Sleep is crucial for everyone, but it is especially important for people with diabetes. Not getting enough sleep can disrupt the body’s ability to regulate blood sugar and insulin levels, leading to serious short-term and long-term health complications. In this article, we will explore what happens when diabetics are unable to get adequate, quality sleep on a regular basis.
Short-Term Effects of Diabetic Sleep Deprivation
Some of the most common short-term effects of sleep deprivation for diabetics include:
Higher Blood Sugar Levels
Without proper sleep, the body produces more counterregulatory hormones like cortisol and glucagon which raise blood sugar. Less sleep also decreases insulin sensitivity and impairs the body’s ability to use insulin efficiently. This combination frequently leads to hyperglycemia (high blood glucose).
Increased Fatigue and Lethargy
Being tired and lacking energy is one of the most obvious effects of inadequate sleep. Fatigue can make it hard to exercise, work, and carry out daily activities. Exhaustion also impacts mood and motivation levels.
More Episodes of Low Blood Sugar
On the other hand, some diabetics experience more frequent hypoglycemic (low blood sugar) events when sleep deprived. This may occur due to inappropriate insulin dosing, missing meals due to fatigue, or impaired physiological glucose regulation. Low blood sugar causes dizziness, confusion, trembling, and loss of consciousness if left untreated.
Increased Appetite and Cravings
Lack of sleep stimulates the “hunger hormones” ghrelin and cortisol. High levels of these hormones increase appetite and cravings for sugary, fatty, salty, and starchy foods. Unhealthy food choices further complicate diabetes management.
Weakened Immune System
Sleep is vital for immune function. Diabetics who skimp on sleep have a harder time fighting infections. The body’s inflammatory and stress responses are also amplified, raising the risk of various diabetes complications.
Impaired Cognitive Function
Sleep deprivation slows reaction time, diminishes focus and concentration, and hinders memory and learning. This impairs decision making abilities, performance at work or school, and safety while driving or operating machinery.
Increased Stress and Anxiety
Lack of sleep negatively affects mood and emotion regulation. Diabetics may feel more stressed, irritable, anxious, or depressed after multiple nights of poor sleep. This takes a toll on relationships and overall wellbeing.
Greater Risk of Accidents and Errors
Drowsiness and slowed reflexes due to sleep loss make diabetics more accident-prone. Car crashes, slip-and-fall injuries, and medical mistakes are more likely when operating in a sleep-deprived state.
Long-Term Dangers of Diabetic Sleep Disorders
While occasional sleeplessness poses short-term risks, long-standing sleep deficits create cumulative damage and chronic disease progression. Some long-term dangers of inadequate sleep for diabetics include:
Cardiovascular Disease
Chronic partial sleep deprivation increases inflammation, elevates blood pressure, and exacerbates cholesterol abnormalities – all contributors to heart disease and stroke. Sleeping less than 6 hours a night is linked to up to a 2-fold increase in cardiovascular events and mortality over time.
Stroke
Research indicates people with diabetes who habitually sleep less than 6 hours have over a 4 times greater risk of stroke compared to those getting 6-8 hours of sleep. Scientists believe immune activation and vascular damage from sleep loss play a role.
Diabetic Neuropathy
Poor sleep enhances pain sensitivity and nerve deterioration. Diabetics with chronic insufficient sleep tend to develop peripheral neuropathy and chronic neuropathic pain more frequently.
Diabetic Retinopathy
The prolonged stress, inflammation, and blood vessel changes caused by sleep deprivation are thought to accelerate diabetic eye disease. Those with fewer than 6 hours of sleep have the highest rates of diabetic retinopathy.
Foot Ulcers and Amputations
Due to neuropathy, impaired wound healing, and immunologic imbalance, chronically sleep-deprived diabetics also face amplified risks of foot sores, infections, gangrene, and amputation over time.
Kidney Disease
Sleep disruption hastens the progression of diabetic nephropathy. Recurrent periods of hyperglycemia and elevated blood pressure related to lost sleep promote kidney damage. Sleep apnea may also directly impair kidney function.
Dementia
Research shows people with diabetes have a 1.5-fold increased risk of dementia. However, those with short sleep duration have the highest dementia rates. Insufficient sleep may promote Alzheimer’s neuropathology.
Premature Death
The combination of accelerated cardiovascular disease, cancer, and organ damage makes sleep deprivation a threat to longevity. One study found sleeping less than 6 hours a night was associated with a 3-fold increased risk of early death in diabetics.
Causes of Diabetic Sleep Disturbances
So what causes this pervasive lack of sleep among those with diabetes in the first place? Several factors play a role:
Uncontrolled Blood Sugar
When blood glucose levels swing too high (hyperglycemia) or too low (hypoglycemia), it disrupts normal sleep cycles. Fluctuating blood sugar can lead to insomnia as well as frequent nighttime awakenings.
