Sleep disturbances remain common in adults with type 1 diabetes (T1D), although evidence supporting sleep-focused behavioral interventions for glycemic improvement remains limited. A randomized controlled trial published in Diabetes Care evaluated whether a structured behavioral sleep intervention could improve glycemic, sleep, and psychological outcomes in adults with T1D.

The analysis included 144 adults with T1D and either short sleep duration (<6.5 hours/night) or irregular sleep patterns, defined as sleep duration variability of at least 1 hour. Participants were randomly assigned to either Sleep-Opt (n=73) or the Healthy Living attention control intervention (n=71), both delivered remotely in eight sessions over 12 weeks.

Primary outcomes included A1C, continuous glucose monitoring (CGM) parameters, and objective sleep measures assessed at baseline and at 6, 12, and 24 weeks, with 12 weeks designated as the primary endpoint.

Findings

• No significant between-group differences were observed in overall A1C levels or continuous glucose monitoring (CGM) parameters at 12 weeks.
• No significant between-group differences were observed in objective sleep outcomes across follow-up visits.
• Sleep duration increased at 6 weeks in both intervention groups.
• Participants receiving Sleep-Opt demonstrated reduced diabetes distress at 6 weeks (median difference −0.18; 95% CI, −0.35 to −0.01).
• Subjective sleep quality improved at 6 weeks with Sleep-Opt.
• At 12 weeks, participants in the Sleep-Opt group with baseline A1C ≥7% demonstrated lower A1C levels than those in the Healthy Living group (marginal mean difference −0.32%; 95% CI, −0.64% to −0.005%; P=0.047).

The findings suggest that sleep-focused behavioral interventions may not improve overall glycemic outcomes in adults with T1D and insufficient or irregular sleep, although modest A1C benefits were observed among participants with baseline A1C ≥7%.