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睡眠质量有负面影响。 神经行为功能此外，数据支持糖尿病患者有更多 睡眠障碍和受损的神经行为功能比没有 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解决。 糖尿病需要一项实验研究来验证睡眠时间对睡眠的直接影响。 1型糖尿病患者的血糖控制和神经行为功能所以我们的 主要研究目的是（1）测试延长睡眠时间是否能改善血糖控制， （2）评估“加强”疗程是否有助于持续睡眠时间;以及（3） 评估“加强”治疗是否可导致HbA 1c发生具有统计学和临床意义的变化， 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）将被分配至睡眠延长或对照条件。的 睡眠延长延长青少年的时间在床上，让一个健康的睡眠时间，而 控制条件不强加规定的睡眠时间表;它控制时间和注意力。 我们将测试睡眠延长对血糖控制关键指标（平均血糖）的影响 水平和在范围内的时间百分比）和次要益处（例如，生活质量，糖尿病相关 痛苦和社会情绪功能）;检查坚持的中介作用， 探索影响的生理途径（例如，心率变异性（HRV）、皮质醇水平）一次 我们的目标实现了，因果关系建立了，建议的睡眠延长 干预将促进对睡眠在糖尿病管理中的作用的认识， 提供有益的干预措施，帮助青少年T1 DM患者。

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.