Sleep Health and Diabetes

Kamaljit Atwal, DO

Diabetes is a chronic health condition that affects more than 30 million Americans and is the seventh leading cause of death in the United States. Most of us know how important weight control, exercise and nutrition are in controlling blood sugars. What impact does sleep have?

Sleep is extremely important in maintaining our body’s performance, not only physically and mentally, but also down to the body’s chemical balances. Diabetes, whether type 1 or 2, comes down to an imbalance of the insulin and blood sugar relationship.

The right amount of sleep is needed to keep the endocrine system working well, so insulin and blood sugar stay balanced. Studies have shown that too little sleep (less than 6 hours) or too much sleep (greater than 9 hours) can increase the risk of developing diabetes and make pre-existing diabetes more difficult to control. Some research suggests a 40% increase in the risk of developing diabetes if sleeping less than four hours per night. The human body is very complicated, and it needs just the right amount of sleep to work properly. The recommendation of about 7–8 hours a night comes from years of research to evaluate the amount of sleep needed for our bodies to function at their best.

Even if your body is getting the right amount of sleep, the sleep needs to be quality sleep. Quality sleep is needed to make sure your body is truly rested with good oxygen levels, few awakenings and able to achieve deep sleep. If the sleep quality is poor, blood sugars will rise, and the insulin produced will be less effective, leading to prediabetic conditions or making diabetes difficult to control.

The most common sleep disorders affecting diabetes are sleep apnea and restless leg syndrome. Sleep apnea is when the back of your throat keeps collapsing during sleep, and oxygen levels fall, leading to disturbed sleep and lack of deep sleep. Restless leg syndrome is when the legs are moving around a lot during sleep because of pain or tingling and numbness, leading to disturbed sleep and lack of deep sleep. Both these conditions cause a rise in blood sugars, increased insulin resistance, increase in stress hormones such as cortisol and the hunger hormone ghrelin, all of which contribute to diabetes. Treatment of these sleep disorders will help balance these hormones and help manage and decrease the risk of diabetes.

Not only does poor sleep affect your blood sugars at night, but in the daytime, your energy levels will be low, leading to poor blood sugar metabolism, lack of exercise and weight gain over time. In short, poor sleep will affect night and daytime blood sugars and insulin effectiveness.

The relationship between sleep and diabetes is complex. Not only do you need a good quantity and quality of sleep for better diabetes control and a decreased risk of diabetes, but if you have poorly controlled diabetes, it will affect your sleep. This stresses the fact that the approach to diabetic management is a multi-approach program, including good sleep, nutrition, exercise, weight loss and medication as directed by your physician.

Making your sleep health a priority will not only help you cut down your diabetes risk or better manage your diabetes, but it will also help with your overall well-being, including managing other chronic health conditions.

Some steps to healthy sleep include:

1. Have a regular sleep and waketime
2. Bedtime routine: Wind down, read, no TV, keep the bedroom dark, cool and quiet
3. Avoid eating 2–3 hours before bed
4. Avoid nicotine, alcohol or caffeine close to bedtime
5. In the daytime, avoid napping for more than 45 minutes, stay active and exercise

Think of healthy sleep as a priority in your health management, as it can help you avoid unnecessary medications and health complications. Healthy sleep equals a healthy body!