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Type 2 diabetes: One often overlooked risk factor in sleep – are you aware of it?

Type 2 diabetes is a common condition that causes the level of sugar (glucose) in the blood to become too high. The number of people living with diabetes is expected to rise to five million by 2025. This figure should come as no surprise, excess weight is a common culprit, and two-thirds of adults are either overweight or obese in the UK. What may come as a surprise, however, is the role sleep plays in developing the condition.

According to the National Sleep Foundation, sleep deprivation is an often overlooked but significant risk factor for type 2 diabetes. The primary reason for this is the impact sleep has on hormone levels.

The health body explained: “With ongoing sleep loss, less insulin (a hormone that regulates blood sugar) is released in the body after you eat.

“Meanwhile, your body secretes more stress hormones (such as cortisol), which helps you stay awake but makes it harder for insulin to do its job effectively. The net effect: Too much glucose stays in the bloodstream, which can increase your risk of developing type 2 diabetes.”

These effects have shown up in people who only get between four and a half to six hours of sleep per night. “In particular, a decrease in slow-wave (or “deep”) sleep—which is thought to be the most restorative stage of sleep—seems to play a major role in maintaining proper insulin sensitivity and blood sugar control,” the National Sleep Foundation said.

Research has confirmed the link between sleep loss and higher insulin resistance. A study, published in Diabetes Care, assessed the sleep of forty people with type 2 diabetes over six nights, checking if they were suffering any problems with their sleep, such as insomnia, sleep apnea or snoring.

People who have a hard time controlling their blood glucose levels have a greater risk of complications

Kristen Knutson

They also provided blood samples so the researchers could analyse insulin and glucose levels. It was found that the diabetics who were also poor sleepers had 23 percent higher levels of blood glucose in the morning, as well as 48 per cent higher levels of blood insulin.

For insulin resistance, these figures meant that poor sleepers with diabetes had 82 percent higher insulin resistance than normal sleepers with diabetes.

Kristen Knutson, lead author on the study, said: “People who have a hard time controlling their blood glucose levels have a greater risk of complications. They have a reduced quality of life . And, they have a reduced life expectancy.”

Eve Van Cauter, co-author of the study, also said: “This suggests that improving sleep quality in diabetics would have a similar beneficial effect as the most commonly used anti-diabetes drugs.”

In addition, getting too little sleep can increase a person’s appetite and reduce their level of satiety, causing them to crave carbohydrates and sugary foods, said the NSF.

Binging on these foods can impair insulin production and cause blood sugar levels to soar, as well as increase body weight. Plus, a lack of sleep makes people less inclined to exercise, which plays a vital role in controlling weight and blood sugar levels.

Short-term sleep deprivation shouldn’t ring alarm bells, these effects can be reversed—and insulin levels can improve—with as little as two full nights of sleep (nearly 10 hours per night), it explained, but try to not make a habit of it.

The NSF recommends aiming for seven to nine hours of uninterrupted sleep on a nightly basis to keep the body functioning optimally and to reduce your risk of developing type 2 diabetes and other health problems.

The NHS recommends making simple lifestyle changes to get a more restful night’s sleep. These include:

  • Keep regular sleep hours – going to bed and getting up at roughly the same time every day will programme your body to sleep better. Choose a time when you’re likely to feel tired and sleepy.
  • Create a restful sleeping environment -your bedroom should be a peaceful place for rest and sleep. Temperature, lighting and noise should be controlled so that your bedroom environment helps you to fall (and stay) asleep. If you have a pet that sleeps in the room with you, consider moving it somewhere else if it often disturbs you in the night.
  • Make sure your bed is comfortable – it’s difficult to get restful sleep on a mattress that’s too soft or too hard, or a bed that’s too small or old.
  • Exercise regularly – moderate exercise on a regular basis, such as swimming or walking, can help relieve some of the tension built up over the day. Make sure that you don’t do vigorous exercise, such as running or the gym, too close to bedtime, though, as it may keep you awake.
  • Cut down on caffeine – cut down on caffeine in tea, coffee, energy drinks or colas, especially in the evening. Caffeine interferes with the process of falling asleep, and also prevents deep sleep. Instead, have a warm, milky drink or herbal tea.
  • Don’t over-indulge – too much food or alcohol, especially late at night, can interrupt your sleep patterns. Alcohol may help you to fall asleep initially, but it will disrupt your sleep later on in the night.
  • Don’t smoke – nicotine is a stimulant. Smokers take longer to fall asleep, they wake up more frequently, and they often have more disrupted sleep.
  • Try to relax before going to bed – have a warm bath, listen to quiet music or do some gentle yoga to relax the mind and body. Your doctor may be able to recommend a helpful relaxation CD.
  • Write away your worries -if you tend to lie in bed thinking about everything you have to do tomorrow, set aside time before bedtime to make plans for the next day. The aim is to avoid doing these things when you’re in bed, trying to sleep.
  • If you can’t sleep, get up – if you can’t sleep, don’t lie there worrying about it. Get up and do something you find relaxing until you feel sleepy again, then go back to bed.

If a lack of sleep is persistent and affecting your daily life, make an appointment to see your GP, said the health body.

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