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However, the mechanistic pathways between sleep and glucose variability remain unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine within- and between-person associations between objective sleep-wake characteristics and glucose variability indices.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Multilevel models were used to analyze concurrent sleep and glucose patterns over 7 days in 42 young adults with T1D in their natural home environment. Young adults with T1D (mean age 22.2 \u00b1 3.0 years, HbA1c 7.2%, 32.6% male) for at least 6 months with no other medical or major psychiatric comorbidity were included. Sleep-wake characteristics were measured via wrist actigraphy and glucose variability indices via a continuous glucose monitor (CGM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Lower sleep efficiency predicted higher glucose variability (less time in range \u03b2 = 0.011 and more time in hyperglycemia \u03b2 = \u22120.011) within-person. A longer wake after sleep onset and more sleep disruptions were associated with higher glucose variability between persons (\u03b2 = 0.28 and 0.31). Higher glucose variability predicted poorer sleep within-person (delayed bedtime, waketime, mid-sleep time, and lower sleep efficiency), while higher glucose variability was associated with poorer sleep and more sleep disruptions between persons (lower sleep efficiency, longer wake after sleep onset, and a higher sleep fragmentation index).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Clinicians can address the reciprocal nature of the sleep-glucose relationship by optimizing sleep and targeting efforts toward a euglycemic range overnight. Sleep habits are a modifiable personal target in diabetes care.<\/jats:p><\/jats:sec>","DOI":"10.1210\/clinem\/dgab771","type":"journal-article","created":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T11:24:07Z","timestamp":1635247447000},"page":"e1085-e1095","source":"Crossref","is-referenced-by-count":29,"title":["Variations in Sleep Characteristics and Glucose Regulation in Young Adults With Type 1 Diabetes"],"prefix":"10.1210","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9901-3853","authenticated-orcid":false,"given":"Stephanie","family":"Griggs","sequence":"first","affiliation":[{"name":"Assistant Professor, Case Western Reserve University, Frances Payne Bolton School of Nursing, Cleveland, OH 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2473-8088","authenticated-orcid":false,"given":"Margaret","family":"Grey","sequence":"additional","affiliation":[{"name":"Annie Goodrich Professor of Nursing and Professor of Pediatrics, Yale University, School of Nursing and School of Medicine, West Haven, CT 06477, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7740-9013","authenticated-orcid":false,"given":"Kingman P","family":"Strohl","sequence":"additional","affiliation":[{"name":"Professor of Medicine, and Physiology and Biophysics, Case Western Reserve University, School of Medicine, Cleveland, OH 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6621-0439","authenticated-orcid":false,"given":"Sybil L","family":"Crawford","sequence":"additional","affiliation":[{"name":"Professor of Nursing, University of Massachusetts Medical School, Graduate School of Nursing, Worcester, MA 01655, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5663-8319","authenticated-orcid":false,"given":"Seunghee","family":"Margevicius","sequence":"additional","affiliation":[{"name":"Senior Research Associate, Case Western Reserve University, Department of Population and Quantitative Health Sciences, Case Comprehensive Cancer Center, School of Medicine, Cleveland, OH 44106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7489-6650","authenticated-orcid":false,"given":"Sangeeta R","family":"Kashyap","sequence":"additional","affiliation":[{"name":"Professor of Medicine, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH 44106, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9393-1212","authenticated-orcid":false,"given":"Chiang-Shan R","family":"Li","sequence":"additional","affiliation":[{"name":"Professor of Psychiatry and of Neuroscience, Yale University, School of Medicine, West Haven, CT 06477, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6669-8163","authenticated-orcid":false,"given":"Sanjay","family":"Rajagopalan","sequence":"additional","affiliation":[{"name":"Professor of Medicine, Director, Cardiovascular Research Institute, Case Western Reserve University, School of Medicine, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3720-2955","authenticated-orcid":false,"suffix":"Jr","given":"Ronald L","family":"Hickman","sequence":"additional","affiliation":[{"name":"Ruth M. 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