Abstract
Objective
We investigated intra-individual reciprocal associations between sleep health dimensions
(individual and composite) and symptoms among young adults with type 1 diabetes (T1D).
Design and measurements
Cross-lagged multilevel models were used to analyze electronic diary-reported sleep
and symptom patterns over 7 days at waketime in 42 young adults with T1D. Sleep health
dimensions included regularity, satisfaction, alertness, timing, efficiency (percentage of time spent asleep), and duration (total sleep time) and symptoms included mood, fatigue, and pain. Covariates included biological sex and age.
Setting and participants
We recruited young adults (mean age 21.5 ± 2.1 years, HbA1c 6.8%, 85% female, 10%
gender minority) with T1D for at least 6 months and no other major medical or psychiatric
comorbidity from social media platforms, the College Diabetes Network, and ResearchMatch.
Results
On days with a better sleep health composite, participants reported lower next-day
symptoms (higher mood, lower fatigue, and lower pain) and on days when participants
reported lower symptoms, participants reported better sleep health (as a composite).
Several individual sleep health dimensions led to lower next-day symptoms (eg, higher
satisfaction, alertness, and efficiency and higher mood); however, symptoms were no
longer predictive of next-day sleep when controlling for prior day sleep.
Conclusions
Optimal sleep health is an antecedent of fewer next day symptoms. Sleep health dimensions
likely have positive additive effects on lower symptoms as some of the individual
sleep health dimensions were not significantly associated with some symptoms among
young adults with T1D.
Keywords
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Article info
Publication history
Published online: December 23, 2022
Accepted:
November 7,
2022
Received in revised form:
October 6,
2022
Received:
May 6,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.
