How do sleep outcomes differ between children and adolescents with type 1 diabetes and peers without diabetes? A meta-analysis and meta-regression.

This study examined differences in sleep duration (primary outcome) and sleep quality (secondary outcomes) between children and adolescents with type 1 diabetes and peers without diabetes. We searched three databases. Eligible studies included participants aged 3-20 years, with and without type 1 diabetes, reporting total sleep time and/or other sleep parameters. Random-effects meta-analyses and meta-regression were performed. Seventeen studies were included (956 with type 1 diabetes; 10,893 controls; mean age 12.7 years; 52.6% female). Total sleep time varied by assessment method, but none of the modality-specific pooled estimates were statistically significant. Actigraphy showed no clear difference (Mean Difference [MD] = -7.30 min/night, 95% CI -19.66 to 5.06; I2 = 19.58%); polysomnography suggested shorter sleep in type 1 diabetes with wide confidence intervals (MD = -19.56 min/night, 95% CI -50.39 to 11.26; I2 = 36.06%); questionnaires tended to report shorter self-reported sleep with substantial heterogeneity (MD = -21.03 min/night, 95% CI -46.79 to 4.72; I2 = 86.5%). Sleep efficiency from actigraphy was slightly lower in type 1 diabetes (MD = -0.52%, 95% CI -0.94 to -0.11; I2 = 0.31%). Other polysomnography-derived sleep variables showed no between-group differences. In conclusion, we found no robust and consistent evidence of differences in sleep duration or most objective sleep parameters between children and adolescents with type 1 diabetes and peers without diabetes across assessment methods.