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 >>
Expert Column - Sleep Disorders In Diabetes
Expert Column - Sleep Disorders in Diabetes Authors: Phyllis C Zee, MD, PhD ; Erik Naylor, PhD This activity is intended for neurologists, psychiatrists, endocrinologists, primary care physicians, internists, and family medicine physicians. The goal of this activity is to provide clinicians who treat patients with insomnia with the most recent basic science and clinical data on the topic -- including specific information on diabetics -- and with the tools to aid in proper clinical management. Upon completion of this activity, participants will be able to: Describe the neurobiology of the waking state, circadian timing, and the temporal organization of sleep and wake behavior. Describe factors that may contribute to sleep difficulties among patients with diabetes in order to guide management and improve quality of life and health in this population. Identify uses of melatonin and how patients with refractory sleep disorders should be referred (ie, PCPS specialists). As an organization accredited by the ACCME, Medscape requires authors and editors to disclose any significant financial relationship during the past 12 months with the manufacturer of any product that may relate to the subject matter of the educational activity, whether or not the activity is commercially supported. Authors are also asked to disclose any mention of investigational products or unapproved uses of products regulated by the U.S. Food and Drug Administration. Professor of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Director, Sleep Disorders Center, Northwestern Memorial Hospital, Chicago, Illinois Disclosure: Phyllis C. Zee, MD, PhD, has disclosed that she has served as an advisor or consultant for Takeda, Sanofi-Aventis, and Sepracor, and has received gran 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 >>
Glu : The T1d Force Awakens: Chronic Sleep Disturbances And Type 1 Diabetes
Type 1 diabetes (T1D) is a force to be reckoned with, every hour of every day. Managing ones blood sugar is hard enough during the day, while trying to work, study, exercise or play. But when night falls, patients, parents and loved ones wage war over something most people take for granted: quality, uninterrupted sleep. Between various symptoms of high or low blood sugar (BG), the treatment of such events, lying awake waiting for BG to level off, and fears and anxiety over what happens next, not to mention all of those noisy alarms on insulin pumps and CGMs, its clear that getting a full night of sleep presents a huge challenge for those with type 1 diabetes. Last month, the Wall Street Journal reported what many of us already know: that interrupted sleep is even more detrimental to overall mood and cognitive abilities like memory and focus, than a reduced period of sleep. The story was based on a recent study published in the journal Sleep by researchers from Johns Hopkins University School of Medicine . This latest research supports our own Glu research, conducted last summer via survey to the Glu community. The sleep survey was a collaborative effort with Dr. Katharine Barnard, a health psychologist and managing director at BHR Limited and a visiting professor at Bournemouth University. Dr. Barnard and her colleagues provide expertise in translating clinical research into quality of life information. Using the data we collected, Dr. Barnard published a paper earlier this month in the Journal of Diabetes Science, entitled Impact of Chronic Sleep Disturbance for People Living with T1 Diabetes . 450 people on our online type 1 community Glu participated in the survey, showing Dr. Barnard and our research team that, as expected, chronic sleep interruptions are extremely 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 >>
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 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 >>
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 >>
Sleep Woes Tied To Blood Sugar Levels In Diabetic Kids
Children with type 1 diabetes may be more likely to have sleep problems that worsen not only their blood sugar control, but also their quality of life, researchers found. Diabetic children with more nightly apnea events had significantly higher glucose levels and spent more time in hyperglycemia than young type 1 diabetics without sleep disturbances, Michelle Perfect, PhD, of the University of Arizona in Tucson, and colleagues reported online in Sleep. And those who reported being sleepier during the day had more trouble in school and worse quality of life, they found. "Despite adhering to recommendations for good diabetic health, many youth with type 1 diabetes have difficulty maintaining control of their blood sugars," Perfect said in a statement. "We found that it could be due to abnormalities in sleep, such as daytime sleepiness, lighter sleep, and sleep apnea. All of these make it more difficult to have good blood sugar control." Some work has shown that sleep can impact glucose regulation. In particular, slow-wave, or deep sleep, may be important in glucose maintenance and insulin sensitivity, the researchers said. In fact, some studies have shown that sleep architecture may be altered in diabetes patients, and they may spend more time in lighter stages of sleep and in the REM stage, and less time in deeper sleep. Yet most research in this area has focused on adults with type 2 diabetes, not young people with type 1 disease, they noted. So Perfect and colleagues assessed 50 type 1 diabetes patients ages 10 to 16 -- 40 of whom had polysomnography data -- and in part of the study, compared them with 40 matched controls. They found that kids with an apnea-hypopnea index score of 1.5 events per hour or greater had higher blood glucose levels on continuous glucose moni 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 >>
