Sleep disturbance in children and adolescents with type 1 diabetes during the war

Sleep is one of the most important physiological processes in the human body. Its disturbances accompany the development of endocrine, neurological and mental diseases, and type 1 diabetes in children and adolescents is no exception. However, acute and chronic stress during war and hostilities has a significant impact on the child’s emotional state, which leads to changes in the structure and quality of sleep compared to healthy ones and to the deepening of existing disorders in children and adolescents with type 1 diabetes mellitus. Objective — to determine the characteristics of sleep disorders in children and adolescents with type 1 diabetes in wartime conditions. Materials and methods. A comprehensive study of the state of the central and peripheral nervous system was conducted with the determination of qualitative and quantitative indicators of night sleep in 174 children and adolescents with type 1 diabetes, with different duration of the disease, terms of manifestation and degree of compensation of carbohydrate metabolism, different levels of physical and of somato­sexual development, who are constantly observed at the SI «Institute of Child and Adolescent Health of the NAMS of Ukraine» and undergo training at the School of Self­Control. A comparative analysis of complaints and research data of patients who were treated in the period before the start of hostilities in Ukraine, as well as during the war in the conditions of a large front­line city, was also conducted. Results and discussion. We established that in children and adolescents with type 1 diabetes, clinical manifestations of damage to the central and peripheral nervous system of varying degrees of severity were detected, depending on the age of manifestation of diabetes, the degree of compensation and the course of the disease. The development of the disease was accompanied by changes in the quality and quantity of sleep in the form of pre­ and intrasomnia disturbances. During the war, the frequency of dyssomnias increased significantly due to factors acting directly during sleep (alarms, explosions, etc.), as well as a general increase in the level of anxiety and depression (for which sleep disturbances are a pathognomonic factor). Conclusions. Disturbances in the duration of night sleep and its quality are observed in children and adolescents with type 1 DM as a manifestation of the underlying disease and reach their maximum severity during the formation of diabetic encephalopathy. War, hostilities affect the emotional sphere of children and adolescents due to the information load (the general atmosphere in society), as well as when they directly witness violence, explosions, lose their homes and relatives, which serves as a basis for the formation of anxiety­depressive and anxiety­ phobic disorders. Thus, there is the emergence of new primary episodes of dysomnia of different duration and severity in those patients with type 1 diabetes, in whom the lesions were not previously registered, and the aggravation and deepening of sleep disturbances in those with these problems over a certain period of time.