sleep Archives - Diabetes Counselling Online

Sleep: zzzzzz…. are you sleeping well?

March 21, 2015 by Imagine_David Leave a Comment

“I slept so badly last night; I simply have no energy to exercise.”

What is Sleep Apnoea?

People with sleep apnoea stop breathing while they are sleeping. This causes them to wake up gasping and can happen as many as hundreds of times per night, although sleep apnoea sufferers do not usually remember waking up.

If you have sleep apnoea, your health may be in danger. People with sleep apnoea have higher chances of traffic accidents and are more likely to develop serious health problems. Sleep apnoea is a known cause of high blood pressure and can lead to to obesity.

Sleep apnoea can also cause relationship problems and depression.

Do I have sleep apnoea?

Usually, people with sleep apnoea find out because a spouse or bed partner noticed them snore or stop breathing during sleep. Other common signs and symptoms include:

Extreme sleepiness
Frequent snoring
Stopping breathing during sleep
Morning headaches
Depression
High blood pressure
Weight problems

Sleep apnoea is most common among men, people who are overweight and the middle-aged. However, research shows that children and post-menopausal women may also be at risk.

What is treatment like?

There are several treatments available for OSA (obstructive sleep apnoea), however most doctors recommend positive airway pressure (PAP) therapy. PAP therapy is safe, effective and non-invasive. It does not require drugs or surgery.

Alternatives including dental appliances may have some benefits for people with mild OSA. There are invasive surgeries available, however, they have variable success rates, and surgery always has a risk of short and long-term complications.

Of the available treatment options, PAP therapy is the safest and most effective. People on PAP therapy have reduced health risks and more energy to do the things they want to do.

**Talk to your doctor about having your sleep pattern assessed**

Health risks

Sleep apnoea can be life threatening. People with sleep apnoea have higher chances of serious health problems like diabetes, high blood pressure, heart disease, stroke and obesity.

Treating sleep apnoea can improve these problems, as well as a person’s overall quality of life. It has been shown to lower blood pressure, improve glucose control and increase energy throughout the day in people with diabetes.

The message is simple—if you have sleep apnoea, you need to get treated!

Diabetes

People with sleep apnoea have higher chances of developing insulin resistance, which can lead to Type 2 diabetes. Sleep apnoea is very common in patients that suffer from diabetes. Approximately 60% of Type 2 diabetes patients have sleep apnoea.

Diabetes patients who receive treatment for their sleep apnoea often have an immediate improvement in their diabetic condition.

If you have diabetes and think you might have sleep apnoea, you need to find out. Treating sleep apnoea can help you control your blood sugar levels and may lower your chances of complications, like heart disease.

High blood pressure

The (American)National Institute of Health lists sleep apnoea as a cause of high blood pressure.

Studies show that about 30% of all people with high blood pressure have sleep apnoea. That number increases to 80% for people taking three or more medications to control their blood pressure.

If you have high blood pressure and sleep apnoea, starting treatment may help you lower your levels significantly and improve your heart health.

Heart disease

Untreated sleep apnoea strains the heart and may cause it not to work properly.

Left untreated, sleep apnoea can lead to heart disease and heart failure.

People with sleep apnoea can lower their chances of developing these problems by getting treated. Sleep apnoea treatment can people help control their blood pressure and improve their heart health.

Stroke

Sleep apnoea can increase a person’s chances of stroke. In fact, studies show that more than 60% of patients who have had a stroke also have sleep apnoea. Stroke patients with untreated sleep apnoea may have a harder time recovering after a stroke than others do.

Recovering from a stroke takes much energy and motivation, but the sleepiness that comes from sleep apnoea can make it difficult for a person to follow rehabilitation programs, causing poor recovery.

Stroke patients with untreated sleep apnoea have higher chances of death than patients who receive treatment.

Obesity

About 40% of obese people have sleep apnoea. Overweight people should be particularly concerned because sleep apnoea may make weight loss more difficult.

