Sleep Problems Common Among Older Adults With Long-Standing Type 1 Diabetes

An observational analysis reported in Diabetes Care examined sleep problems among 963 participants with type 1 diabetes in the DCCT/EDIC study. Participants had a mean age of 64 years and mean diabetes duration of 43 years; 52% were male. Validated questionnaires assessed obstructive sleep apnea (OSA) risk, sleep quality, and excessive daytime sleepiness, with logistic regression used to examine demographic and clinical associations.

Intermediate/high OSA risk, defined as STOP-Bang ≥3, was present in 64%; 43% had poor sleep quality and 10% had excessive daytime sleepiness. Previously diagnosed OSA and current positive airway pressure device use were reported by 29% and 19%, respectively. Each 1 percentage-point increase in current or mean HbA1c was associated with 15%–20% higher odds of any sleep problem. After adjustment for age, sex, BMI, and mean HbA1c, cardiovascular autonomic neuropathy was associated with higher odds of intermediate/high OSA risk. Albuminuria and severe hypoglycemia were associated with higher odds of poor sleep quality.

The findings support attention to sleep assessment in older adults with long-standing type 1 diabetes. Questionnaire-defined OSA risk does not establish an OSA diagnosis, and the observational associations do not demonstrate causality or show that improving glycemia would improve sleep. Only the abstract was available for this update.