Sleep and Type 1 Diabetes with Dr. Alice Gregory
Sleep plays a crucial but often underestimated role in managing Type 1 Diabetes (T1D), especially in children and teenagers. Balancing blood sugars, growth, hormones and emotional well-being becomes even more complex when sleep is disrupted-something many T1D families know all too well.
In this section, we turn to a leading sleep researcher to explore how sleep and T1D are connected. We uncover expert insights on why sleep matters, how T1D can interfere with it, and what practical steps parents can take to support healthier rest for their child or teen.
Whether your family is newly navigating night-time highs and lows or looking to improve long-term sleep quality, this expert backed Q&A is here to help.
1. Can you tell the T1D Wave Rider community about yourself and your background with sleep research?
I have conducted research into sleep for a quarter of a century now- although my perspective on sleep changed once my son was diagnosed with T1D in 2019.
2. Why is sleep duration and sleep quality so important for T1D toddlers, children and teenagers?
We spend a third of our lives asleep- which indicates just how important it is in our lives. We are learning more and more about the importance of sleep for different domains of life. Just some of those are growth and repair within the body, learning and memory and emotional regulation.
3. Are there long term developmental consequences of sleep disruptions caused by T1D early in childhood?
I think the answer is that we are not totally sure. One thing we do know is that sleep is adaptable. For example, if you are dramatically sleep deprived and finally get some rest, you will probably spend an unusually long period in certain types of sleep (e.g. deep sleep and REM sleep) and less time in others (e.g. light sleep). We want to know how adaptable sleep is in other circumstances (such as for those living with T1D).
4. How in your research have you found the use of closed-loop insulin delivery systems to affect sleep quality in young individuals newly diagnosed with T1D and their parents?
This is interesting. As someone whose son uses a closed loop insulin delivery system and has a large network of friends whose children use these insulin delivery systems, anecdotally, they are transformative for sleep. However, this is not always clear and consistently backed up by the literature. We examined sleep in young people newly diagnosed with T1D and their parents and compared those given a hybrid closed-loop insulin delivery system soon after diagnosis with those who received standard care. We found that the differences for sleep between the groups were non-significant (although there were some interesting trends in the expected direction).
Find the article here: Closed-Loop Therapy and Sleep in Young People Newly Diagnosed with T1D and Their Parents
5. What should an ideal bedtime routine include?
Consistency is key when it comes to a good bedtime routine. For example, a consistent pattern of relaxing or mundane events (e.g. for young children- a drink, quite playtime, brushing teeth, a bedtime story) will help us prepare for sleep. What seems so unfair is that people living with T1D will know how difficult it can be to follow a routine as the condition can be unpredictable. For example, if I want my son to sleep at 9pm this can be tricky if he has a hypo just before bed or is struggling with hyperglycemia which can make falling asleep tricky. My advice would be to do what you can to support your sleep but appreciated that there will be things related to diabetes that can make following sleep tips difficult- but to try to accept what can’t be changed.
I’ve worked on a few projects that I hope will help people struggling to sleep (although always consult a healthcare provider before making any changes- especially given that there may be additional factors to consider in those with diabetes when it comes to sleep).
For a book to help children relax before bedtime:
The Sleepy Pebble and Other Stories
For some sleep tips:
The Gift of Sleep: 50 Tips for a Better Night’s Rest
6. As a parent of a T1D son, with your knowledge of sleep- do you have any helpful routines, rules in place for bedtime with regard to sleep quality that would be helpful to others?
I try to follow standard advice. For example, I help light set the body clock in the day and avoid it at night, so that we do not think we should still be awake. I make sure that my son avoids caffeine and especially late in the day, etc.
One thing I want to share and I hope others will find reassuring is that I have been reading and writing about sleep for 25 years, yet I am not too worried about the inevitable poor nights associated with T1D. The main thing is to make sure you are not at risk the next day (e.g. don’t drive if sleep deprived). Sleep has been ignored in the public health arena for decades, however, it is now perhaps being over-valued. We need to get the balance right.