The sleepiness that comes from sleep apnoea may cause people to overeat, sleep more, and exercise less. Some people, as a matter of habit, will eat to “wake up” when they feel drowsy during the day. That in turn can cause them to gain more weight, which may make their sleep apnoea even worse.

Being treated for sleep apnoea can help obese people gain the energy to exercise more and lose weight.

SLEEP QUIZ

This short quiz is designed to help you to recognize possible sleep apnoea so that you can realise there can be relief for your symptoms.

While awake

Do you wake up in the morning tired and foggy, not ready to face the day?
Do you have headaches in the morning?
Are you very sleepy during the day?
Do you fall asleep easily during the day?
Do you have difficulty concentrating, being productive, and completing tasks at work?
Do you carry out routine tasks in a daze?
Have you ever arrived home in your car but couldn’t remember the trip from work?

Adjustment and emotional issues

Are you having serious relationship problems at home, with friends and relatives, or at work?
Are you afraid that you may be out of touch with the real world, unable to think clearly, losing your memory, or emotionally ill?
Do your friends tell you that you’re not like yourself?
Are you depressed?
Are you irritable and angry, especially first thing in the morning?

Medical, physical condition, and lifestyle

Are you overweight?
Do you have high blood pressure?
Do you have pains in your bones and joints?
Do you have trouble breathing through your nose?
Do you often have a drink of alcohol before going to bed?
If you are a man, is your collar size 17 inches (42 centimetres) or larger?

During sleep and in the bedroom

Do you snore loudly each night?
Do you have frequent pauses in breathing while you sleep (you stop breathing for ten seconds or longer)?
Are you restless during sleep, tossing and turning from one side to another?
Does your posture during sleep seem unusual? (Do you sleep sitting up or propped up by pillows?)
Do you have insomnia? (Waking up frequently and without a reason)
Do you have to get up to urinate several times during the night?
Have you wet your bed?
Have you fallen from bed?

What is your score?

If you answered “yes” to any of these questions, you may have sleep apnoea.

However, if you answered “yes” to any of the following especially important four questions, this strongly suggests that sleep apnoea is the problem.

Are you very sleepy during the day?
Do you fall asleep easily during the day?
Do you snore loudly each night?
Do you have frequent pauses in breathing while you sleep (you stop breathing for 10 seconds or longer)?

Talk to your doctor today. More on sleep and diabetes HERE

Bon nuit / good night

Kind Regards,

David, Diabetes Educator @ Diabetes Counselling Online

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Sleep & Diabetes

December 17, 2014 by Imagine_David Leave a Comment

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

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Juggling Wellness and Diabetes

September 15, 2014 by Sally Leave a Comment

I’m writing this personal kind of blog on a Saturday. I love Saturdays. They encompass lots of things I love to do which all contribute to my wellbeing. This morning I was out on my run and because it’s Saturday and lovely Spring weather lots of my neighbours were also out and about. Nearly everyone I ‘ran’ into made the comment about how well I looked. I had at least 3 such comments this morning and they inspired me to share with you what I believe to be the key to being well with diabetes, or what works for me anyway.

This is important to me because I have diabetes and I’m turning 50 next year, so I know that if I don’t focus on being well myself I’m in a higher risk group to lose my wellness that is so important to me. I want to do all I can to hold onto it for as long as I can, so I can enjoy more of this wonderful life. I’m also passionate about helping others to be well too to the best of their ability, so here goes!

Sleep

Every Saturday I get to sleep in. Yay! To catch up on a few hours I may have missed through the busy-ness of my week. Time to give my body a chance to repair and relax. I usually get to sleep in until around 8am, which is a big improvement on my 6-6.30am starts on other days of the week. The only thing that stops me from doing this is waking early with a hypo, but this morning my BGLs behaved themselves. This week I found an awesome article in The Conversation on the importance of sleep which I encourage you to read. It’s just so important for our wellbeing, and especially so for us with diabetes.

