In a lot of cases, one condition triggers another, and then they merge to torture us. That type of connection is between diabetes and sleep disorders, loss of sleep can increase the chances of diabetes, while diabetics are often not getting enough sleep.
Diabetes occurs when the body is not able to respond and produce insulin, which leads to a higher level of sugar in the blood and urine. It is estimated that currently, around 30 million Americans have some type of it, which is approximately 28% to 32% of the population, but what is concerning even more is the fact that around 83 million have a prediabetes condition, which if it is not treated correctly can cause Type 2 in the next five years.
Today we will be discussing the relationship between diabetes and different sleep disorders, how can they be treated, how they interfere with one another, and what are the possible treatments.
Types of Diabetes
This title stands for a group of conditions or disorders, which hinders the body’s ability to process glucose, which is blood sugar. This condition requires constant maintenance, control, and careful observation, without it, the sugar will start piling up in the blood, and increasing the risk of various dangerous complications such as heart diseases and stroke.
Some types of this illness can appear in childhood, and they do not depend on the weight or inactive lifestyle, so each case should be treated individually. There are three main types of it, and we will now explain them briefly, but besides them, some more rare types are cystic fibrosis-related and monogenic diabetes.
- Type 1 is also called juvenile and occurs as a consequence when the body stops producing insulin. People who suffer from it depend on insulin, and they need to take its artificial forms daily; otherwise, they would not survive.
- Type 2 is also known as insulin resistance, and it impacts how our body uses insulin. The main difference in comparison to the Type 1 is that in this case, the body is producing insulin, but the body cells are not responding to it in a way they should be, or as they did before. This type is usually connected to obesity, and according to the data provided by the National Institute of Diabetes and Digestive and Kidney Diseases, this is its most common type.
- Gestational diabetes is a specific type which can strike women during their pregnancy when the body is less sensitive to insulin. However, this is not something which will happen to all pregnant women, and it usually goes away after they gave birth.
Prediabetes is a term which many doctors use to define the condition of a person who has borderline diabetes, which is usually when the blood sugar level is between 100 and 125 mg/dl. So the glucose level is not too high, but not low enough to be in the safe zone. Anything between 70 and 99 mg/dl is considered normal, while everything above 126 is considered as diabetes. People who have this borderline diabetes have a higher risk for Type 2, but they will not experience all the symptoms of it. Most common risk-factors for this condition are:
- HDL cholesterol level below 40 or 50 mg/dL
- History of PCOS or high blood pressure
- Medical family history
- Sedentary lifestyle
- Being older than 45
The exact cause of Type 1 is unknown, while for the Type 2 things are much more introduced, so the resistance to insulin occurs as a consequence of some of the following things:
- Due to the genetics or environment, a person cannot produce enough insulin to cover the amount of glucose they intake.
- The pancreas cannot stand the increasing demands, and excess glucose starts circulating through the blood.
- The body is trying to produce more insulin to cover the extra glucose.
- Over time, insulin can become less effective; hence, the level of blood sugar will rise.
Can Lack of Sleep Cause Diabetes?
Researchers were able to find a link between poor sleep and Type 2, several studies have confirmed that not enough sleep, or sleeping less than 5 hours per night, increases the risk of this disease. People who sleep little, usually also have a below average tolerance on glucose even though they were not diagnosed or had any symptoms of illness.
Some studies found the connection between lack of sleep and insulin resistance, or Type 2. One case study presented at the American Diabetes Society showed that healthy youngsters who sleep less than 6.5 hours regularly have higher chances to become insulin resistant. On the other hand, sleepers who spend at least 7.5 hours snoozing have significantly lower risk to get it.
The enchanted circle involves diabetes, poor sleep, and obesity. Lack of sleep can cause obesity, which is one of the primary causes of this illness. Missing sleep regularly affects our appetite and glucose level and causes our body to struggle when controlling hunger or having to recognize satiation. Also, sleep-deprived people are usually exhausted at the same time, which hinders their intentions and readiness to exercise and fight with their weight loss. Sleeping more than 7 hours per night is essential for the prevention of obesity and other illnesses, including diabetes.
Diabetes Sleep Problems
Most of the people with it usually struggle with some other disorders at the same time, and it is confirmed that insomnia runs among them more often since the symptoms of their condition cause them problems with falling asleep quickly and the lack of sleep only aggravates their symptoms.
A higher level of blood sugar during the daytime will hinder the body’s ability to rest at night, and being tired all the time will have a negative impact on the body’s ability to control the glucose level.
Some of the common sleep disorders which diabetic experience are:
- Sleep apnea, a breathing disorder, which results in occasional breathing stops during the sleep, is particularly common among obese diabetics, so it usually goes hand in hand with sleep apnea.
- Restless leg syndrome is also common among diabetics, and it contributes to their poor sleep.
- Insomnia, or difficulty with falling or staying asleep
- A higher level of glucose can lead to many painful and uncomfortable sensations such as tingling or burning in the toes, fingers, feet, and hands.
Restless Leg Syndrome
One of the sleep disorders which is often experienced among diabetics is the RLS if your legs get twitchy during the night, and you feel the urge to move them, most likely it is RLS. The uncontrollable urge to move the legs, and the uncomfortable feeling in them at the same time are the main symptoms of RLS. It usually feels like something is crawling over your leg, or tickling it from inside, and it can be very intense. However, if a pain in your feet wakes you up, it should not be RLS, neuropathy, or nerve damage, which also strikes diabetics and causes them many sleep problems, but the condition can be controlled with prescribed medications.
In the case of RLS, the tingling sensation will disappear when you start moving your legs, but it tends to get back quickly once you stop. The itchy symptoms usually begin around the evening hours and bedtime, and become more present during the night, hindering the patients sleep or preventing him from falling asleep. It has been stated that RLS runs more often among diabetics than among the healthy people, it could be that it is a feature of diabetic neuropathy, but it is also common among the patients with Parkinson’s, multiple sclerosis or kidney diseases.
