Madrid-Valero, J.J.; Ware, Julia; Allen, Janet M; Boughton, Charlotte K; Hartnell, Sara; Wilinska, Malgorzata E; Thankamony, Ajay; de Beauforte, Carine; Schierloh, Ulrike; Campbell, Fiona M; Sibayan, Judy; Bocchino, Laura E; Kollman, Craig; Hovorka, Roman and Gregory, Alice M.. 2023. Sleep quality and quantity in caregivers of children with type 1 diabetes using closed-loop insulin delivery or a sensor-augmented pump. Pediatric Diabetes, 2023, 7937007. ISSN 1399-543X [Article]

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Abstract or Description

Introduction: Parents of children living with type 1 diabetes (T1D) often report short and/or poor quality sleep. The development of closed-loop systems promises to transform the management of T1D. This study compared sleep quality and quantity in caregivers of children using a closed-loop (CL) system or sensor augmented pump (SAP) therapy.

Method: Data from sleep diaries, accelerometers and questionnaires were provided by forty parents (classified as caregiver 1 [main analyses] or 2 [supplementary analyses] based on their contribution towards treatment management) of 21 very young children aged 1 to 7 years living with T1D (mean age 4.7 [SD=1.7]). Assessments were made at a single post-randomisation time-point when the child was completing either the 16-week CL arm (n=10) or the 16-week SAP arm (n=11) of the main study.

Results: Overall, there was a mixed pattern of results and group differences were not statistically significant at the p<.05 level. However, when we consider the direction of results and results from caregiver 1, sleep diary data showed that parents of the CL (as compared to the SAP) group reported a shorter sleep duration, but better sleep quality, fewer awakenings and less wake after sleep onset (WASO). Actiwatch data showed that caregiver 1 of the CL (as compared to the SAP) group had a: shorter sleep latency; greater sleep efficiency; and less wake-after-sleep-onset. Results from the Pittsburgh Sleep Quality Index also showed better sleep quality for caregiver 1 of the CL group as compared to the SAP group.

Conclusions: Results from this study suggest that sleep quality and quantity in parents of children using CL was not significantly different to those using SAP. Considering effect sizes and the direction of the non-significant results, CL treatment could be associated with better sleep quality in the primary caregiver. However, further research is needed to confirm these findings.

Item Type:	Article
Identification Number (DOI):	https://doi.org/10.1155/2023/7937007
Additional Information:	The main KidsAP02 study was funded by the European Commission within the Horizon 2020 Framework Programme under the grant agreement number 731560. Additional support for the artificial pancreas work from National Institute for Health Research Cambridge Biomedical Research Centre, and JDRF (22-2013-266 and 2-RSC-2019-828-M-N). Dexcom supplied discounted continuous glucose monitoring devices.
Data Access Statement:	Data availability: The data that support the findings of this study are available from the corresponding author, [RH], upon reasonable request.
Keywords:	Artificial pancreas, Caregivers, Children, Closed-loop, Parents, Sleep, Type 1 diabetes
Departments, Centres and Research Units:	Psychology
Dates:	Date Event 19 May 2023 Accepted 13 June 2023 Published Online
Item ID:	33528
Date Deposited:	19 May 2023 11:51
Last Modified:	10 Aug 2023 13:51
Peer Reviewed:	Yes, this version has been peer-reviewed.
URI:	https://research.gold.ac.uk/id/eprint/33528

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