Sleep and Diabetes
Fluffy pillows, a cozy down comforter, and warm blankets sound like the perfect way to relax at the end of your day, right? Not only does sleep rest your body and refresh your mind, but a solid nights sleep is crucial to good diabetes health.
When it comes to catching your Zs, the average adult needs about eight hours of sleep per night. However, recent surveys show the average adult now sleeps less than seven hours a night, and more than one-third of adults report daytime sleepiness so severe that it interferes with work and social functioning at least a few days each month. As many as 70 million Americans may be affected by chronic sleep loss or sleep disorders, at an annual cost of $16 billion in health care expenses and $50 billion in lost productivity.
The amount of sleep a person needs also increases if he or she has been deprived of sleep in previous days. Not counting those sheep can create a "sleep debt," which is very much like an overdrawn bank account. Eventually, your body will demand that the debt be repaid. While we may be able to adjust to a sleep-depriving schedule, our judgment, reaction time, and other functions are impaired by a lack of sufficient sleep.
According to the National Sleep Foundations 2007 Sleep in America poll, the amount you sleep can also contribute to your overall health. Women who responded to the poll that they were in poor health also experienced daytime sleepiness a few days a week, have missed work due to sleepiness, and are more likely to have used a sleep aid than those who categorized themselves as in excellent health. This trend can do more than make us grumpy and groggy - not getting enough sleep can contribute to the risk of developing diabetes. A study published in the Archives of Internal Medicine found that women who slept only five hours a night were 2 times more likely to have diabetes as those who slept seven or eight hours. One explanation for this link is that sleep-deprivation increases insulin resistance, which contributes to diabetes. Another study found that, when healthy young men slept only 4 hours a night for 6 nights in a row, their insulin and blood sugar levels mimicked those seen in people who were developing diabetes. If you already have diabetes, a pattern of sleep-deprivation only further contributes to a flux in blood sugars.
The current epidemic of diabetes and obesity also appears to be related, at least in part, to chronically getting inadequate sleep. Even though regular exercise and a healthy diet is very important, evidence is growing that sleep is a powerful regulator of appetite, energy use, and weight control. During sleep, the bodys production of the appetite suppressor leptin increases, and the appetite stimulant grehlin decreases. Studies find that the less people sleep, the more likely they are to be overweight or obese and prefer eating foods that are higher in calories and carbohydrates. Feeling sleepy can cause you to eat more comfort foods. People who report an average total sleep time of 5 hours a night, for example, are much more likely to become obese compared to people who sleep 78 hours a night. A number of hormones released during sleep also control the bodys use of energy. A distinct rise and fall of blood sugar levels during sleep appears to be linked to sleep stage. Not getting enough sleep overall or enough of each stage of sleep disrupts this pattern.
Sleeping can help stave off the sniffles, protect your heart, and keep you safer from the flu. During sleep, your body creates more cytokinescellular hormones that help the immune system fight various infections. Lack of sleep can reduce the bodys ability to battle any infections. Research also reveals that a lack of sleep can reduce the bodys response to the flu vaccine. For example, sleep-deprived volunteers given the flu vaccine produced less than half as many flu antibodies as those who were well rested and given the same vaccine. People with diabetes are encouraged to get a flu shot every year, so make it count by getting some rest, too!
A good nights sleep doesnt begin once youre lying in bed. Help your body prepare for being well-rested by developing good sleep-smart habits during the course of the day. Try to wake up at the same time every day to set a schedule for your body. Also, hitting the gym can help you fall sleep more easily, as will avoiding caffeine consumption in the afternoon. Taking good care of yourself will make you count less sheep and score more sleep, which can make all the difference in your diabetes life.
Excerpted and adapted from: National Institutes of Health: Your Guide to Healthy Sleep
References: Archives of Internal Medicine study "Role of Sleep Duration and Quality in the Risk and Severity of Type 2 Diabetes Mellitus" by Kristen L. Knutson, PhD; Armand M. Ryden, MD; Bryce A. Mander, BA; Eve Van Cauter, PhD.
National Sleep Foundation's "2007 Sleep In America" poll.
Reviewed by Francine Kaufman, MD. 4/08
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