Around 30 million people in the US have diabetes, making it the 7th most significant cause of mortality in the country. Most people with diabetes have type 2, a chronic illness brought on by insulin resistance.
Insulin is a hormone that aids in transferring glucose from the blood into cells such as those found in the skeletal muscles, adipose tissue, liver, and other tissues for cellular energy production. Insufficient insulin production or insulin’s inability to move glucose into these cells are the root causes of insulin resistance.
As a result, glucose levels in the blood rise, resulting in the classic diabetes sign of hyperglycemia. Heart and renal damage are possible repercussions if this isn’t controlled.
Many people with type 2 diabetes also struggle with insomnia or other sleep disorders due to the close relationship between the two conditions.
Fortunately, paying close attention to one’s diet, exercise routine, and blood sugar levels can profoundly affect one’s sleep quality and, thus, general health.
This article will discuss the link between diabetes and sleep disorders, possible explanations, and various treatments for those who suffer from this condition. We will also go through how adjusting your way of life can help you control your diabetes and sleep problems, which will boost your health and well-being in the long run.
The Impact of Diabetes on Sleep
One study found that almost 50% of persons with type 2 diabetes also have insomnia. Insomnia and fatigue the next day are symptoms of hyperglycemia and hypoglycemia, abnormal swings in blood sugar that happen during the night.
Just like with many chronic diseases, worrying or feeling down about having the disease can keep you up at night.
When blood sugar levels are excessive, the kidneys overreact by increasing the frequency of urination. These nighttime treks to the restroom can be very disruptive to sleep. The inability to fall asleep could be one of the effects of high blood sugar, headaches, increased thirst, and fatigue.
But, low blood sugar at night can also be caused by not eating too long or taking an improper dose of diabetic medication. After a bad night’s sleep, you could feel agitated or confused when you awake.
Fatigue, inability to sleep and other similar symptoms should be discussed with a medical expert. Your doctor can determine the cause and work with you to maintain a healthy blood sugar level.
What Effect Does Not Getting Enough Sleep Have on Blood Sugar?
Diabetes appears to play a role in sleep disturbances and vice versa. High blood sugar levels in people with diabetes and prediabetes have been associated with poor sleep quality, specifically with a lack of restorative slow-wave sleep.
To what extent one influences the other, or if other factors are at play, remains unclear. Lack of sleep has been shown to affect insulin, cortisol, and oxidative stress, which can affect blood sugar levels.
Hyperglycemia is more common in people with diabetes who sleep for fewer than six hours each night or more than eight hours per night. Sleep deprivation not only spikes blood sugar levels in persons with diabetes but also increases the likelihood of developing insulin resistance.
This connection is evident from a young age. Having a later bedtime or an inconsistent sleep schedule has been linked to increased blood sugar levels, even in persons who do not have diabetes. Nevertheless, this could be due to several other factors, such as the correlation between poor sleep hygiene and a poor diet.
Reduced levels of the satiety hormone leptin and elevated levels of the hunger hormone ghrelin are both effects of sleep deprivation. Those with trouble sleeping may be more prone to seek relief from their low energy levels by eating items that boost blood sugar, increasing their risk of obesity and diabetes.
People with type 2 diabetes who have trouble sleeping or wake up frequently during the night may be less likely to adhere to other guidelines for diabetic self-care, such as engaging in sufficient physical activity and keeping careful tabs on blood glucose levels.
Those with type 2 diabetes may suffer long-term consequences from sleep deprivation beyond the short-term impact on blood sugar levels. Individuals with problems falling or keeping asleep are more likely to say they are in severe emotional discomfort.
Also, preliminary data suggest a link between insufficient sleep and cognitive deterioration in older adults with diabetes.
Sleep Disorders That Are Common in Individuals With Diabetes
Maintaining proper sleep hygiene is crucial for ensuring one’s physical and mental health and is thus an integral part of any healthy lifestyle. Yet, people with diabetes are more likely to suffer from various sleep disturbances, which can have severe consequences for both their health and the effectiveness of their diabetes care.
Diabetes can lead to a variety of sleep problems, the most prevalent of which include:
1. Insomnia
As a result of elevated blood sugar levels and other diabetes-related symptoms, obese patients with type 2 diabetes often experience insomnia. Constant worry about falling asleep is a hallmark of insomnia. Very high blood sugar levels and anxiety both increase the likelihood of sleeplessness.
2. Restless Legs Syndrome (RLS)
Around 20% of persons with type 2 diabetes suffer from restless legs syndrome, characterized by tingling or other annoying feelings in the legs that might prevent one from falling asleep. Peripheral neuropathy is an additional risk factor for people with diabetes.
Peripheral neuropathy can be treated to lessen the risk of permanent nerve damage. Peripheral neuropathy, brought on by nerve injury, shares many symptoms with restless leg syndromes, such as numbness, tingling, and limb pain. Therefore, those experiencing these symptoms should see a doctor.
3. Obstructive Apnea of Sleep (OSA)
To briefly stop breathing is a hallmark of the sleeping disease known as obstructive sleep apnea. A bed companion may notice snoring and gasping, but the affected individual is typically unaware of the condition. These breathing interruptions lead to micro-arousals (very brief awakenings), which disrupt the normal flow of sleep and lower the quality of rest achieved.
