The Relationship between Diabetes and Sleep

  • Diabetes and sleep are intricately connected, and many people with type 2 diabetes experience poor sleep quality or insomnia.

  • It’s estimated that one in two people with type 2 diabetes have sleep problems due to unstable blood sugar levels and accompanying diabetes-related symptoms. High blood sugar (hyperglycemia) and low blood sugar (hypoglycemia) during the night can lead to insomnia and next-day fatigue. Feelings of depression or stress about the disease itself may also lead to lost sleep.

  • Just as diabetes can cause sleep problems, sleep problems also appear to play a role in diabetes. Getting poor sleep or less restorative slow-wave sleep has been linked to high blood sugar levels in people with diabetes and pre-diabetes. It is not entirely clear whether one causes the other or whether more variables are at work.

  • Researchers believe that sleep restriction may affect blood sugar levels due to its effects on insulin, cortisol, and oxidative stress.

  • One-quarter of people with diabetes report sleeping less than six hours or more than eight hours a night, which puts them at a higher risk of having elevated blood sugar. In addition to raising blood sugar levels in people who already have diabetes, sleep deprivation also raises the risk of developing insulin resistance in the first place. This link becomes apparent as early as childhood.

  • Studies have found that later or irregular sleeping schedules are correlated with higher blood sugar, even in non-diabetic people. However, there may be other variables that explain this, such as the fact that people with irregular sleeping schedules are more likely to follow an erratic diet.

  • Sleep deprivation raises levels of ghrelin, the hunger hormone, and decreases levels of leptin, the hormone that makes us feel full. To compensate for lower energy levels, people who sleep poorly may be more likely to seek relief in foods that raise blood sugar and put them at risk of obesity, which is a risk factor for diabetes.

  • In addition to its immediate effects on blood sugar levels, poor sleep can take a long-term toll on individuals with type 2 diabetes. There is tentative evidence to suggest that people with diabetes who do not get enough sleep may be at a higher risk for cognitive decline later in life.

The Relationship between Diabetes and Sleep Disorders

  • 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.

  • Though sleep apnea does not directly cause diabetes, it is a risk factor for type 2 diabetes and has been shown to increase insulin resistance, even in non-diabetic and non-overweight people. The American Diabetes Association estimates that up to one in four people with type 2 diabetes also suffers from OSA (Obstructive Sleep Apnea) and a further quarter of type 2 diabetics suffer from another sleep-related breathing disorder.

  • OSA appears to affect insulin resistance and glucose control even after controlling for obesity. Not only does OSA cause sleep fragmentation that interferes with slow-wave sleep, but it also periodically cuts off the body’s oxygen supply. Together, these effects lead to insulin resistance and impaired glucose metabolism.

Sources: The Sleep Foundation | Wikipedia | National Library of Medicine