The way in which RLS should be treated depends on how often the symptoms occur, how severe are they, and how much they hinder your sleep. Some patients claim that taking a warm bath, or stretching and doing some light exercises helps with keeping the symptoms under control, but medications or iron supplements should do the work.
Once the patients get their diabetes diagnosed, the danger of getting some other illnesses or disorders on the way only rises, so diabetics also have a strong predisposition for developing sleep apnea. Having sleep apnea means that you will occasionally stop breathing while you are sleeping and being unaware of it. Although the sleepers with this disorder are having no clue about what is going on with them, these breathing pauses are preventing them from entering into a stage of deep sleep. The good news is that there are successful treatments for sleep apnea, and they include the CPAP machine, weight loss, change of sleep position, or allergy treatment; it depends on the severity of the disorder and other individual properties.
It is very hard for an individual who is single to know if he/she has sleep apnea, but if you are waking up often throughout the night, or you feel tired during the daytime, and most importantly, your bed partner claims that you have been snoring, it is sleep apnea. Also, some of the symptoms are morning headaches and gasping for breath, but not everyone will have the same signs or combination of them. Usually, most people find out that they have a nocturnal sleep problem only when someone else suggests them that they have been snoring, that is when they start researching and usually undertaking sleep studies, which is the only way to be diagnosed with sleep apnea. Sleep studies for sleep apnea can be done in two ways, you can do it in your home, with a device which will record your breathing, and you can do it in a lab in a sleep clinic.
The most effective type of treatment for sleep apnea is the CPAP machine. CPAP stands for continuous positive airway pressure, and it is a machine which blows the air through a hose to the mask on the patient’s face. Patients need to wear this mask every time they go to sleep because it will keep their throat opened, and their breathing will be back to normal. This treatment is working, but for some patients, it could be an issue to get used to sleeping with a mask on. Masks come in various types; some go to the nostrils, some will cover only the nose, or the nose and the mouth, etc. There is also another treatment called oral appliance, and this is done by a dentist who needs to take a mold of your teeth, and in its most common type, the dentist would use patients upper teeth as a brace, to pull closer the lower jaw.
A part of therapy for those with mild types of sleep apnea is weight loss and visiting a psychologist. Another option is positional therapy, which means that the patient has to avoid sleeping on the back and find a new preferred position instead. In many cases, patients tie something to their pajamas so that if they accidentally fall asleep on their back or they turn around during the night, this object will make them feel uncomfortable, forcing them to change the position. Some people even used tennis balls and sewed them to their pajamas, and you can try this too, or use something smaller and lighter. Apnea can also be treated surgically.
Sleep apnea should not be neglected. Even though patients are not aware of it most of the time, it affects their daytime, and by treating it they will have more energy, less fatigue, and be able to deal with their illness better. Especially patients coping with Type 2 should treat their sleep apnea, because it will decrease their resistance to insulin, and lower the risk of stroke and heart attacks.
Studies have confirmed the connection between Type 2 diabetes and insomnia, which was not a surprise, and the longer the person has symptoms of insomnia, the higher the risk of diabetes. The population of younger people with insomnia is particularly liable to developing some type of this illness; everyone who has less than 40 years, and has insomnia should consider changing their lifestyle.
A large study gathered the data from 28,000 people of both sexes, who were diagnosed with insomnia from the beginning of 2001 till the end of 2004, and none of them had diabetes when they were diagnosed with insomnia. Researchers were following their data and sleep disorder progress for six years on average, or until they were diagnosed with the illness. In the end, they concluded that the risk of getting diabetes is 16% higher in people who were diagnosed with insomnia since the data of participants were compared to the data of millions of healthy people from the National Health Insurance base.
When it comes to age, among insomniacs, people younger than 40 had a higher risk of getting Type 2, than those who were older, regardless of their sex. The younger group had a 31% higher chances of Type 2, than the people of their age who were free of insomnia. Diagnosed insomniacs between 41 and 65 years old have 26% more chances for diabetes than healthy people of the same age, and those older than 66 are only 6% more likely to get another diagnose.
The duration of insomnia played a key role according to the researchers; patients who were living with it for eight years had a 50% higher risk of diabetes. The risk was around 14% higher at those who had insomnia for less than four years.
The clear answer to the question of how insomnia increases the risk of diabetes does not exist, but scientists have a few ideas. Since lack of sleep is connected to glucose metabolism, and balance of hormones ghrelin and leptin, that can affect appetite and take over control of it, and lead to overeating.
Irregular sleep pattern also triggers unhealthy eating habits, such as the intake of too many calories and fats, but sleep deprivation also decreases our sensitivity to insulin, affecting the way our body uses insulin in the reduction of glucose level.
In diabetics with insomnia, insomnia is treated as a primary cause, and many scientists believe that most of its symptoms come from bad habits, unhealthy lifestyle, etc. That is why they all first start recommending a change in lifestyle and sleep hygiene. Make sure that a night of good sleep becomes your priority, and that you have comfort, darkness, optimal temperature, quiet surroundings, etc.
Keeping Diabetes and Sleep Disorders Under Control
Since these conditions cannot be cured with a single treatment or medication, they require maintenance and proper care, to prevent their aggravation.
One of the essential things that anyone can do is pretty simple, and it is based on healthy and regular meals. Eating healthy food and maintaining the glucose level during the day will ease the body’s duty to keep them under control during the night and provide better sleep quality. Keeping the sugar level under control will reduce the intensity of RLS symptoms and neuropathy. A night of quality sleep will, in return, lower the blood sugar level and ease diabetes symptoms.