More than 29 million Americans suffer from diabetes, according to the Centers for Disease Control and Prevention, with millions more falling into the “prediabetes” range. Keeping blood glucose levels under control is essential to good health, both for people with diabetes and those who do not have the disease. Although most people know that dietary choices and exercise affect blood sugar levels, many do not realize that sleep can also have a dramatic effect on glycemic control. Failing to get enough sleep or getting poor quality sleep can have serious effects on your blood sugar. This is unhealthy for all individuals but particularly dangerous for those with diabetes or prediabetes.
How the Body Regulates Blood Sugar Levels
Glucose, a type of sugar, is the body’s primary energy source. Cells throughout your body depend on glucose to continue operating. When you eat a meal, your stomach breaks carbohydrates down into glucose molecules. This glucose is absorbed into the bloodstream, where it circulates throughout your body.
The body prefers for blood sugar levels to be kept within a tight range. To achieve this, a hormone called insulin is released by the pancreas into the bloodstream. Insulin tells your body’s cells to increase their uptake of glucose from the blood, resulting in lower blood sugar levels. If blood sugar levels dip too low -- such as after an intense bout of exercise -- another hormone signals the liver to release its excess glucose stores to restore balance.
People with diabetes have a difficult time responding properly to insulin. Those with type 1 diabetes are unable to produce insulin, making them unable to keep their glucose levels under control. Individuals with type 2 diabetes gradually become insensitive to insulin over time, making it difficult to their bodies to respond appropriately to elevated blood glucose. Impaired insulin sensitivity can result from dietary factors, such as high consumption of simple carbohydrates and fat. However, lack of sleep and blood sugar levels are also linked, particularly for those with type 2 diabetes.
Connection between Sleep Deprivation and Blood Sugar Levels
Poor Sleep is Associated with Poor Blood Glucose Control
Sleep is a time for your body to focus on rebuilding and repairing its tissues. As a result, getting a good night of rest is associated with a variety of health benefits. Most relevant for people with diabetes is the connection between sleep and endocrine system functioning. The endocrine system governs the release of hormones including insulin. As many hormones are released at specific times of day, maintaining a regular sleep-wake schedule ensures that your endocrine functioning remains normal.
Because the endocrine system is so deeply intertwined with your sleep-wake cycle, sleep deprivation can have a serious effect on glycemic control. During certain phases of the sleep cycle, glucose metabolism is less effective (Morgan & Tsai, 2015). This is due to a lower need for brain glucose and alterations in the release of insulin during sleep. As a result, disruption certain stages of the sleep cycle can affect your body’s ability to effectively process blood glucose. Furthermore, periods of sleep deprivation are associated with lower glucose tolerance, poorer insulin sensitivity, and dysregulated levels of hormones governing appetite. This may lead to a craving for midnight snacks or intense hunger in the morning, triggering further swings in blood glucose levels.
People with Sleep Apnea are Particularly At Risk for Blood Sugar Problems
There appears to be a bidirectional relationship between sleep apnea and diabetes: people with diabetes aremore likely to develop sleep apnea, and those who have poor quality sleep because of sleep apnea may experience problems with glycemic control that elevate their risk for type 2 diabetes. According to the International Diabetes Federation, more than half of people with type 2 diabetes have some form of sleep disturbance, with ⅓ having obstructive sleep apnea. Additionally, up to 40% of people with sleep apnea have or will develop diabetes.
Sleep apnea is a condition in which your airway periodically becomes restricted during the night, cutting off your supply of oxygen. These frequent disruptions to your nighttime sleep may leave you feeling exhausted in the morning. Sleep apnea also disrupts your metabolic pathways, making you more vulnerable to glucose intolerance and insulin resistance. Even for individuals without diabetes, sleep apnea can lead to poor blood glucose control that may easily push you into the prediabetes range. Scientists do not yet understand why sleep apnea affects blood sugar levels so strongly, but research in this area is ongoing.
Practicing Good Sleep Hygiene Can Improve Glycemic Control
The best thing you can do to keep your blood sugar levels within a steady range is to establish a routine for your diet, exercise, and sleep patterns. If you find yourself having trouble sleeping, consider your sleep hygiene practices. The following tips can help you get a better night of sleep and thus experience improved glycemic control:
Use a CPAP machine. If you have sleep apnea, using a CPAP is essential to ensure your brain gets the oxygen it needs. Scientific research has shown that using a CPAP improves glycemic control in diabetic patients (Babu et al., 2005), making this a critical treatment for those with sleep apnea. Getting fitted for a CPAP mask can ensure that you get a comfortable night of sleep while treating your sleep apnea.
Establish a regular bedtime. Going to bed at the same time each night and waking up at the same time in the morning is important for getting good quality sleep. Weekends are not an exception to this rule! Try to keep your weekend schedule relatively similar to weekdays to avoid disrupting your sleep-wake cycle.
Avoid electronics before bed. The glowing screen of your phone or TV can send “stay awake” signals to your brain. Shut off your electronic devices at least 30 minutes before bed to promote feelings of tiredness.
Limit caffeine intake. Enjoy your morning cup of coffee, but try to limit your caffeine consumption throughout the day. Even drinking a caffeinated beverage in the midafternoon can result in sleep dysregulation when you try to go to bed.
Limit alcohol consumption before bed. One alcoholic beverage per evening is fine, but drinking more than that can impair your sleep. Although you may feel like you fall asleep better after having a few drinks, you are likely to experience poor sleep quality that leaves you feeling unrested in the morning.
Make your bedroom a good sleep environment. Ensure that your bedroom is comfortable for sleeping by running a white noise machine, blocking external sources of light, and keeping the room cool.
Establish a bedtime routine. Finding a routine that helps you wind down is a good way to prime your body to fall asleep. Enjoying a mug of decaffeinated tea, meditating, taking a bath, or reading a book are great ways to prepare for sleep.
Avoid daytime naps. If you get poor sleep at night, you may fall into a vicious cycle in which you nap during the day, only to find that you can’t fall asleep at night. Limit daytime naps to no more than 20 or 30 minutes to preserve your nighttime sleep quality.
If you have tried improving your sleep hygiene but still have difficulty falling asleep, staying asleep, or feeling well rested in the morning, a sleep disorder may be to blame.
Visiting a sleep specialist is the best way to ensure that your sleep problems do not go undetected. This is particularly important for people with diabetes or prediabetes, as getting a good night of rest is essential to metabolic functioning, proper endocrine system regulation, and good glycemic control.
Make an appointment with your Seattle sleep specialist for an accurate diagnosis and to understand how sleep may impact your medical health. Call Sound Sleep Health at (425) 279-7151 today!