Brief Literature Review: The Potential of Diabetes Technology to Improve Sleep in Youth With Type 1 Diabetes and Their Parents: An Unanticipated Benefit of Hybrid Closed-Loop Insulin Delivery Systems

Sleep has recently gained attention as a risk factor for higher A1C levels and problems with the management of type 1 diabetes, especially in the adolescent population (1). Sleep has also become a prime target for interventions because it has been established as a risk factor for obesity, insulin resistance, and type 2 diabetes (2), and the most recent American Diabetes Association Standards of Medical Care in Diabetes recommends that providers assess sleep quality as part of routine diabetes management (3). It is important to develop behavioral sleep-promoting interventions specific to type 1 diabetes because of the management and nocturnal issues that are unique to this disease. However, although behavioral modifications may improve sleep habits and increase sleep duration, these changes do not address the underlying physiology, including constantly fluctuating blood glucose levels and the need to make frequent treatment decisions overnight. Thus, we believe that one of the potential benefits of new hybrid closed-loop insulin delivery systems, which reduce glycemic variability by automatically adjusting basal insulin doses based on continuous glucose monitoring (CGM) readings, is a positive impact on the sleep of patients with type 1 diabetes, as well as their caregivers.