{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T22:36:02Z","timestamp":1781130962677,"version":"3.54.1"},"reference-count":36,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T00:00:00Z","timestamp":1750204800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009477","name":"Lottery Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009477","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100019168","name":"Starship Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100019168","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To assess how automated insulin delivery (AID) impacts sleep in young people with type 1 diabetes and suboptimal glycaemia (HbA1c\u2009\u2265\u200969\u2009mmol\/mol).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a randomised controlled trial comparing AID to usual care in 80 participants (aged 7\u201325\u2009years) over 13\u2009weeks. Sleep was a secondary outcome assessed at baseline and 13\u2009weeks using questionnaires (subjective) and accelerometry (objective).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All participants completed the trial; 64 provided subjective and 40 provided objective sleep data. Participants reported poor subjective sleep quality alongside high levels of sleep disturbance and sleep\u2010related impairment at both timepoints. At 13\u2009weeks, sleep\u2010related impairment improved more in the intervention group than in controls (MD\u2009=\u2009\u22124.7; 95% CI\u2009=\u2009\u22128.7, \u22120.8;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02), with no between\u2010group differences in other subjective measures. Accelerometry data showed the intervention group spent 21 more minutes awake after sleep onset (WASO) (MD\u2009=\u200921; 95% CI\u2009=\u20091, 41;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04) and experienced a 4 percentage point decline in sleep efficiency (MD\u2009=\u2009\u22124.2; 95% CI\u2009=\u2009\u22128.0, \u22120.3;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03), compared to controls after 13\u2009weeks. These results paralleled substantial improvements in HbA1c for intervention participants compared to controls (MD\u2009=\u2009\u221234\u2009mmol\/mol; 95% CI\u2009=\u2009\u221243, \u221225;\n                      <jats:italic>p<\/jats:italic>\n                      \u2010value &lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although AID improved some subjective sleep aspects, sleep efficiency reduced and WASO increased. The relationship between glycaemia and sleep remains unclear, suggesting that effective sleep improvement in young people with T1D may require multifactorial approaches extending beyond improving glycaemia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dme.70093","type":"journal-article","created":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T01:53:33Z","timestamp":1750298013000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of automated insulin delivery on subjective and objective sleep in children and young adults with very high\n                    <scp>HbA1c<\/scp>\n                    : Sleep outcomes from the\n                    <scp>CO<\/scp>\n                    \u2010\n                    <scp>PILOT<\/scp>\n                    randomised controlled trial"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5675-0339","authenticated-orcid":false,"given":"Venus R.","family":"Michaels","sequence":"first","affiliation":[{"name":"Department of Paediatrics and Children's Health University of Otago  Dunedin New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6266-8802","authenticated-orcid":false,"given":"Alisa","family":"Boucsein","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Children's Health University of Otago  Dunedin New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6312-7795","authenticated-orcid":false,"given":"Jillian J.","family":"Haszard","sequence":"additional","affiliation":[{"name":"Biostatistics Centre University of Otago  Dunedin New 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Provincial Key Laboratory of Diabetology  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirley D.","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Children's Health University of Otago  Dunedin New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1579-3870","authenticated-orcid":false,"given":"Ryan G.","family":"Paul","sequence":"additional","affiliation":[{"name":"Te Huataki Waiora School of Health, University of Waikato  Hamilton New Zealand"},{"name":"Waikato Regional Diabetes Service Te Whatu Ora Waikato  Hamilton New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8962-2708","authenticated-orcid":false,"given":"Esko","family":"Wiltshire","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health University of Otago  Wellington New Zealand"},{"name":"Te Whatu 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