LAUSR

Sleep is recognized as an important component of health for people with type 1 diabetes (T1D), with significant associations identified between sleep quality, glycemic outcomes, and diabetes self-management. Adolescents, who are particularly vulnerable to insufficient sleep and have difficulty meeting glycemic targets, typically experience differences in sleep during the summer versus school months. We examined barriers to sufficient sleep during summer and fall months amongst adolescents ages 11-17 with T1D. Adolescents (n=10, mean age 14.1 years, 40% female, 80% non-Hispanic White) with T1D participated in qualitative, semi-structured interviews to explore seasonal differences in barriers to sleep. Interviews were audio and video recorded, transcribed using Otter-AI software with manual review for accuracy, independently coded by two trained research staff, and themes were identified. Interviews were completed by five adolescents during the summer and five during school months. Barriers to achieving sufficient sleep for both time periods included diabetes-related issues (e.g. hypoglycemic episodes, glucose variability, fear of hypoglycemia, and device use), peers, activities, and family factors. School, activities, family and diabetes disruptions were equally prominent barriers during the school year, whereas diabetes disruptions were the most common barriers during the summer. While device alarms disrupted sleep at both times, adolescents reported that diabetes technologies had an overall net positive impact on sleep during the school year due to reduced worry, but a neutral impact during the summer. Adolescents agreed it would be helpful to talk about sleep concerns or ways to improve sleep. Diabetes management is a consistent reason for insufficient sleep duration in adolescents with T1D. In addition, similar to adolescents without T1D, academic, social, and family obligations were barriers to obtaining sufficient sleep during the school year. While some sleep disruptors may not be modifiable, assessment by a clinician who can provide guidance on methods to improve sleep health may be beneficial and well received. Because diabetes health care providers have frequent contact, routine visits provide an opportunity to identify sleep concerns and provide both diabetes and non-diabetes guidance to address sleep health. Further exploration of sleep behaviors and barriers in adolescents with T1D is warranted. 5-ECR-2022-1179-A-N, JDRF and Helmsley