Diabetes And Sleep
Tweet Sleep can affect your blood sugar levels and your blood glucose control can also affect your sleep, which results in trouble sleeping. Difficulty getting a good night's rest could be a result of a number of reasons, from hypos at night, to high blood sugars, sleep apnea, being overweight or signs of neuropathy. If you have blood sugar levels that are either too high or too low overnight, you may find yourself tired through the next day. Lethargy and insomnia can both have their roots in blood sugar control and can be a key in re-establishing a healthy sleep pattern.. Getting a good night’s sleep The following may help to promote better sleep: Keep your blood glucose under control Ensure your bed is large and comfortable enough – and pillows at a comfortable height Ensure your room is cool (around 18 degrees celcius) and well ventilated Ensure your room is dark and free from noise – if this is not possible, you may benefit from a sleeping blindfold or ear plugs Incorporating a period of exercise into each day Stick to a regular bed time Can a lack of sleep be a cause of diabetes? Research has shown that sleep deprivation and insulin resistance may be linked. People who regularly lack sleep are will feel more tired through the day and more likely to eat comfort foods. A good night’s sleep is important for our hormones to regulate a large number of the body’s processes, such as appetite, weight control and the immune system. Trouble sleeping from high sugar levels High blood sugar levels can impact upon your sleep. It could be that the high levels make it less comfortable for you to sleep – it may make you feel too warm or irritable and unsettled. Another factor is if you need to go the toilet during the night. For people with regularly high blood sugar l Continue reading >>
Sleep Characteristics In Type 1 Diabetes And Associations With Glycemic Control: Systematic Review And Meta-analysis - Sciencedirect
Sleep characteristics in type 1 diabetes and associations with glycemic control: systematic review and meta-analysis Author links open overlay panel SirimonReutrakula Adults with type 1 diabetes (T1D) reported poorer sleep quality based on questionnaire scores than adults without T1D. Adults with T1D and poor sleep quality or sleeping 6 hours had poorer glycemic control. Children with T1D had shorter measured sleep duration than children without T1D. The estimated prevalence of obstructive sleep apnea (OSA) in adults with T1D was 51.9%. Adults with T1D and moderate-to-severe OSA tended to have poorer glycemic control. The association between inadequate sleep and type 2 diabetes has garnered much attention, but little is known about sleep and type 1 diabetes (T1D). Our objectives were to conduct a systematic review and meta-analysis comparing sleep in persons with and without T1D, and to explore relationships between sleep and glycemic control in T1D. Studies were identified from Medline and Scopus. Studies reporting measures of sleep in T1D patients and controls, and/or associations between sleep and glycemic control, were selected. A total of 22 studies were eligible for the meta-analysis. Children with T1D had shorter sleep duration (mean difference [MD] = 26.4 minutes; 95% confidence interval [CI] = 35.4, 17.7) than controls. Adults with T1D reported poorer sleep quality (MD in standardized sleep quality score = 0.51; 95% CI = 0.33, 0.70), with higher scores reflecting worse sleep quality) than controls, but there was no difference in self-reported sleep duration. Adults with TID who reported sleeping >6 hours had lower hemoglobin A1c (HbA1c) levels than those sleeping 6 hours (MD = 0.24%; 95% CI = 0.47, 0.02), and participants reporting good sleep quality had lower Continue reading >>
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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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Obstructive Sleep Apnea Common In Type 1 Diabetes
Obstructive Sleep Apnea Common in Type 1 Diabetes BOSTON Obstructive sleep apnea (OSA) is common in people with type 1 diabetes and is associated with abnormal glycemia and microvascular complications but not body mass index (BMI), a new study finds. The data were presented June 7, 2015 here at the American Diabetes Association (ADA) 2015 Scientific Sessions by Laurent Meyer, MD, an endocrinologist at Hopitaux Universitaires de Strasbourg, France. The link between type 1 diabetes and OSA has been reported in three previous small trials, but this study of 90 adults with type 1 diabetes is the largest such trial to date and the first to use both continuous glucose monitoring and sleep studies to investigate the relationship between OSA and both hypo- and hyperglycemic variation, Dr Meyer explained. In the study, OSA was particularly common among those with long disease duration and was associated with higher rates of diabetes complications, including retinopathy and peripheral neuropathy. "The main message for clinicians is to think of OSA in type 1 patients with a long duration of diabetes. With the design of our study we can't say check at 10 or 15 years, but in my opinion if [a patient has] a duration of more than 20 years, it's important to check for OSA," Dr Meyer told Medscape Medical News in an interview. Sleep apnea is ordinarily associated with obesity, but the French patients in this study were not excessively overweight, with a mean BMI of 26 kg/m2, suggesting that the OSA may be due to other factors. "In our study the BMI was near normal.I think perhaps it's linked to cardiac autonomic neuropathy.Like other degenerative complications, it may be linked to an infiltration of soft tissue in the upper airways by glycated products. I think OSA must be considered a Continue reading >>
