Sleep Disorders, Electronic Device Use, and Family Support: Looking for a Link in Type 1 Diabetic Adolescents Regarding Their Glycemic Control

Abstract

Background: Sleep is a key element in adolescent health and affects glycemic control in diabetic patients. Electronic device use and family support are contributing factors to sleep characteristics and glycemic management in type 1 diabetes (T1D) patients. Objectives: This study assessed the interaction between electronic device use, family support, sleep quality, and glycemic control in T1D adolescents. Methods: This cross-sectional study was conducted on T1D adolescents who attended the diabetes clinic at Besat Hospital, Hamadan, Iran, from February 2021 to February 2022. Valid Persian versions of the Pittsburgh Sleep Quality Index (PSQI) and Perceived Social Support from Family (PSS-Fa) Questionnaires were employed to measure sleep quality and family support. We used a self-report questionnaire to assess the time spent on TV, video games, and the Internet. Patients’ characteristics, including hemoglobin A1C (HbA1c) levels, were obtained during the follow-up sessions. Statistical analysis was performed using SPSS 21. Kruskal-Wallis and Dunn’s tests were applied to compare different sleep disorder groups in terms of quantitative variables. Spearman’s correlation test examined the association of PSS-Fa scores and quantitative variables. Results: We recruited 171 patients with a mean age of 12.48 ± 1.75 years. Nine patients (5.3%) had no/mild sleep disorder, 75 (43.9%) had moderate sleep disorder, and 87 (50.9%) had severe sleep disorder. HbA1c was not associated with sleep disorders (P-value = 0.476). Among electronic devices, only watching TV was associated with sleep disorders (P-value = 0.023). Perceived Social Support from Family scores were lower in adolescents with severe sleep disorders than no/mild (P-value = 0.026) and moderate (P-value = 0.029) sleep disorder groups. PSS-Fa scores correlated with the number of annual visits (P-value = 0.033; ρ = 0.164), the time since diabetes diagnosis (P-value = 0.003; ρ = -0.229), and the HbA1c level (P-value < 0.001; ρ = -0.271). Conclusions: A supportive family can contribute not only to better sleep outcomes but also to more desirable glycemic management in T1D adolescents. Digital devices might deteriorate sleep quality, but the pattern of this effect needs further investigation.