How are you sleeping at night? All too often, the answer is the same: not well.

Diabetes and sleep problems often go hand in hand. Diabetes can cause sleep loss, and there’s evidence that not sleeping well can increase the risk of developing diabetes.

Symptoms

Symptoms associated with insufficient sleep include feeling tired, irritability, slurred speech, blurred vision, memory loss, inability to concentrate, episodes of confusion, hallucinations, nausea, impotence and reduced sexual drive. Extreme sleep deprivation can cause psychosis and death. However, there are no documented cases of a healthy human dying from sleep deprivation (although mortality from accidents does occur). Before death occurs in healthy, sleep-deprived humans, the brain forces itself to have ‘micro-sleeps’.

Evidence

In the past decade, there has been growing evidence that too little sleep can affect hormones and metabolism in ways that promote diabetes.

Current data suggests that the relationship between sleep restriction, weight gain and diabetes risk may involve at least three pathways: 1. alterations in glucose metabolism; 2. upregulation of appetite; 3. decreased energy expenditure. from The Metabolic Consequences of Sleep Deprivation

A 1999 Lancet study at the University of Chicago – the researchers monitored the blood glucose levels of 11 healthy young men who were allowed only four hours of sleep per night — from 1 a.m. to 5 a.m. — for six nights.

That study showed that after only a week of short bedtimes, their glucose tolerance was impaired. There could be dramatic effects even after only a week.

After 6 nights of little sleep, the men had higher-than-normal blood glucose levels. (The levels were not high enough to be diagnosed as diabetes, however). The effects went away once the men were back on their normal sleep schedule.

Experts also believe that chronic sleep deprivation may lead to elevated levels of the stress hormone, cortisol. Elevated cortisol may in turn promote insulin resistance, in which the body can’t use the hormone insulin properly to help move glucose into cells for energy.

Low Sleep = High Blood Sugar?

High blood glucose level is a red flag for sleep problems among people with diabetes.

Diabetes and sleep problems often go hand in hand. Diabetes can cause sleep loss.

If the blood glucose level is high the kidneys want to pass this excess glucose out in the urine. Getting up to pee in the middle of the night disturbs the sleep.

People who are tired will eat more because they want to get energy from somewhere. That may mean over-eating during the day > higher blood glucose level at night> getting up to pee>poor sleep etc etc.

Eating well throughout the day – having a safe and effective diabetes self care plan – to have your blood glucose level on target may have you be able to sleep better at night.

Low Sleep = Low Blood Sugar?

Conversely, having a hypo during the night is likely to wake you and destabilise your sleep.

A wise action to take would be to measure your blood glucose level occasionally at 2-3 am in order to exclude overnight hypoglycaemia.

The Link Between Lack of Sleep and Weight

Some studies show that people who get less sleep tend to be heavier than those who sleep well. People who are tired will eat more because they want to get energy from somewhere. That may mean over-eating during the day > higher blood glucose level at night> getting up to pee>poor sleep etc etc.

Sleep loss could also affect energy expenditure via its impact on the levels of leptin and ghrelin. Since several human studies have demonstrated reduced levels of leptin after sleep loss, it is possible that the reduction in leptin is associated with a reduction in energy expenditure. Similarly, the increase in ghrelin after partial sleep restriction could be associated with a decrease in NEAT (Non-exercise activity thermogenesis). *Experimental evidence is currently lacking to support either hypothesis*

Sleep Apnea?

There is also a link between diabetes and sleep apnea, a sleep disorder marked by loud snoring and pauses in breathing while you sleep. The culprit may be excess weight, which can cause fat deposits around the upper airway that obstruct breathing. So being overweight or obese is a risk factor for sleep apnea as well as diabetes.

If you have diabetes, are overweight, and snore, tell your doctor. You may need a sleep study.

Sleep apnea can prevent a person from getting a good night sleep, which can worsen diabetes. In sleep studies, you are monitored while you sleep for sleep disorders such sleep apnea.

There are many effective treatments for sleep apnea. These include lifestyle changes such as weight loss for mild cases and devices to open up blocked airways for more significant cases.

Sleep: How Important?

In general, people living with diabetes have to be very careful about sleep. Anything that throws off your routine can make you feel a lack of energy and fatigue. The more fatigued you feel, the more your motor is running, and the more likely you are to develop insulin deficiencies.

How Much Sleep?

On average, we need 7.5 hours per night, but your sleep requirement is genetically determined and varies.

It can be about four hours on the short end to 10 or 11 on the long end.

Want to know if you are sleep-deprived? The answer is simple…..If you use an alarm clock, you are. If you were getting adequate sleep, your brain would awaken you before the alarm goes off.

HELP

Improve your sleep habits: SNORE Australia

MJA (Medical Journal of Australia) Sleep Disorder Supplement

Australasian Sleep Association

So, turn off your electronic device…. and go get some sleep!

Kind Regards,

David,

Diabetes Educator @ Diabetes Counselling Online