Fear of hypoglycaemia and parent sleep disturbance in families of young children with type 1 diabetes

BACKGROUND: Parents of young children with type 1 diabetes (T1D) commonly report fear of hypoglycaemia (FH), which may prompt night-time vigilance and disrupt sleep. We examined whether FH relates to parent-reported sleep disturbance using baseline (pretreatment) data from a multisite randomized clinical trial. We also evaluated whether these associations remain after accounting for other parent concerns and child demographic and device covariates. METHODS: Parents of children ages 2-7 years (N = 180) completed questionnaires assessing FH (HFS-PYC), sleep disturbance (PROMIS-S), diabetes distress (PAID-PR), anxiety (PROMIS-A) and depressive symptoms (CESD-R). We collected demographic and clinical data and obtained 14-day continuous glucose monitoring (CGM) downloads from young children when available. We used Pearson correlations, partial correlations and multiple regression models to test FH-sleep associations. RESULTS: Parents reported slightly elevated sleep disturbance (M = 57.9 ± 8.1). Higher FH total, worry and hypoglycaemia avoidance behaviour scores showed positive associations with sleep disturbance in unadjusted models (all p < 0.05). After adjusting for anxiety, diabetes distress and elevated depressive symptoms, FH total and worry scores continued to predict sleep disturbance, whereas hypoglycaemia avoidance behaviours did not. In regression analyses, FH total, diabetes distress and elevated depressive symptoms each uniquely predicted sleep disturbance; anxiety and child clinical/device characteristics did not. In the CGM subset, parent sleep disturbance did not relate to children's glycaemic metrics. CONCLUSIONS: FH, particularly worry-driven FH, independently contributes to parent sleep disturbance in families of very young children with T1D. Screening for FH and offering interventions targeting FH worry may help improve parent sleep.