How patients with diabetes should manage their sleep

IMAGINE sleep as the body's nightly orchestra, conducting vital processes that repair tissues, build muscles, and optimise metabolic functions. For those navigating the complexities of diabetes, the significance of these nocturnal processes becomes even more critical, especially in regulating blood sugar levels.

During sleep, the body releases growth hormone, which helps regulate glucose metabolism. As such, having adequate sleep is important as it helps improve insulin sensitivity, making it easier for the body to use insulin effectively.

Poor sleep patterns, such as insufficient sleep or disrupted sleep, can lead to insulin resistance, a key factor in the development and management of type 2 diabetes.

In 2021, an estimated 529 million people were living with diabetes and it is predicted to increase to 1.3 billion by 2050.

Not getting enough rest and sleep can have a negative impact on people with diabetes. One outcome of sleep deprivation is an increase in the hormones ghrelin and reduced leptin levels that regulate appetite and hunger. This imbalance caused by sleep deprivation may lead to higher calorie intake during the day.

This coupled with a poor sleep pattern can lead to fatigue and reduced energy levels. This can discourage physical activity and exercise, which are essential for managing diabetes.

It is therefore important to keep a consistent sleep pattern and maintain a regular sleep schedule.

Various interventions are being explored to improve sleep quality in people with diabetes. These may include behavioural interventions like cognitive behavioural therapy for insomnia (CBT-I), lifestyle modifications, and, in some cases, drugs.

Metabolic processes disrupted

In CBT-I, a trained provider helps to identify thoughts, feelings and behaviours that make their sleep problems worse and replace them with habits that can support sound sleep. The goal is to address both the quantity and quality of sleep to positively impact metabolic health and diabetes management.

While most of us are aware that having insufficient sleep is bad as it can lead to sluggishness and irritability, having too much sleep can be detrimental in many ways.

Studies have shown that there is a "J-shaped" relationship, which refers to the observed association between extremes of sleep duration (too much or too little) and an increased risk of developing diabetes, with an optimal sleep duration appearing to be in the range of seven to nine hours per night.

This is because too little or too much sleep may disrupt metabolic processes, potentially contributing to insulin resistance and an elevated risk of diabetes. As such, achieving a balanced and regular sleep pattern is essential for overall health and diabetes prevention.

While many people may find themselves sleeping more as they get older, this should not change their sleep patterns as most adults usually need the same amount of sleep throughout their adult years.

As such, if a person still feels tired and sleepy after nine hours of sleep, it might be a sign that they have other health conditions such as diabetes or heart disease. Going for a sleep study or sleep test is recommended to rule out any other possible sleep disorder. – 360info, February 11, 2024

Shaun Lee is a pharmacist by profession with an interest in improving the health outcomes of communities around him and beyond. He is also a professor at Monash University Malaysia's school of pharmacy.