0886 Impact of Multidimensional Sleep Health on Glycemic Control and Self-Reported Health Outcomes in Type 1 Diabetes

Abstract Introduction Sleep is important to health in patients with type 1 diabetes (T1D). This study comprehensively explored the impact of individual sleep dimensions, (e.g. satisfaction, alertness, timing, efficiency, duration, and regularity) as well as global multidimensional sleep health (MSH) on glycemic control and other self-reported health outcomes in T1D. Methods Data from 118 adults with T1D participating in an ongoing sleep intervention study (NCT04506151) were analyzed. Satisfaction was assessed by the Pittsburgh Sleep Quality Index and alertness by the Epworth Sleepiness Scale. Timing (sleep midpoint), efficiency, duration, and regularity (standard deviation of sleep midpoint) were derived from 7-day actigraphy. A composite MSH score was the sum of “Good” individual sleep health dimensions. Glycemic control was assessed through blinded 7-day continuous glucose monitoring (time-in-range (TIR, % of glucose levels between 70-180 mg/dL) and %CV), and hemoglobin A1C level (A1C). Self-reported outcomes (diabetes self-care and psychological factors) were collected through validated questionnaires. Multiple regression analyses were performed to determine whether individual sleep dimension and MSH scores independently predicted glycemic control or self-reported outcomes. Results Median (IQR) age was 33.87 (27.4, 43.61) years, 69.49% were female, and mean (SD) A1C was 6.74% (.93). After adjusting for covariates, only less sleep regularity was associated with poorer glycemic control [higher %CV (β=.262, p<.01), less TIR (β=-.280, p<.01) and higher A1C (β=-.175, p<.05)]. Sleep satisfaction was associated with higher diabetes quality of life (β=-.243, p<.01), lower diabetes distress (β=-.189, p<.05), lower fatigue (β=-.249, p<.01), and lower depression (β=-.211, p<.05). Daytime sleepiness was associated with higher fatigue (β=.228, p<.05), while later sleep timing was associated with higher depressive symptoms (β=.211, p<.05). Higher sleep efficiency was associated with lower anxiety and depression (β=-.305, p<.01, β=-.293, p<.01), respectively. Sleep duration was not associated with any outcomes. Higher MSH was significantly associated with higher TIR (β=.191, p<.05), lower A1C level (β=-.266, p<.01), and lower depression (β=-.211, p<.05), Diabetes self-care measures were not predicted by any individual sleep dimensions or MSH score. Conclusion Individual sleep dimensions and MSH composite score are linked to glycemic and self-reported psychological outcomes, highlighting the importance of comprehensive sleep health evaluation in T1D. Support (if any) NIH/NIDDK R01DK121726