Sleep Quality and Glycemic Control in Type 1 Diabetes: A Retrospective Cohort Study Using Advanced Technological Devices

Introduction/Aim: Type 1 diabetes (T1D) challenges glycemic control, with sleep disturbances affecting insulin sensitivity and glucose variability. This study aimed to observe sleep quality in T1D patients and glycemic outcomes, particularly at bedtime hours. Methods: This retrospective observational study, conducted at an Italian clinical center, included T1D patients using Medtronic devices. Sleep quality was assessed using the Italian version of the Pittsburgh Sleep Quality Index (PSQI), and glycemic outcomes were analyzed with CGM data. Descriptive statistics and non-parametric tests were applied for statistical comparisons. Results: Of 45 patients, four were excluded, leaving 41 for analysis. The mean PSQI score was 6.0 ± 4.1, with 36.6% showing poor sleep quality. No significant differences in age, sex, BMI, or diabetes duration were found. Poor sleepers had a higher time above range level 2 (TAR2) (6.3 ± 6.2%) compared to good sleepers (4.1 ± 5.0%). During bedtime hours, poor sleepers showed a significantly higher TAR2 (6.7 ± 7.2% vs. 3.3 ± 6.2%, p = 0.013). Conclusions: Poor sleep quality is associated with increased nocturnal hyperglycemia in T1D patients. Enhancing sleep quality may contribute to improved glycemic control, particularly during nighttime. Future research should explore targeted sleep interventions in diabetes care, and specific lifestyle-based healthcare programs are recommended to optimize glycemic outcomes.