Sleep: The Most Forgotten Blood Sugar Strategy
How a good night of sleep transforms my diabetes the next day Sleep is usually an afterthought in diabetes, taking a back seat to food, exercise, medication, and glucose monitoring. It took me a long time – and a lot of my own data – to realize that sleeping well is actually a mission-critical blood sugar strategy. What is remarkable about sleep is how pervasive it is: it impacts next-day blood sugars very directly AND indirectly. In fact, when diaTribe readers email me with blood sugar problems, I almost always ask them how much they are sleeping. This excerpt from Bright Spots & Landmines is from the beginning of the fourth and final chapter on sleep, and it highlights a topic that doesn’t receive nearly enough attention in the diabetes world: why a good night of rest contributes in major and minor ways to next-day blood sugars. Why Is Sleep in This Book? It has a strong connection to diabetes: studies repeatedly show too little sleep is associated with higher A1c and blood glucose levels; greater insulin resistance; more hunger, calories eaten, and carb cravings; weight gain; higher levels of depression; lower quality of life; and beyond. A slew of biological changes occur with too little sleep, including higher levels of cortisol (stress), increased inflammation, and changes in hunger hormones, which can all contribute to greater insulin resistance and higher blood glucose levels (citations below). Sleep is a highly underrated diabetes tool, especially because it is changeable almost immediately: I can almost always get more sleep tonight if I make it a priority. At least 7 hours of sleep: more next-day blood glucose levels in range, less insulin, more energy, better mood, less hunger Getting 7 or more hours of sleep per night is a Diabetes Bright Spot on many Continue reading >>
Can Getting More Sleep Improve Blood Sugar Control? What One Month Of Tracking My Sleep Revealed
Twitter summary: Get more sleep! I use more insulin+ have worse BGs w/ less sleep. Academic studies show less sleep negatively impacts diabetes+much more. “Adam, you can sleep when you’re dead,” said one of my friends who seemed particularly fond of sleep deprivation. Funny, but I couldn’t help recalling the years of advice we’ve all heard to get more sleep. So I began wondering – is the more-sleep bandwagon just public health rhetoric, or is there really something to it? In the past few months, this issue has gained a lot more attention, (see below), especially as sleep relates to diabetes. This article summarizes my personal experience tracking my own sleep over the past two months, a research review of sleep and diabetes, and strategies to improve your sleep. The Surprising Results from Tracking My Sleep I recently visited a friend who works for Teach for America in Miami. His schedule requires him to wake up before the sun rises, meaning a lot of very tired mornings. He’s a big fan of an iPhone app called Sleep Cycle, and after he told me about it, it got me hooked. The app uses the iPhone’s accelerometer to sense movement as you sleep, and it has two great features: 1) it allows you to track your sleep very easily, and 2) it has an “intelligent” alarm clock that awakens you when you’re in light sleep. The ability to easily and painlessly track my sleep was my favorite part of the app. It gives time in bed and a “sleep quality score” (0-100%). To assess the impact of sleep on my diabetes, I compared my Sleep Cycle data to my blood glucose and insulin pump data. The results of tracking my sleep over a month were fascinating. While I cannot say the results below show a causal effect (formal academic studies below do that), I believe two thing Continue reading >>
How Can Type 1 Diabetes Affect Sleep?