Those who are overweight or obese are more likely to get OSA because their thicker neck circumference can block their airway. The problem is treatable with a CPAP machine that maintains an open airway to facilitate normal breathing and lessen nighttime awakenings.
4. Narcolepsy
Some studies have found an association between type I diabetes and narcolepsy. In type I diabetes, the immune system mistakenly targets the pancreatic cells responsible for producing insulin. The immune system attacks the hypocretin-producing cells in the brain in narcolepsy.
Damage to the brain’s hypocretin-producing cells leads to persistent disease. Type-I diabetes and narcolepsy can be rooted in the body’s immunological system; the two ailments are related.
Relationship Between Sleep Apnea And Diabetes
Even in people who are neither diabetic nor overweight, sleep apnea has been shown to increase insulin resistance, making it a risk factor for developing type 2 diabetes.
Around 25% of people with type 2 diabetes also have obstructive sleep apnea (OSA), and another quarter has another respiratory condition when sleeping, as reported by the American Diabetes Association.
Obstructive sleep apnea and type 2 diabetes are more common in obese and overweight. Nevertheless, obstructive sleep apnea appears to alter insulin resistance and glucose regulation regardless of weight.
OSA disrupts slow-wave sleep by waking you up frequently during the night and depriving your body of oxygen at critical times. These effects, taken as a whole, cause insulin resistance and a breakdown in glucose metabolism.
Many studies have shown that treating sleep apnea with CPAP, even temporarily, can reduce blood sugar levels and insulin resistance. Although some studies have shown changes in blood glucose levels after treating OSA, others have not.
Some researchers speculate that the link may be attributable to factors other than OSA, such as weight.
While further study is needed to define the relationship between sleep apnea and diabetes, it is already known that physical health plays a significant role in both conditions. Sleep apnea treatment in persons with type 2 diabetes may be most successful when it entails dietary changes and CPAP use.
Tips For Diabetics to Improve Their Sleep
Now that you know the impact diabetes can have on your sleep and vice-versa and the common sleep disorders resulting from it, it’s time we got down to finding a solution.
This section of the article will discuss in length what you can do to stop the vicious circle of diabetes and lack of sleep. Read on to know more.
1. Control Your Blood Sugar
Good sleep hygiene begins with managing diabetes, which is trickier than it seems. Maintaining blood glucose levels within the recommended ranges should help with most sleep-related concerns, lowering the risk of consequences or avoiding unpleasant interruptions.
See your physician about a continuous glucose monitor or other choices that may ease your burden if you’re having trouble keeping track of your sugar levels.
2. Stay Hydrated
Due to increased kidney water consumption, people having diabetes are more likely to get dehydrated. In some cases, this can occur even though the person’s glucose levels appear under control, resulting in dehydration and frequent urination.
You may have trouble sleeping because you get up several times throughout the night to use the bathroom. Despite your best efforts to regulate your blood sugar, you may still feel the consequences of dehydration.
Having sufficient water intake during the day (but not immediately before bed) and maintaining your sugar in the recommended range can help you sleep better at night and avoid diabetic ketoacidosis symptoms like itching skin and waking up parched.
3. Change Your Basal Insulin Dose
If your CGM is constantly alarming you about a low or high trend, you might want to consider lowering your basal insulin dose.
Until the morning, when cortisol levels naturally rise, your blood sugar shouldn’t fluctuate much while you sleep. If your blood sugar increases late at night, you could benefit from taking half of your daily basal insulin dose in the morning and the other half before bed.
Avoiding carbs before bed can help you avoid having to dose insulin or lower your basal insulin if you’re prone to lows at night.
4. Do No Eat Right Before Bed
Eating right before bed is risky since it could raise your blood sugar or trigger a hypoglycemic episode if you inject too much insulin. If you frequently find yourself in this situation, eliminating meals a few hours before bedtime or sticking to low-carb options may help.
5. Seek A More Optimal Weight
Those who suffer from sleep apnea may be able to alleviate their symptoms, including diabetes, by maintaining healthy body weight. If you want to know if this is a good choice for you and how to start losing weight, consult your doctor.
6. Start a Workout Routine
Increasing insulin sensitivity and the proportion of slow-wave or restorative sleep you get every night are two ways to help manage blood sugar.
However, before commencing an intensive workout regimen, you should consult your doctor since doing so could lead to significant disease due to a buildup of ketones in the bloodstream.
Summary
Poor sleep quality is only one of the many ways diabetes can compromise a person’s health and well-being. Insomnia, restless leg syndrome and obstructive sleep apnea are all frequent sleep disorders in people with diabetes, and they can adversely affect both physical and mental health.
Diabetic people must understand the connection between their disease and sleep problems if they are to take appropriate action to improve their quality of life.
Improving sleep quality and general health is possible for people with diabetes through proper disease management, maintaining appropriate sleep hygiene, and pursuing medical therapy for the symptoms of any underlying sleep disorders.
Medical treatments, such as continuous positive airway pressure (CPAP) for sleep apnea, may be combined with lifestyle adjustments, such as keeping a healthy weight, avoiding alcohol and cigarettes, and engaging in regular exercise.
People with diabetes should prioritize practicing healthy sleep habits and getting medical help if they notice any signs of a sleep issue. Individuals can enhance their health and quality of life by taking control of their diabetes and treating any resulting sleep issues.
