Early birds have better sleep quality and emotional well-being in T1 Diabetes

Recent research in the chronotypes of people with type 1 diabetes found that the morning chronotype has better sleep quality and emotional well-being than those with evening and intermediate chronotypes. The study results were published in the journal Sleep Science.  

T1 diabetes which is common in childhood and adolescence but can occur at any age. The circadian rhythm which is a master clock controlling all the biological processes and functions is influenced by environmental cues, among which the most important being the light-dark cycle. Any disturbance in this rhythm can lead to many diseases and also diabetes. Sleep parameters, sleep disorders, chronotypes, and mood variables have been largely studied in previous studies in patients with type 2 Diabetes Mellitus (T2DM) but not many were done in T1 DM. Hence researchers conducted an observational, cross-sectional study to analyze chronotypes, sleep, and mood variables and to describe their association with some metabolic variables in T1 diabetics. 

Adults with T1DM were evaluated by various questionnaires for chronotypes by the Morningness-Eveningness Questionnaires, sleep quality by Pittsburgh Sleep Quality Index (PSQI), excessive daytime sleepiness by Epworth Sleepiness Scale (ESS), symptoms of depression by Patient Health Questionnaire - 9 (PHQ-9) and emotional well-being by Emotional Well Being Index (IWHO-5). A few metabolic variables were included. 

What was found: 

• Ninety-five patients with a mean age of 38 years (range 18–70) and an average body mass index (BMI) of 24.4 Kg/m2 participated in the study (52.6% were males). 
• Among the total, The Intermediate chronotype was predominant with 56 of the participants (55%).
• Poor quality of sleep was found in 67.4% of the sample, excessive daytime sleepiness in 14.7%, depressive symptoms in 6.3% by PHQ9, and low perception of well-being by IWHO-5 in 16.8%.
• When compared with the other chronotypes evening chronotype scored worse in sleep quality (p = 0.05) and had lower well-being (p = 0.03). 
• Higher MEQ values (morningness) correlated with lower height (p = 0.043), lower values in the PSQI (p = 0.021); and higher values in emotional well-being (p = 0.040).

Thus, the morning chronotype had a significant correlation with better sleep quality and higher scores in emotional well-being.

Key takeaways: 

• The intermediate chronotype was the most common in T1DM.
• Two-thirds reported poor sleep quality and 14.7% indicated excessive daytime drowsiness. 6.3% had a possible diagnosis of a depressive condition, and 16.8% had a poor self-perception of emotional well-being. 
• The morning chronotype was associated with improved sleep quality and higher emotional well-being ratings. 

Further reading: Valiensi SM, Folgueira AL, Diez JJ, et al. Is Being a Lark Healthier for Patients with Type 1 Diabetes Mellitus? Sleep Sci. 2023;16(1):75-83. Published 2023 Apr 19. doi: 10.1055/s-0043-1767749