Extending Sleep to Improve Glycemic Control in Pediatric Type 1 Diabetes

众所周知，健康青年的睡眠障碍对健康有负面影响。 神经行为功能。此外，数据支持糖尿病患者有更多的 睡眠障碍和神经行为功能受损比没有睡眠障碍的人 糖尿病。不幸的是，睡眠并没有在青少年的标准临床护理中得到常规的解决 糖尿病。需要一项实验研究来验证睡眠时间对 青年1型糖尿病患者的血糖控制和神经行为功能。因此，我们的 研究的主要目的是：(1)测试延长睡眠时间是否能改善血糖控制和青少年 对于T1 DM患者；(2)评估“助推器”训练是否有助于持续睡眠时间；以及(3) 评估“强化”治疗是否可以导致HbA1c在统计学上和临床上有意义的变化， 血糖控制的黄金标准。在拟议的随机研究中，多达175名青年(年龄) 10至16)具有T1 DM将被指定为睡眠延长或控制条件。这个 延长睡眠时间会延长年轻人在床上的时间，从而获得健康的睡眠时间，而 控制条件并不强加规定的睡眠时间表；它控制时间和注意力。 我们将测试睡眠时间延长对血糖控制关键指标(平均血糖)的影响 水平和时间百分比)和次级福利(例如，生活质量、与糖尿病相关的 苦恼和社会-情绪功能)；考察坚持的中介作用，以及 一次探索影响的生理途径(例如，心率变异性(HRV)、皮质醇水平) 我们的目标实现了，并建立了因果联系，拟议的延长睡眠 干预将促进对睡眠在糖尿病管理和治疗中作用的了解 提供有益的干预，帮助患有T1 DM的青少年。

It is known that sleep disturbances in healthy youth have negative effects on neurobehavioral functioning. Further, data support that individuals with diabetes have more sleep disturbances and compromised neurobehavioral functioning than individuals without diabetes. Unfortunately, sleep is not routinely addressed in standard clinical care for youth with diabetes. An experimental study is needed to verify the direct impact of sleep duration on glycemic control and neurobehavioral functioning in youth with type 1 diabetes. Therefore, our primary study aims are to (1) Test if lengthening sleep improves glycemic control and in youth with T1DM; (2) Assess if “booster” sessions can contribute to sustained sleep length; and (3) Assess if “booster” sessions can lead to statistically and clinically meaningful changes in HbA1c, the gold standard of glucose control. In the proposed randomized study, up to 175 youth (ages 10 through 16) with T1DM will be assigned to a Sleep Extension or a Control condition. The Sleep Extension lengthens youth's time in bed to allow for a healthy sleep duration, whereas the control condition does not impose a prescribed sleep schedule; it controls for time and attention. We will test the impact of sleep extension on key indices of glycemic control (average glucose levels and % time in range) and secondary benefits (e.g., quality of life, diabetes-related distress, and social-emotional functioning); examine the mediating role of adherence, and explore physiological pathways of effect (e.g., heart rate variability (HRV), cortisol levels) Once our aims are achieved and a causal link is established, the proposed Sleep Extension intervention will advance knowledge about the role of sleep in diabetes management and provide a beneficial intervention to help youth with T1DM.