We all know the miserable after-effects of a poor night’s sleep. Unfortunately, that dreary, frazzled, anxious state can be a more common reality for for someone with Type 1 diabetes. Doctors at the Sleep Disorders Program at the Louis Stokes Cleveland VA Medical Center estimate that 40-50% of people with diabetes complain of poor sleep. And getting a good night’s rest can help in blood glucose management as well as overall health. So what should you watch out for if you have Type 1? And how can you better your odds of a good night’s rest? Here are the most common sleeping disorders that you may be faced with and some basic advice on how to maintain healthy sleep hygiene. Sleep Apnea A person with sleep apnea stops and starts breathing repeatedly while asleep, preventing them from achieving deeper states of sleep. Warning signs of sleep apnea include: daytime drowsiness excessive nighttime snoring There are two kinds of sleep apnea – Obstructive sleep apnea – occurs when the upper airway or throat region narrows, oxygen levels decrease, and eventually the brain triggers a response to wake the person up (at least enough to take a full breath and reopen the airway). Central sleep apnea – occurs when brain signals to the muscles that control breathing are confused. Both types of sleep apnea prevent a person from getting the kind of deep, restful sleep needed to wake up feeling refreshed. While scientific research has long highlighted a correlation between Type 2 diabetes and obesity and an increased risk for obstructive sleep apnea, sleep apnea occurrences is also high in those with Type 1 diabetes. Some studies have found obstructive sleep apnea in as many as 30% of adults with Type 1 diabetes. And the majority of those tested maintained a healthy, normal weig Continue reading >>
Sleeping With Type 1 Diabetes: Osa And Other Sleep Issues Linked
A couple weeks ago we discussed how sugar/glucose levels can affect your sleeping and how they correlate with sleep disorders and overall tiredness. Sleep can affect your blood sugar levels, and your blood glucose control can also affect your sleep. It’s a vicious cycle. High blood sugar levels make it less comfortable for you to sleep by feelings of warmness, irritability and unsettledness. Low Blood sugar levels cause a variety of problems within your central nervous system which can include nightmares, confusion, sleepwalking and restlessness. In our Educational Series for National Diabetes Month we are going to briefly discuss the relationship between Type 1 diabetes, OSA, and other common sleep disturbances. Diabetes Types Type 1 diabetes Type 2 diabetes Symptoms usually start in childhood or young adulthood. People often seek medical help, because they are seriously ill from sudden symptoms of high blood sugar. The person may not have symptoms before diagnosis. Usually the disease is discovered in adulthood, but an increasing number of children are being diagnosed with the disease. Those who are obese or have a higher BMI are more at risk. Episodes of low blood sugar level (hypoglycemia) are common. There are no episodes of low blood sugar level, unless the person is taking insulin or certain diabetes medicines. It cannot be prevented. It can be prevented or delayed with a healthy lifestyle, including maintaining a healthy weight, eating sensibly, and exercising regularly. Obstructive Sleep Apnea Obstructive sleep apnea (OSA) is the most common form of sleep apnea. Apnea literally translates as "cessation of breathing" which means that during sleep your breathing stops periodically during the night for a few seconds. These lapses in breathing can occur for up to Continue reading >>
Deprivation Nation: How Lack Of Sleep Can Lead To Diabetes
1 of 2 The Dangers of Sleep Deprivation On the sofa, in front of the TV. On the train, surrounded by fellow commuters. In the movie theater, before the film begins. If you can't stay awake in any — or all — of these places, it's a good bet you're sleep-deprived. This lack of shut-eye does more than make you chronically grouchy; it elevates your risk of high blood pressure and obesity. And now there's a whole new reason to put an end to your sleep starvation: Skimping on rest could increase your chances of getting type 2 diabetes, a disease once believed to be caused primarily by being overweight. In fact, just three consecutive nights of inadequate sleep can elevate a person's risk to a degree roughly equivalent to gaining 20 to 30 pounds, according to a 2007 study at the University of Chicago. "Sleep may be as important as exercise or diet when it comes to developing diabetes," says Eve Van Cauter, MD, a professor of medicine and the senior author of the study. This revelation backs up previous research from Yale and the New England Research Institutes, which showed that people who clock six hours or less of sleep a night are twice as likely to develop diabetes in their lifetime as those who snooze seven hours. Translation? If you're not getting enough rest — even if you're slim and fit — you're putting your health in serious jeopardy. The Connection Between Sleep and Diabetes Here's what we know: Diabetes arises when the body can't properly break down blood sugar, aka glucose, leaving your cells starved for energy. One thing that greatly increases your chances of a blood-sugar malfunction is being overweight. Excess fat makes it harder for cells to properly use insulin, a hormone that helps keep glucose levels normal. So what does sleep have to do with any of Continue reading >>
The Sleep-diabetes Connection
Whenever diabetes patients enter Lynn Maarouf’s office with out-of-control blood sugar levels, she immediately asks them how they are sleeping at night. All too often, the answer is the same: not well. “Any time your blood sugar is really high, your kidneys try to get rid of it by urinating,” says Maarouf, RD, the diabetes education director of the Stark Diabetes Center at the University of Texas Medical Branch in Galveston. “So you are probably getting up and going to bathroom all night long -- and not sleeping well.” Diabetes and sleep problems often go hand in hand. Diabetes can cause sleep loss, and there’s evidence that not sleeping well can increase your risk of developing diabetes. Maarouf says high blood sugar is a red flag for sleep problems among people with diabetes for another reason. “People who are tired will eat more because they want to get energy from somewhere,” she says. “That can mean consuming sugar or other foods that can spike blood sugar levels.” “I really push people to eat properly throughout the day and get their blood sugars under control so they sleep better at night,” Maarouf says. “If you get your blood sugar under control, you will get a good night sleep and wake up feeling fabulous with lots of energy.” “There is some evidence that sleep deprivation could lead to pre-diabetic state,” says Mark Mahowald, MD, director of the Minnesota Regional Sleep Disorders Center in Hennepin County. According to Mahowald, the body's reaction to sleep loss can resemble insulin resistance, a precursor to diabetes. Insulin’s job is to help the body use glucose for energy. In insulin resistance, cells fail to use the hormone efficiently, resulting in high blood sugar. Diabetes occurs when the body does not produce enough in Continue reading >>
