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Depressive and anxiety symptoms in relation to sleep architecture in children and adolescents with type 1 diabetes

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Authors: M. Jančinová 1;  M. Čiljaková 1;  J. Vojtková 1;  M. Kostková 1;  K. Pozorčiaková 1;  A. Šujanská 1;  Z. Sňahničanová 1,2;  A. Müllerová 1;  O. Chromá 1;  P. Ďurdík 1;  P. Bánovčin 1
Authors‘ workplace: Klinika detí a dorastu JLF UK a UNM, Martin 1;  Divízia Onkológia, Martinské centrum pre biomedicínu (BioMed), JLF UK, Martin 2
Published in: Čes-slov Pediat 2019; 74 (1): 22-29.
Category:

Overview

Objectives:

Youth with type 1 diabetes (T1D) are more susceptible to develop depressive and anxiety symptoms. In combination with disturbed sleep, these conditions may significantly affect adherence to treatment. We investigated the depressive and anxiety symptoms, personality traits, sleep architecture, compensation, and duration of T1D and their possible intercorrelations in a sample of children and adolescents.

Methods:

The sample consisted of 50 subjects aged 10–18 years hospitalized at the time of research at the Pediatric Department. We used self-report validated scales for detecting depressive and anxiety symptoms. Sleep architecture was measured by single night polysomnography (PSG). The values of patients' glycated hemoglobin (HbA1c) reflecting glycemic control and disease duration was determined according to the data in the medical record.

Results:

The depressive and anxiety symptoms were detected in 28% and 27.91% subjects, respectively. The main differences between depressed and non-depressed groups included significantly longer central apnoeic events (12.24±1.69 vs 8.15±6.16, p=0.038) as well as apnoeic–hypopnoeic events (12.82±2.31 vs 8.71±5.77, p=0.045) despite the comparable HbA1c, age, and duration of T1D. In contrast to our expectations, no significant association between HbA1c and depressive (r=-0.02; p<0.05) nor anxiety (r=0.09; p<0.05) symptoms was found. Depressive and anxiety symptoms correlated on a statistically significant level (r=0.51; p<0.05). Personality trait of extraversion-introversion correlated on the moderate level with sleep parameters total sleep time (r=-0.40; p<0.05), deep sleep efficiency (r=-0.42; p<0.05), the percentage of total sleep time spent in sleep stages NREM N2 (r=0.52; p<0.05) and NREM N3 (r=-0,42; p<0.05).

Conclusion:

The longer duration of central apnoeic and apnoeic–hypopnoeic events found in youth with T1D and depressive symptoms, suggest possible role of depressive symptomatology between sleep disordered breathing and metabolic control. Further research in possible shared mechanisms underlying these conditions is needed.

Keywords:

depressive symptoms – anxiety symptoms – Personality traits – sleep

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