Eating Well

As a dietitian you would know that I am particularly passionate on this topic! This is the only topic in today’s blog that I’m qualified to talk about as a health professional, and it’s such an important one! The Australian Dietary Guidelines that we follow actually makes the comment, “Diet is arguably the single most important behavioural risk factor that can be improved to have a significant impact on health.” It is something that I think about, read up on and focus on every day.

Today I started with my fibre rich, low-GI and high nutrient breakfast, a combination of two cereals that enjoy eating together topped with skim milk. I had a banana for morning tea and a delicious bowl of vegetable and low-GI carb rich Minestrone soup. This afternoon I’ll probably have a snack of a handful of nuts and another piece of fruit. We have a delicious lean meat and vegetable rich stir-fry planned which we’ll serve with plain Basmati rice, and I’ve marked out my favourite Black Cherry yogurt for dessert.

I know that I’m getting the nutrients I need to be well each day, and I’m sure it must also reflect in my outward appearance when I’m out on my run, makeup free in my daggy running shorts too lol

Regular Exercise

Nice segway to the exercise! Also lots of evidence here to support wellbeing, reducing inflammation, improving mental health and keeping our BGLs more stable. You may know that I’m a golfer. I try to play 18 holes in a comp twice a week, and 9 holes if I have time as a break in my day on a Friday. On the days I’m not golfing I do my best to get in at least the minimum recommended 30 minutes of moderate physical activity. Usually I try for 45 minutes. Since I’ve been doing this I have noticed a big improvement in the stability of my glycemic control as my fitness has improved. It’s so worth the effort even when you don’t really feel like it!

Family Time/Love

I’m incredibly fortunate to have so much love and support from my family, but I guess it works both ways in that I also love and support them! I believe that love and giving love is an important part of wellbeing. We hug each other a lot in our household, and in the wider family too. Have you hugged someone today and told them you love them?

Being sociable

Although I was out on my run, I enjoy stopping along the way on a Saturday as I have more time available to me to chat with my lovely neighbours in the suburb I live in. I chat with the children, and the parents, and the older people, and the neighbours who are my friends. To me this is important as I feel loved within my community too, and I know that I’m helping some of these people to feel loved too <3

Hard Work

I enjoy working. It keeps my brain active. It gives me a purpose and keeps me inspired each day to stay well and make the most of my life. The lovely Helen Wilde called me a workaholic this week, which made me think. You know I probably am a workaholic, but that’s because I love what I do and it makes me happy to help other people to be well. But I honestly try very hard to keep a balance with the other important factors in my life.

For those of you who are lucky to be retired or not have to ‘work’ as such I would encourage some kind of volunteer role as it can really be so rewarding and contribute to your wellness. We have some awesome volunteers who help us out at Diabetes Counselling Online. You can read more about our team and some of our ambassadors here. They’re so important in making our charitable organisation what it is.

Keeping the Balance

Of course, being Saturday, I also have household chores to do, preparation cooking for the week ahead, and I might even fit in a quiet hour of reading a book. It’s always a good day, and means I really relax and enjoy myself on my day of rest (and golf) Sunday.

If you try to imagine all these aspects (including any others you may have yourself) as a number of balls that you’re juggling, I believe that remaining well is all about keeping a balance amongst them. Sometimes you need to drop one ball to keep the others going smoothly, but don’t forget it and go back to collect it as soon as you can. I don’t see diabetes as one of those balls – it’s just part of me and often influences how I manage some of those balls/aspects.

Hopefully some of this will inspire you to focus on keeping your balls in the juggle, and know where you can make some positive changes to improve your own wellness. Diabetes Counselling Online actually has a whole section on the website on Diabetes & Wellbeing. Check it out!

You know we’re here to help. With love, Sally.

Sally is the Social Media Dietitian with Diabetes Counselling Online, owner of her private practice (Marchini Nutrition), and has had type 1 diabetes for close to 40 years and coeliac disease for many years too. You can access a list of all Sally’s Diabetes Counselling Online blogs here.

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