Link Between Sleep & Diabetes: Everything You Need To Know
According to National Sleep Foundation, 63% of American population do not get enough daily sleep. Do you also know that most people who suffer from diabetes often have poor sleeping habits? This includes irregular sleeping schedule, difficulty falling asleep and staying asleep. And although little has been mentioned about caregivers and parents of diabetes patients, they are more likely to acquire poor sleeping habits and have a higher tendency to suffer from sleeping problems and consequently develop Type 2 diabetes themselves. So if you have diabetes or are currently caring for someone who has diabetes, this article will educate you more about how sleeping disorders can affect your health and how you can get better sleep. This article will cover the following topics: Relationship Between Sleep and Diabetes Your health and sleep go hand in hand. When you do not sleep enough, your body does not get the needed time to repair. As a result, you tend to be unfocused and irritable, and you suddenly have the urge to eat. If this scenario sounds too familiar to you, maybe you should rethink about the relationship between sleep and your diabetes. The Missing Link — Hormones Sleep plays a crucial role in restoring our body cells. Under healthy conditions, after eating, the pancreas secretes insulin to signal fat cells and muscles to absorb the glucose from food to be used for energy creation and prevents the body from using fat as energy source. This chain of reaction causes the blood glucose levels to resume normal. And to prevent the individual from feeling hungry, the body produces the hormone leptin to depresses the appetite. However, when it comes to diabetes individuals, the muscle and fat cells fails to respond to insulin. This causes a high glucose level in the bloodst Continue reading >>
Yep, Sleep And Stress Affect Diabetes!
I recently started using a CGM (continuous glucose monitor), something I chronicled in this blog recently. It’s been an eye-opening change for me, and the detailed picture it reveals of my blood sugar moment-to-moment has been invaluable. Seeing that stunning detail has also confirmed a number of long-standing truisms that I’ve always been told by my diabetes educators and doctors but couldn’t quite see for myself. Among them: Fiber really DOES slow down the absorption of carbs and lessen the spike. Along the same lines: Lower-glycemic foods really do have a milder spike than a refined-carb bomb like a bagel! The pizza effect? Uh, yeah, absolutely a thing, and an annoying one at that — in fact, this is one of the main reasons I am back to looking into finally switching from daily injections to a pump (actually, I just found out that my insurance WILL cover the costs of the pump and supplies, a very welcome change since the last time I looked into it). The biggest eye-opener of all, however, has been seeing the profound impact sleep and stress can have on blood sugar. The importance of good sleep is something everyone is told about going back to childhood, and it falls into that category of commands that can be easily shrugged off. “Oh, it’s not gonna matter THAT much, right?” The same is true for the effects of stress on the body. Sure, we all give the idea lip service, but I think deep down, many of us have held to a belief that the impact can’t really be that substantial. But the past few weeks have proven both of these to me in a big way. Let’s start with stress. As you may know, stress is not always negative in how it feels. There is negative stress and positive stress. Negative stress is the kind we tend to avoid and dislike — work deadlines, ho Continue reading >>
Lack Of Sleep And Its Effect On Blood Sugar Levels
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 dif Continue reading >>
People In The Know: Parental Burnout
Brought to you by Lilly Diabetes | Disney Q: Ive read about kids with type 1 experiencing diabetes burnout, but in our family, I actually think Im the one having a tough time. How can I get my type 1 mojo back? My daughter is relying on me. A: No one says being the parent of a child with type 1 diabetes is easy. But before you get to the point of total burnout, use the energy you have left to reach out for help with all that youre doing to keep your child healthy. I can almost promise you that an avalanche of support is out there just waiting to reach back. The first place to look? Your partner. In families where both parents shoulder a childs type 1 care, a division of labor may stop (or lessen, at least) the emotional and physical toll your childs needs may take. While managing diabetes is not the same as caring for an infant, there are some startling similarities, like lack of sleep. If youre up all night monitoring your childs blood sugar after an unexpected low or high, youre up against the same sleep deprivation you experienced during the days of midnight feedings. And just like the emotional havoc it may have contributed to when you were a new mom, getting too little sleep now may be whats robbing you of your mojo. Is your partner home at night to share late-night monitoring duties? If so, set up a rotating schedule of whose turn it is to stay up when needed. In families where another parent is not available to share in care duties, do your best to find someone who is. Is Grandma nearby? Does your sister live down the street? Start to create a list of people who understand what it takes to care for your child. Often these are people who have already stepped up and offered their support so take it! If you need to take a break from your childs care to keep from re Continue reading >>
Can Diabetes Affect Your Sleep Schedule?
