How Sleep Quality Impacts Your Metabolic Health
Sleep duration is only part of optimal sleep hygiene.
Sleep quality also seems to have a significant impact on metabolic health. One study followed adult men for eight years and found that subjects who reported interrupted sleep and difficulty maintaining sleep had double to triple the risk of developing type 2 diabetes.
The regulation of glucose and insulin are partially controlled by cortisol , which tells our body that something stressful is happening and preparing to have the energy to utilize against this real or perceived threat.
To help the body prepare, cortisol mobilizes the stored glucose from the liver into the bloodstream. It also decreases insulin production in the pancreas and reduces insulin sensitivity in the body, which means that the glucose is less likely to be utilized by cells and more likely to remain in circulation, elevating blood glucose levels.
Since our cortisol levels tend to be lower during the evening and early part of the night, our glucose levels tend to stabilize around a lower range at night. Sleep deprivation for just six days can increase cortisol levels, which in turn can elevate blood sugar.
Sleep deprivation can also trigger an increase in growth hormone, which decreases glucose uptake by the muscles, further contributing to a rise in blood glucose levels.
A lack of high-quality sleep may also increase your appetite, leading to a higher likelihood of overeating.
How Diabetes And High Blood Sugar Affects Your Sleep
To make matters worse? Having diabetes usually makes quality sleep even more elusive. Heres how:
- Sleep Apnea: Many people who have type 2 diabetes also suffer from sleep apnea. When untreated, pauses in breathing can cause people to wake up hundreds of times throughout the night.
- Peripheral Neuropathy: Nerve damage in the legs or feet is common among people with diabetes, and can lead to tingling, numbness, burning, or pain that can make it tougher to doze off.
- Restless Leg Syndrome: Another condition common among those with diabetes, RLS can cause feelings of needing to move your legs while sitting or lying down, which can make it harder to fall or stay asleep.
- High or Low Blood Sugar: Both can make it difficult to achieve restful sleep. Too-high blood sugar can leave you feeling hot, irritable, or unsettled. Blood sugar thats too low could result in nightmares, or cause you to wake up feeling sweaty or clammy.
- Nocturia: Nocturia, or nighttime urination, is a common problem among diabetics thats usually the result of uncontrolled blood sugar. Having higher amounts of sugar in your urine may cause you to wake up and have to go more frequently during the night.
What Does Research Say About Diabetes And Sleep
Just two weeks ago, the CDC released a report called Insufficient Sleep is a Public Health Epidemic. Reading the title alone is daunting enough, though the third sentence into the introduction is the real kicker: Persons experiencing sleep insufficiency are also more likely to suffer from chronic diseases such as hypertension, diabetes, depression, and obesity, as well as from cancer, increased mortality, and reduced quality of life and productivity. Yikes. Heres a smattering of the studies I found linking too little sleep to adverse effects. For a great overview read this free article from the Sleep Medicine Review by Dr. Kristen Knutson and colleagues.
1. Impaired diabetes control: In a 2006 study, sleep duration and quality were significant predictors of A1c in 161 patients with type 2 diabetes. In fact, for every three hours of perceived sleep debt , the predicted A1c was 1.1% more than the median. Another study in people with type 2 diabetes asked patients to fill out a sleep questionnaire and compared it to their A1c. Poor sleep quality was significantly correlated with worse glycemic control. A different study in young people with type 1 diabetes found that sleepiness and/or poor sleep habits correlated with reduced quality of life, depressed mood, lower grades, and lower standardized reading scores.
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What Sleep Disorders Are Common In People With Diabetes
Individuals with type 2 diabetes have a higher chance of developing accompanying sleep disorders, the most common being restless legs syndrome and obstructive sleep apnea.
- Restless Legs Syndrome : Approximately one in five people with type 2 diabetes have restless legs syndrome, marked by tingling or other irritating sensations in the legs that can interfere with getting to sleep. People with diabetes are also at risk for another condition called peripheral neuropathy. Caused by nerve damage, the symptoms of peripheral neuropathy are very similar to RLS and include numbness, tingling, and pain in the extremities. People who experience these symptoms should consult a healthcare provider, as peripheral neuropathy requires treatment to reduce long-term nerve damage.
- Obstructive Sleep Apnea : Obstructive sleep apnea is a sleep disorder in which a person momentarily stops breathing at recurring intervals throughout the night. In most cases, the person is not aware this is happening, though a bed partner may observe snoring and gasping. These lapses in breathing cause micro-arousals that interfere with the natural progression of the sleep stages and impair sleep quality. OSA typically occurs in people who are overweight or obese, as they often have a thicker neck circumference that interferes with the airway. The condition can be treated with a continuous positive airway pressure device that keeps the airway open to restore normal breathing and reduce interruptions to sleep.
Stay Away From Stimulants At Night
Avoid drinking caffeinated beverages, exercising, and even doing simple work around the house at night.
