.m. and rising at 6 a.m., for example. Consultants worked with the kids and their families to adopt the sleep regimens and checked in with them regularly to see if they were sticking to their schedules.

At the end of the study, the participants in the group instructed to extend their sleep each night had increased their z’s by only 30 minutes. And kids in the group aiming for a regular sleep schedule snoozed just a few minutes more each night.

Yet, to Perfect’s surprise, both groups showed measurable improvements in blood glucose levels and improved reading ability. They also reported feeling less anxiety. “Even though they only achieved 30 minutes more, that still had measurable effects,” Perfect says.

In post-study surveys, Perfect also learned that kids couldn’t manage alone. Sixty percent told her afterward that getting the extra sleep, or sticking to a more regular schedule, would be difficult without support.

The ADA-funded study, published last year in the journal Clinical Practice in Pediatric Psychology, helped Perfect and her team win a $2 million, five-year grant from the National Institutes of Health to conduct a larger study looking at changing children’s sleep routines over a longer period of time. She hopes the data will help make sleep recommendations a standard part of diabetes care—and that more-rested kids will be healthier kids, too.

Catch More Z’s

Turn it off. Research shows the blue light from cell phones, computers, and TV screens disrupts the hormones that make you sleepy.

Parents, do a room check. Kids may be in their bedrooms but not necessarily asleep.

Establish routines. A consistent sleep schedule is helpful. Try to go to sleep and wake up at the same time every day.

Help Support Diabetes Science

If you would like to support diabetes research like the Amaranth Diabetes Foundation has done with Michelle Perfect, PhD, please go to diabetes.org/researchdonation.


Learn how estate and trust gifts made to the American Diabetes Association can change the future of diabetes. Call 888-700-7029 or e-mail plannedgiving@diabetes.org for more information.



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