What is the Relationship Between Diabetes and Sleep?

Up all night counting sheep?  Lack of good quality sleep is a problem for many Americans.  About 50 to 70 million Americans have sleep disorders, reports the American Sleep Apnea Association. Quality sleep is another issue for 84 million people (1 in 3 adults) who do not regularly get the recommended amount of sleep (the figure varies based on age), which can impact health.[1]

It also turns out there also is a strong connection between diabetes and sleep. A study found that 50% of people with Type 2 diabetes have sleep problems due to fluctuating blood sugar levels. Conversely, sleep disturbances can increase the risk of developing insulin resistance and prediabetes. [2]

How blood sugar levels affect diabetes and sleep

Unstable blood sugar levels can result in high blood sugar (hyperglycemia) or low blood sugar (hypoglycemia). During the night, these fluctuations can lead to sleep-disturbing symptoms resulting in fatigue the next day. Stress and depression that often accompany a chronic disease like diabetes can be another cause of diabetes sleep deprivation.

Sleep disturbance symptoms caused by blood sugar fluctuations include:

Frequent urination: High blood glucose levels can cause the need to urinate. When blood sugar levels are too high, the kidneys must work harder to eliminate excess glucose from the blood.  Urination helps to eliminate the excess glucose from the body. If your blood sugar is elevated at night, you may need to go to the bathroom several times, resulting in sleep disturbances.

Dehydration: When there is extra glucose in the blood, your body draws water from your tissues, which can result in dehydration. If you feel thirsty at night, you may wake up to get a drink of water.

Dizziness and sweating: Low blood sugar can cause dizziness, sweating and shakiness, affecting sleep.

Other complications can impact diabetes and sleep

Having diabetes can result in other complications that can impact enough or quality sleep:

Peripheral neuropathy: The National Institute of Health (NIH) National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) estimates up to one-half of people with diabetes have peripheral neuropathy, nerve damage, due to high blood glucose or blood sugar.[3] Peripheral neuropathy causes tingling, numbness, and loss of feeling, usually in the feet. Peripheral neuropathy is associated with diabetes sleep deprivation because many people experience worsening symptoms at night. [4]

Obstructive sleep apnea: Obstructive sleep apnea is a sleep disorder in which a person momentarily stops breathing at recurring intervals throughout the night. Generally, the person is not aware this is happening. These lapses in breathing cause very brief awakenings that interfere with the natural progression of the sleep stages and impair sleep quality.[5]  A study conducted in 2009 found that over 86 percent of participants who were obese and had Type 2 diabetes had sleep apnea.[6]

Restless leg syndrome (RLS): RLS causes twitchiness and discomfort in the legs during sleep. It is common among diabetics due to diabetic neuropathy, which causes nerve damage.

The effect of lack of sleep on diabetes

While diabetes can affect sleep, a lack of sleep can affect diabetes. The NIDDK reports studies have shown that repeatedly wakening up during the night, insufficient sleep, excessive sleep, and irregular sleep all promote glucose intolerance. Furthermore, if a person has prediabetes or diabetes, poor sleep will worsen the condition.[7]

Lack of sleep impacts diabetes in other ways. It can result in excess eating to restore energy, resulting in a rise in blood sugar. A lack of sleep also makes it more difficult to maintain weight and can increase the risk of obesity, which can lead to the development of Type 2 diabetes.

Research also found when people ate healthily but slept less than six hours a day, their risk of Type 2 diabetes increased compared to people in a normal sleep category (seven to eight hours).[8]

Take control of diabetes and sleep

CDC recommends to get more quality sleep:[9]

• Wake up and go to bed at around the same time every day, even on weekends.
• Keep your room dark, quiet, relaxing, and cool.
• Remove electronic devices from the bedroom.
• Get some exercise during the day and maintain a healthy diet.
• Avoid large meals and alcohol before bedtime.
• Avoid caffeine in the afternoon or evening.

Do not let diabetes sleep deprivation make dealing with your condition more difficult. Follow these recommendations to make sure you put those sheep to rest.

Hashtags:

#diabetes #diabetessleep #insomnia

[1] “The State of Sleep Health in America 2023,” sleephealthorg, Accessed August 3, 2024. https://www.sleephealth.org/sleep-health/the-state-of-sleephealth-in-america/

[2] Cervoni, RD, Barie, “Sleep and Diabetes,” Verywell Health, September 9, 2022. https://www.verywellhealth.com/diabetes-and-sleep-6503882

[3] “Diabetic Neuropathy,” NDDK, Accessed August 3, 2024. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/nerve-damage-diabetic-neuropathies/peripheral-neuropathy#peripheralneuropathys

[4] “Why is Neuropathy Worse at Night,” Cleveland Clinic, January 3, 2020. https://health.clevelandclinic.org/why-is-neuropathy-worse-at-night

[5] Pacheco, Danielle, Singh, Dr. Abhinav, “Lack of Sleep and Diabetes,” Sleep Foundation.org., October 26, 2023. https://www.sleepfoundation.org/physical-health/lack-of-sleep-and-diabetes

[6] Foster GD, Sanders MH, Millman R, Zammit G, Borradaile KE, Newman AB, Wadden TA, Kelley D, Wing RR, Sunyer FX, Darcey V, Kuna ST; Sleep AHEAD Research Group. Obstructive sleep apnea among obese patients with type 2 diabetes. Diabetes Care. 2009 Jun;32(6):1017-9. doi: 10.2337/dc08-1776. Epub 2009 Mar 11. PMID: 19279303; PMCID: PMC2681024. https://pubmed.ncbi.nlm.nih.gov/19279303/

[7] “The Impact of Poor Sleep on Diabetes Type 2, NDDK, March 17, 2021. https://www.niddk.nih.gov/health-information/professionals/diabetes-discoveries-practice/the-impact-of-poor-sleep-on-type-2-diabetes

[8] Murfet, Guiliana and Lin, Shanshan, “Scientists Identify a Link Between Sleep and Type 2 Diabetes Risk,” Science Alert, April 21, 2024. https://www.sciencealert.com/scientists-identify-a-link-between-sleep-and-type-2-diabetes-risk

[9] “About Sleep,” CDC, Accessed August 4, 2024, https://www.cdc.gov/sleep/about/index.html