Neuropathy
Diabetic nerve damage often produces pain, numbness, tingling, and uncomfortable sensations in the legs and feet which make it difficult to fall or stay asleep.
Restless Leg Syndrome
Restless legs syndrome causes unpleasant creeping and crawling feelings in the lower limbs when lying down. This sleep disorder is more prevalent among diabetics – especially those with peripheral neuropathy.
Nocturia
Excessive urination at night (nocturia) is common in diabetes. Needing to wake up multiple times a night to urinate interrupts sleep. It can be caused by uncontrolled blood sugar, neuropathy, or early diabetic kidney disease.
Sleep Apnea
Obstructive sleep apnea causes recurrent pauses in breathing and chronic intermittent hypoxia. Sleep apnea occurs in over half of diabetics, further impairing glucose homeostasis.
Gastrointestinal Issues
Gastroparesis, constipation, diarrhea and other GI issues from diabetic autonomic neuropathy or sensorimotor neuropathy disrupt sleep.
Medication Side Effects
Some diabetes medications like diuretics, beta blockers, statins, ACE inhibitors, and antidepressants can cause insomnia, vivid dreams, night sweats, and other sleep disturbances as side effects.
Anxiety and Depression
Diabetes doubles the risk of anxiety disorder and increases rates of clinical depression. These mood disorders make initiating and maintaining sleep more challenging.
Obesity
Two out of three people with type 2 diabetes are obese. Obesity predisposes people to sleep disorders like sleep apnea. Excess weight also directly impairs sleep quality.
Sedentary Lifestyle
Low physical activity levels, common in diabetes, reduce sleep need and make it harder to fall and stay asleep. Lack of exercise disrupts circadian rhythms.
Poor Sleep Hygiene
Habits like inconsistent bedtimes, exposure to screens before bed, uncomfortable sleep environments, and consumption of caffeine or alcohol too close to bedtime undermine sleep.
Tips to Improve Diabetic Sleep Health
If you or a loved one with diabetes struggles with insufficient or poor-quality sleep, there are steps you can take to improve sleep:
– Get blood sugar under control through medication adjustment, glucose monitoring, lifestyle changes, or insulin therapy if needed. Avoid wild swings in blood glucose.
– Develop healthy sleep habits like a consistent bedtime routine, limiting naps, and keeping the bedroom dark and technology-free.
– Be physically active during the day to promote sleepiness at night.
– Limit caffeine, alcohol and heavy meals before bedtime.
– Relax pre-sleep with stretching, breathing exercises, meditation or music.
– Ask your doctor about diabetes medications that can improve sleep.
– Have neuropathic pain, restless legs, sleep apnea, insomnia or other sleep disorders diagnosed and treated.
– Optimize the sleep environment with supportive mattresses and bedding, blackout curtains, white noise or ear plugs, cool temperatures and humidity.
– See a sleep specialist for guidance on maximizing diabetic sleep health through sleep hygiene, medical therapies, and/or equipment like CPAP for sleep apnea.
– Consider cognitive behavioral therapy for insomnia to reduce anxiety and conditioned sleeplessness.
– Communicate with healthcare providers about sleep challenges at each visit to identify solutions.
– Track sleep patterns using sleep diaries or wearable devices to identify barriers and measure improvements.
– Prioritize sleep by designating at least 7-9 hours for it each night and scheduling other obligations around it.
The Importance of Quality Sleep with Diabetes
Healthy sleep is foundational to properly managing diabetes and avoiding complications. During sleep, the body repairs itself, restores mind and body, regulates blood sugar, controls appetite, enhances immunity, improves insulin action, and carries out other essential biological functions. Skimping on sleep disrupts these vital processes.
Poor sleep also undermines diabetes self-care. Sleep-deprived patients often lack the energy, focus or motivation needed to stick to their medication regimen, glucose checking, meal planning, exercise program, foot care, and other important self-management behaviors. This perpetuates a vicious cycle of worsening metabolic health.
That’s why adequate, restorative sleep should be a top priority for all people living with diabetes. Take steps to diagnose and treat any sleep disorders, and be disciplined about getting 7-9 hours of quality sleep per night. Your overall health and blood sugar control will benefit immensely from the investment in rest.
Conclusion
Sleep disorders and sleep deprivation are incredibly common yet underappreciated challenges among the diabetic population. Failing to get sufficient sleep on a chronic basis sets off an array of metabolic disturbances and magnifies risks for both short-term complications like uncontrolled blood sugar as well as long-term complications including heart disease, neuropathy, renal failure and dementia. However, by being proactive to identify and remedy sleep deficiencies, diabetics can protect their health. It takes diligence to overcome sleep disruptions caused by poor glucose control, diabetes comorbidities, medications and unhealthy habits. But doing so pays major dividends in terms of facilitating diabetes management, avoiding complications and supporting general wellbeing. Prioritizing sleep is a wise investment that all people with diabetes should make.