Sleep plays a significant role in our overall wellbeing, particularly concerning conditions like type 2 diabetes. Research has established a strong connection between inadequate sleep and the risk of developing type 2 diabetes. 7 to 8 hours appears to be best, with increasing risk of diabetes both below and above those hours.
In this article we will look at the mechanisms involved and provide some tips on how to improve sleep. As ever, please talk to your doctor or medical practitioner most familiar with your medical history before implementing any changes in diet, exercise or lifestyle, especially if you are under treatment. Links to any supporting studies or resources are at the end of page.
People most at risk are those with too little sleep, those with disturbed sleep (noisy, neighbours, kids, sleep apnea) or have sleep patterns that do not conform to circadian rhythms - our natural daily cycles based on sun-up and sundown - shift work, jet-lag and even 'social-lag' can be involved.
Several mechanisms contribute to the relationship between sleep and Type 2 diabetes:
Insulin Resistance
Lack of sleep disrupts the body's ability to use insulin efficiently. Sleep deprivation decreases insulin sensitivity in cells, making it harder for the body to regulate blood sugar levels effectively.
Hormonal Imbalance
Sleep deprivation affects hormones such as leptin and ghrelin, which regulate hunger and fullness. When sleep is insufficient, levels of ghrelin (the hunger hormone) rise, and leptin (the hormone that signals fullness) decreases. This hormonal imbalance often leads to overeating and unhealthy food choices, contributing to weight gain and diabetes.
While being overweight is often involved in type 2 diabetes, a significant number of people can be normal weight and still affected. Read more on the significance of one's personal fat threshold here.
Stress Hormones
Chronic lack of sleep triggers the release of stress hormones like cortisol. Elevated cortisol levels can lead to increased insulin resistance and higher blood sugar levels, both risk factors for Type 2 diabetes.
Disrupted Circadian Rhythms
The body's internal clock, governed by circadian rhythms, regulates various physiological processes, including metabolism. Irregular sleep patterns can disrupt these rhythms, leading to metabolic dysfunction and an increased risk of diabetes.
Inflammation
Poor sleep has been linked to increased inflammation in the body. Inflammation plays a role in the development of insulin resistance and is associated with various complications related to Type 2 diabetes.
Improving Sleep for Diabetes Management
Addressing sleep patterns and ensuring adequate rest is crucial for individuals with or at risk of Type 2 diabetes. Implementing healthy sleep habits, often referred to as sleep hygiene, can significantly improve both the quality and duration of sleep.
This includes:
Maintaining a consistent sleep schedule.
Creating a relaxing bedtime routine.
Optimising the sleep environment, have a dark quiet room.
Limiting exposure to electronic devices before sleep.
Other sleep promoting habits also include:
Managing caffeine intake, especially in the afternoon. Not only coffee and teas - including green tea and matcha, sports drinks and supplements or soft drinks can all contain caffeine.
Getting regular exercise, although avoid intensive exercise within a few hours of bed.
Avoiding large meals immediately before bed.
Avoiding alcohol. This can help you get to sleep but the quality of sleep can be severely impacted.
Final Thoughts
Understanding the intricate relationship between sleep and type 2 diabetes is essential for prevention and management strategies. By recognising the effects of poor sleep and the underlying mechanisms, individuals can make informed lifestyle choices to prioritise sleep and reduce their risk of developing type 2 diabetes or its complications.
For most people, improving health is about finding motivation and prioritising self-care with an ultimate goal of taking action. If you want to take effective and targeted steps that fit into your unique lifestyle, The Whole Health Practice is here to help.
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Related Studies
Nôga DA, Meth EMES, Pacheco AP, Tan X, Cedernaes J, van Egmond LT, Xue P, Benedict C. Habitual Short Sleep Duration, Diet, and Development of Type 2 Diabetes in Adults. JAMA Netw Open. 2024 Mar 4;7(3):e241147. doi: 10.1001/jamanetworkopen.2024.1147. PMID: 38441893; PMCID: PMC10915681.
Chen Y, You Y, Wei M, Yang P, Zhang Q, Li X, Zuo Q, Cao Q. Exploration of physical activity, sedentary behavior and insulin level among short sleepers. Front Endocrinol (Lausanne). 2024 Oct 14;15:1371682. doi: 10.3389/fendo.2024.1371682. PMID: 39469577; PMCID: PMC11513348.
Zuraikat FM, Laferrère B, Cheng B, Scaccia SE, Cui Z, Aggarwal B, Jelic S, St-Onge MP. Chronic Insufficient Sleep in Women Impairs Insulin Sensitivity Independent of Adiposity Changes: Results of a Randomized Trial. Diabetes Care. 2023 Nov 13:dc231156. doi: 10.2337/dc23-1156. Epub ahead of print. PMID: 37955852.
Albers JD, Meertens RM, Savelberg HHCM, Köhler S, Wesselius A, Schram MT, Stehouwer CDA, de Galan BE, van Greevenbroek MMJ, van der Kallen CJH, Eussen SJPM, Bosma H, Schaper NC, Koster A. Both short and long sleep durations are associated with type 2 diabetes, independent from traditional lifestyle risk factors-The Maastricht Study. Sleep Health. 2023 Oct;9(5):733-741. doi: 10.1016/j.sleh.2023.06.009. Epub 2023 Aug 10. PMID: 37573207.
Lu H, Yang Q, Tian F, Lyu Y, He H, Xin X, Zheng X. A Meta-Analysis of a Cohort Study on the Association between Sleep Duration and Type 2 Diabetes Mellitus. J Diabetes Res. 2021 Mar 24;2021:8861038. doi: 10.1155/2021/8861038. PMID: 33834077; PMCID: PMC8012145.
Parameswaran G, Ray DW. Sleep, circadian rhythms, and type 2 diabetes mellitus. Clin Endocrinol (Oxf). 2022 Jan;96(1):12-20. doi: 10.1111/cen.14607. Epub 2021 Oct 12. PMID: 34637144; PMCID: PMC8939263.
Antza C, Kostopoulos G, Mostafa S, Nirantharakumar K, Tahrani A. The links between sleep duration, obesity and type 2 diabetes mellitus. J Endocrinol. 2021 Dec 13;252(2):125-141. doi: 10.1530/JOE-21-0155. PMID: 34779405; PMCID: PMC8679843.
Ogilvie RP, Patel SR. The Epidemiology of Sleep and Diabetes. Curr Diab Rep. 2018 Aug 17;18(10):82. doi: 10.1007/s11892-018-1055-8. PMID: 30120578; PMCID: PMC6437687.
Reutrakul S, Van Cauter E. Sleep influences on obesity, insulin resistance, and risk of type 2 diabetes. Metabolism. 2018 Jul;84:56-66. doi: 10.1016/j.metabol.2018.02.010. Epub 2018 Mar 3. PMID: 29510179.
Shan Z, Ma H, Xie M, Yan P, Guo Y, Bao W, Rong Y, Jackson CL, Hu FB, Liu L. Sleep duration and risk of type 2 diabetes: a meta-analysis of prospective studies. Diabetes Care. 2015 Mar;38(3):529-37. doi: 10.2337/dc14-2073. PMID: 25715415.
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