Diabetes is a condition in which the body is unable to produce insulin properly. This causes excess levels of glucose in the blood. The most common types are type 1 and type 2 diabetes. If you have type 1, your pancreas doesn’t produce insulin, so you must take it on a daily basis. If you have type 2, your body can make some of its own insulin, but it’s often not enough. This means that your body can’t use the insulin correctly. Depending on how well you control your blood sugar, you may or may not experience symptoms. Short-term symptoms of high blood sugar can include frequent thirst or hunger, as well as frequent urination. It isn’t uncommon for these symptoms to have an impact on the way you sleep. Here’s what the research has to say. In one 2012 study, researchers examined the associations between sleep disturbance and diabetes. Sleep disturbance includes difficulty falling asleep or staying asleep, or sleeping too much. The study found a clear relationship between sleep disturbance and diabetes. The researchers say that sleep deprivation is a significant risk factor for diabetes, which can sometimes be controlled. Having diabetes doesn’t necessarily mean that your sleep will be impacted. It’s more a matter of what symptoms of diabetes you experience and how you manage them. Certain symptoms are more likely to cause issues when you’re trying to rest: High blood sugar levels can cause frequent urination. If your blood sugar is high at night, you could end up getting up frequently to use the bathroom. When your body has extra glucose, it draws water from your tissues. This can make you feel dehydrated, prompting you to get up for regular glasses of water. The symptoms of low blood sugar, such as shakiness, dizziness, and sweating, can affect your slee Continue reading >>
How Is Diabetes Affected By Insomnia?
Who’s At Risk and Why? Diabetes is worse when combined with insomnia symptoms, doctors have conclusively discovered. In fact, insomnia makes most medical diseases much worse in ways we are only just now finding out and can chemically disrupt the body’s insulin balance enough to even be a root cause for certain types of diabetes. The Chemistry of the Sleep-Wake Cycle Since diabetics are sensitive to blood glucose levels and chemical balances in the body, it’s illustrative to explore just how detrimental disruptions in the sleep cycle can be. Studies have shown that diabetes worsens when adult sufferers sleep less than 6 hours per night or more than 9.(1) The loss of normal sleep hours or addition of sleep hours seems to undo the body’s chemistry and completely throw off-balance the blood glucose levels. Doctors don’t know for sure the exact chemistry behind this phenomenon outside of the observation. This underscores the importance of the sleep cycle chemistry. Further studies have shown that chronic insomnia in healthy people can also instigate diabetes. Loss of sleep interrupts insulin balance—leads to insulin resistance—which in turn can lead to more severe medical problems and Type 2 diabetes. Diabetes Management Much of the challenge for diabetics is proper and long-term management of their diabetes. When the sleep-wake cycle is also mismanaged, so too is the diabetes. Like many other medical diseases and conditions, diabetes is sensitive to sleep disturbances. But insomnia, as a set of symptoms, is usually secondary to something else. Insomnia is characterized in a number of ways: you could have problems going to sleep (sleep onset insomnia), problems waking up and going back to sleep (middle of the night insomnia), or waking up in the early dawn unab Continue reading >>
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Type 1 Diabetes And Sleep
IN BRIEF In people with type 1 diabetes, sleep may be disrupted as a result of both behavioral and physiological aspects of diabetes and its management. This sleep disruption may negatively affect disease progression and development of complications. This review highlights key research findings regarding sleep in people with type 1 diabetes. Recent research has increasingly identified sleep as a key process for the maintenance of good cardiovascular and metabolic health. Disturbed sleep patterns (i.e., restriction, deprivation, and fragmentation) in healthy young adults produce alterations in both metabolism and cardiovascular disease risk markers. Sleep restriction refers to reduced amount of total sleep (i.e., sleeping 5 hours instead of 8 hours); sleep deprivation