The only type of evening workout you should consider is a slow-paced yoga session that can prepare your body for sleep. Otherwise, youll speed up your blood flow, and itll take a while for your body to calm down.
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Diabetes And Sleep: A Vicious Cycle
The relationship between diabetes and sleep is complicated, and experts still have a lot to learn about how the whole thing works. What they do know? How much sleep you get could play a role in whether you develop type 2 diabetes in the first place.
First, theres the growing connection between sleep and obesity. Being overweight is a major risk factor for type 2 diabetes. Whats more, evidence shows that there are several ways that skimping on sleep could lead to weight gain:
- When youre zonked, you dont have the energy to exercise.Research suggestsVerified SourceAmerican Academy of Sleep MedicineSociety focused on sleep medicine and disorders, and the AASM is who authorizes U.S. sleep medicine facilities.View sourcethat people who stay up late spend more time sitting than people who wake up early.
- Feeling tired means youre less likely to make healthy food choices, too. When youre exhausted, pizza or takeout just feel easier than a big kale salad.
- Staying up late means more time to eat. People who stay up into the wee hours at night have been found to eat 550 more calories than those who go to bed early.
- Lack of sleep messes with your hormones. Sleep deprivation causes your body to pump out more of the stress hormone cortisol, which is linked to weight gain. Youre also flooded with more of the appetite-stimulating hormone ghrelin.
The Connection Between Lack Of Sleep And Diabetes
âThere is some evidence that sleep deprivation could lead to pre-diabetic state,â says Mark Mahowald, MD, director of the Minnesota Regional Sleep Disorders Center in Hennepin County.
According to Mahowald, the body’s reaction to sleep loss can resemble insulin resistance, a precursor to diabetes. Insulinâs job is to help the body use glucose for energy. In insulin resistance, cells fail to use the hormone efficiently, resulting in high blood sugar.
Diabetes occurs when the body does not produce enough insulin or the cells do not properly use the insulin. When insulin is not doing its job, high blood sugar levels build in the body to the point where they can harm the eyes, kidneys, nerves, or heart.
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The Link Between Sleep Health And Diabetes Explained
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Most people are aware that family medical history, what you eat, your weight, and being active can prevent type 2 diabetes, or diminish its risks for other chronic health issues in those already diagnosed.
But do you know that diabetes can have a major impact on your sleep health? Inversely, not getting the required minimum sleep of seven hours a night for most adults can increase your risk of diabetes. Thats mostly because sleep deprivation can throw hormone levels out of whack, including the bodys ability to produce enough insulin, the hormone that regulates blood sugar. People with type 2 diabetes dont use insulin efficiently and dont produce enough insulin .
There are sleep disorders that can make the risk for diabetes higher, said Dalia Lorenzo, M.D., a neurologist with Miami Neuroscience Institute, part of Baptist Health South Florida. And diabetics have a higher incidence of sleep disorders. So, its a two-way street.
About half of all people with diabetes have some form of nerve damage, which can include neuropathy. Peripheral neuropathy can cause tingling, pain, numbness, or weakness in your feet and hands, and can contribute to restless leg syndrome a major contributor to lack of sleep.
The Quality of Sleep
Sleep Apnea and Insulin Sensitivity
There is some evidence that the low oxygen that occurs with sleep apnea can actually
The Link Between Sleep Health and Diabetes Explained
The Quality of Sleep
Easy Before Bed Routines For People With Diabetes
Managing diabetes whether you have type 1 or type 2 is a full-time job. Your condition doesnt clock out at 5 p.m. when youre ready to take a break. You have to maintain your blood sugar checks, medication, exercise, and eating habits all day to keep your disease under control.
In fact, you should be mindful of your diabetes all the way until bedtime. Before you set the alarm and settle in under the covers each night, here are a few bedtime to-dos that will help you get more control over your diabetes and sleep more soundly.
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Body Mass Index And Obesity Risk
Several large epidemiological studies from different countries have observed an association between sleep duration and body mass index in both adults and children. Short sleep durations have been associated with increased prevalence of obesity in Spain, Japan and the U.S. . A French study of adults dichotomized sleep duration and found a slightly but significantly higher mean BMI among women reporting sleeping 6 hours less versus those sleeping more than six hours after adjustment for age and area of residence, but this difference was not observed among men . Several studies have observed a U-shaped association between sleep duration and body mass index , which indicates that both short and long sleep is associated with higher BMI. For example, the Wisconsin Sleep Cohort Study observed the lowest BMI at an average bedtime of 7.7 hours per night. A recent study in the rural U.S. observed a significant negative association between sleep duration and BMI . Thus, most studies have observed increased BMI or obesity prevalence with shorter sleep duration, and some have found higher BMI among those who report long sleep durations.
