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Sleep disorder and behavior problems in children with type 1 diabetes mellitus

  • Evin Ilter Bahadur ORCID logo EMAIL logo , Şervan Özalkak ORCID logo , Asena Ayça Özdemir ORCID logo , Semra Çetinkaya ORCID logo and Elif Nursel Özmert ORCID logo
Published/Copyright: October 28, 2021
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 35 Issue 1

Abstract

Objectives

To examine sleep and behavior problems in children with type 1 Diabetes Mellitus (T1DM) compared to nondiabetic controls in a bridging country between east and west and to evaluate the interaction of sleep on behavior problems, maternal sleep, and maternal depressive symptoms.

Methods

The study included children with T1DM (4–12 years old) and age/sex-matched healthy controls. Parents completed the Children Sleep Habits Questionnaire (CSHQ), Children Behavior Checklist/4–18 (CBCL/4–18), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), and a study-specific sociodemographic questionnaire. Clinical parameters regarding T1DM were collated from medical records.

Results

Participants included 75 children with T1DM and 49 controls. Based on CSHQ results 65.3% of all participants in both groups had sleep problems. Children with T1DM slept less and had higher daytime sleepiness problems than controls (p=0.024, p=0.008, respectively). No association was found between CSHQ or sleep duration and mode of diabetes treatment (pump, multiple daily injections) or glycemic control. CSHQ correlated with maternal PSQI (r=0.336 p=0.004) and BDI (r=0.341 p=0.004) in children with T1DM, but there was no association amongst controls. Children with T1DM had higher internalizing problems compared to controls. CSHQ and BDI correlated with internalizing, externalizing, and the total scores of the CBCL/4–18 in children with T1DM (R2=0.260 p<0.001; R2=0.207 p<0.001, R2=0.381 p<0.001 respectively). In controls, only BDI was associated with internalizing, externalizing, and the total scores of the CBCL/4–18.

Conclusions

Children with T1DM should be evaluated for sleep pattern and quality at follow-up, to identify those at risk for behavior problems and improve maternal life quality. Large longitudinal studies are necessary to assess the effect of new diabetes treatment modalities on sleep.

Keywords: behavior problems; children with type 1 diabetes mellitus; maternal mental health; maternal sleep quality; sleep problems
Corresponding author: Evin Ilter Bahadur, Department of Pediatrics, Division of Developmental Pediatrics, Hacettepe University Faculty of Medicine, Ankara, 06100, Turkey, Phone: +90 312 305 18 59, Fax: +903123118226, E-mail:

  1. Research funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

  2. Author contributions: Ilter Bahadur E. concepted and designed the study; contributed to drafting the article and revising it critically for important intellectual content, Ozalkak S. contributed acquisition of data, drafting the article, Ozdemir A A. contributed to analysis and interpretation of data; drafting the article, Ozmert E N and Çetinkaya S contributed to analysis and interpretation of data; revising it critically for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  3. Conflict of interest: The authors have no other financial relationships or conflicts of interest relevant to this article to disclose.

  4. Informed consent: Informed consent was obtained from all individuals included in this study. This was a case-control study and it was conducted in a single health clinic, in Ankara, Turkey.

  5. Ethics Committee Approval: Approved by the Medical Ethics Committee of the University of Health Science, Gaziyaşargil Education, and Research Hospital, registration number: 548.

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Received: 2021-08-05
Accepted: 2021-10-11
Published Online: 2021-10-28
Published in Print: 2022-01-27

© 2021 Walter de Gruyter GmbH, Berlin/Boston

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  21. Two Japanese siblings with arginase-1 deficiency identified using a novel frameshift mutation of ARG1 (p.Lys41Thrfs∗2)
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https://doi.org/10.1515/jpem-2021-0523
Keywords for this article
behavior problems; children with type 1 diabetes mellitus; maternal mental health; maternal sleep quality; sleep problems

Articles in the same Issue

  1. Frontmatter
  2. Review Article
  3. Medullary thyroid carcinoma in children: current state of the art and future perspectives
  4. Original Articles
  5. Newly defined peroxisomal disease with novel ACBD5 mutation
  6. Pediatric adrenocortical tumors cohort characteristics and long-term follow-up at a single Argentinian tertiary center
  7. Sleep disorder and behavior problems in children with type 1 diabetes mellitus
  8. Increased hepcidin levels and non-alcoholic fatty liver disease in obese prepubertal children: a further piece to the complex puzzle of metabolic derangements
  9. Screening for testicular adrenal rest tumors among children with congenital adrenal hyperplasia at King Fahad Medical City, Saudi Arabia
  10. The association between vitamin D levels and metabolic syndrome components among metropolitan adolescent population
  11. Utility of wrist circumference in recognition of metabolic syndrome in overweight and obese South Indian children and adolescents
  12. Ketoacidosis in new-onset type 1 diabetes: did the severity increase during the COVID-19 pandemic?
  13. Predictors of decreased bone mineral density in childhood systemic lupus erythematosus: possible role of osteoprotegerin gene polymorphisms
  14. Psychiatric behavioral effect and characteristics of type 2 diabetes mellitus on Japanese patients with Prader-Willi syndrome: a preliminary retrospective study
  15. Biochemical predictors of metabolically unhealthy obesity in children and adolescents
  16. Adiposity rebound in very-low-birth-weight infants
  17. The association between a metabolically healthy overweight/obesity phenotype and markers of inflammation among Chinese children and adolescents aged 10–18 years
  18. Case Reports
  19. Management of perinatal HPP during critical illness/ECMO
  20. Wolfram-like syndrome – another face of a rare disease in children
  21. Two Japanese siblings with arginase-1 deficiency identified using a novel frameshift mutation of ARG1 (p.Lys41Thrfs∗2)
  22. An atypical presentation of a pathogenic STK11 gene variant in siblings not fulfilling the clinical diagnostic criteria for Peutz-Jeghers Syndrome
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