refers to total sleep loss or prevention of sleep; and sleep fragmentation refers to sleep periods that are broken up by multiple awakenings throughout the night. Conditions that accompany type 1 diabetes (e.g., hyperglycemia, glucose variability, and hypoglycemia) may result in sleep disruption. Sleep disruption in people with type 1 diabetes may negatively affect disease progression and the development of complications. Thus, the purpose of this review is to summarize the relevant recent research on sleep in people with type 1 diabetes. Sleep Quality and Sleep Architecture (Structure of Sleep) Children (1) and adults (2) with type 1 diabetes subjectively report poorer sleep quality than healthy control subjects. Objective measures based on polysomnography (PSG) demonstrate that children with type 1 diabetes spend more time in stage 2 (lighter) sleep and less time in stage 3 (deep) sleep compared to healthy children (3). Young adults with type 1 diabetes also exhibit more stage 2 sleep and tend to have les Continue reading >>
Diabetes And The Importance Of Sleep
To paraphrase the old Cole Porter love song: Birds do it, bees do it, even educated fleas do it. Let's do it, let's . . . sleep? "Sleep is a biological imperative," says Stuart Quan, M.D., a Harvard Medical School professor of sleep medicine and editor of the Journal of Clinical Sleep Medicine. "You can't not sleep," he says. Virtually all animals sleep. Fruit flies have been shown to have sleep cycles, and even sea sponges have sleeplike periods, Quan says. While experts have different theories on why we sleep, it's well proven that getting too little has serious consequences for your health and diabetes. Shorting yourself on shut-eye can worsen diabetes and, for some people, even serve as the trigger that causes it. People who don't sleep enough may: -- impair the body's use of insulin. -- have higher levels of hormones that cause hunger. -- crave junk food. No snooze, you lose People who don't get enough sleep often have higher levels of chronic inflammation and insulin resistance. Lack of sleep also can increase production of cortisol (the body's primary stress hormone), impair memory and reflex time, elevate blood sugar, and increase appetite -- ultimately promoting weight gain, says Carol Touma, M.D., an endocrinologist at the University of Chicago who focuses on sleep research and metabolism. And the more you weigh, the worse you sleep. Research by Madhu H. Rao, M.D., an endocrinologist at the University of California, San Francisco, found that a person's body mass index (BMI) affects slow-wave sleep, the deep sleep cycles needed for maximum rest. Very preliminary results of Rao's current research on the effects of sleep restriction in healthy volunteers show an increase in insulin resistance in the range of 10 to 15 percent. But mysteries remain. Will sleeping m Continue reading >>
Diabetes And Sleep Problems
Sleep difficulties are more common in people who have diabetes than in people who don’t. That’s because having diabetes raises the risk for certain sleep problems such as sleep apnea and restless legs syndrome. Learn more about how diabetes affects sleep, the common types of sleep problems and most importantly, how they can be treated so that you can finally get a good night’s sleep. Frequently Asked Questions Even though I get enough sleep, I feel tired a lot and have nodded off at work. Why might this be? I have pain in my feet that keeps me awake at night. What could be causing this? Sometimes at night my legs feel “twitchy” and I have to keep moving them. Could this be restless legs syndrome? Once in a while I wake up during the night feeling shaky and sweaty. Is this due to my diabetes? I have to get up several times during the night to use the bathroom. What is causing this? How much sleep do I need every night? What is the downside if I don’t get enough sleep? I have trouble falling asleep at night, but I don’t want to take a sleeping pill. What else can I do? I recently gained quite a bit of weight and now I’m waking up a lot during the night. What could this be? Diabetes and Sleep Problems This booklet was developed by Joslin Diabetes Center and Beth Israel Deaconess Medical Center and supported by funding from the ResMed Foundation. Learn more about the common causes of sleep problems among people with diabetes as well as common treatment options. Download the Joslin Diabetes Center booklet Diabetes & Sleep Problems below. Continue reading >>