Things That Can Affect A Fasting Blood Sugar Test
A fasting blood sugar level is usually ordered by a physician either to check for a new diagnosis of diabetes or to monitor a person who is known to have diabetes, according to the Mayo Clinic. Slinkin says the analysis is important because, according to IDF, 415 million people have diabetes.
Exercise before a fasting blood sugar test can affect your lab results.Credit: Tetra Images/Tetra images/GettyImages
Blood sugar, also known as glucose, is the bodys main source of energy. A fasting blood sugar level is a measurement of how much glucose is in a persons blood after 12 hours without eating or drinking anything other than water, according to the Cleveland Clinic. Thats why this simple blood test is usually done in the morning, before breakfast/ If your fasting blood sugar is high, it is likely a sign of diabetes.
In order to understand what can affect a fasting blood sugar level, its helpful to know a bit more about how the body processes glucose.
Denis claims that the body gets most of its glucose supply from metabolizing the carbohydrates in food, per Kaiser Permanente. Insulin, a hormone produced by the pancreas, helps move glucose out of the bloodstream and into the cells, lowering blood sugar levels in the process. But people with diabetes have systems that either dont make enough insulin or cant use the insulin that they do have effectively. This leads to high blood sugar, or hyperglycemia.
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How Are You Sweetening Your Coffee What You Add To Your Cup May Affect Your Blood Sugar Levels
Whether you were recently diagnosed with type 2 diabetes or have been living with the condition for several years, you know how fickle blood sugar levels can be, and how important it is that they stay controlled.
Proper blood sugar control is key for warding off potential diabetes complications, such as kidney disease, nerve damage, vision problems, stroke, and heart disease, according to the National Institutes of Health . Plus, keeping your levels in check on a daily basis can help you stay energized, focused, and in a good mood, explains Lisa McDermott, RD, CDCES, a diabetes specialist with the Pittsburgh-based Allegheny Health Network.
According to the American Diabetes Association , proper medication, effective meal planning, regular exercise, and regular blood sugar checks can all help you keep your levels within a healthy range. The ADA recommends blood glucose stay within 80 to 130 milligrams per deciliter before meals and below 180 mg/dL two hours after the start of a meal. Furthermore, the organization recommends getting an A1C test, which measures your average blood glucose over the past two to three months, at least twice per year if your levels are stable and you are meeting treatment goals.
The Somogyi Effect Causing Blood Sugar Level To Go Up During The Night:
There is another possible reason behind the high blood sugar levels in the morning or blood sugar levels that go up through the night and that is, the Somogyi Effect. When a person has too low blood sugar levels, which is possible for hypoglycaemia patients, the body sends signals to the liver through the hormones to release more glucose into the blood for performing the bodily functions. It is the bodys own way of rescuing itself from the adverse effects of low blood sugar, which is usually the inability to produce energy and perform the physiological tasks. When this release is extremely high, more than what is needed or more than usual, it is called the Somogyi Effect. It is named after Dr. Michael Somogyi, who first discovered this condition and the reason behind this. It results into high blood sugar levels in the morning.
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How Can People With Diabetes Cope With Sleep Issues
Careful management of blood sugar levels can help improve sleep for people with type 2 diabetes. Additionally, given the close relationship between diabetes and sleep, good sleep hygiene habits are particularly important. These include both daytime and nighttime habits, such as:
- Adhering to a diet plan that works for you and helps keep blood sugar controlled
- Getting regular exercise
- Keeping a regular sleep schedule
- Avoiding stimulants like caffeine or nicotine before bed
- Keeping the bedroom cool, dark, and quiet
Based on your personal situation, your doctor may be able to recommend sleep aids for diabetics or additional ways to get better sleep. They may choose to conduct a polysomnogram, or sleep study, to see if a sleep disorder is to blame for your sleep problems. Secondary sleep disorders can then be treated with targeted therapies such as a CPAP machine.
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How To Get Better Sleep 16 Expert Tips
Why We Sleep is less about how to improve sleep, but it does include many useful tips towards the end of the book. If you have read chapter 4 of Bright Spots & Landmines, you will recognize some of these.
Dr. Walkers #1 piece of advice to improve sleep was a surprise to me: go to bed and wake up at the same time of day no matter what including on weekends. He notes this is perhaps the single most effective way of helping improve your sleep . This tip is missing from Bright Spots & Landmines, as I hadnt heard it so strongly emphasized before.
I have using two phone alarms at night a Bedtime is Coming, yellow-light alarm at 9:45 pm, followed by a Get Ready for Bed, red-light alarm at 10:15 pm. This is helpful as a reminder, though its easy to turn off the alarms and keep doing stuff. If you have a partner, it helps if he/she is also dedicated to getting more sleep with you accountability goes a long way.
Other tips to improve sleep:
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Melatonin is not a powerful sleeping aid in and of itself, though it can help with jet lag take it around 7-8pm in the new time zone. Melatonin does have a significant sleep placebo effect, meaning it might appear to work simply because you think it works.
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