Ramadan-Induced Lifestyle Changes: Effects on Sleep and Physical Activity in Non-Fasting Type 1 Diabetes Patients.

Objectives: In this study we aimed to identify sleep patterns, physical fitness, and barriers to physical activity (PA) during Ramadan observance in a cohort of nonfasting individuals with type 1 diabetes (T1D).

Methods: Sixty-one nonfasting patients with T1D, age 28.34±9.43 years, ranging from 15 to 54 years, completed questionnaires before and during Ramadan. The questionnaires included 3 assessment instruments: the Barriers to Physical Activity in Type 1 Diabetes (BAPAD1), the Pittsburgh Sleep Quality Index (PSQI), and the International Physical Activity Questionnaire.

Results: During Ramadan, there was no significant change in BAPAD1 scores compared to before Ramadan (p=0.378). The primary barriers encompassed hypoglycemia risk, work schedules, diabetes control, and fatigue. Moreover, subjective sleep quality deteriorated during Ramadan compared to the pre-Ramadan period (p<0.001). Sleep duration decreased by 58 minutes (p<0.01) and was associated with later bedtimes and more awakenings. There was a notably decrease in PA levels (p=0.042), particularly for vigorous activities (p=0.017), whereas sedentary time showed a significant increase (p=0.008).

Conclusions: Ramadan observance did not affect barriers to PA in individuals with T1D despite alteration of sleep patterns and PA levels. Lifestyle alterations associated with Ramadan observance significantly impact individuals with T1D who are not fasting, resulting in reduced PA, shortened sleep duration, and increased sedentary time.