- The Sound Sleeper
Webinar: Sleep's impact on diabetes
Watch and learn how sleep affects blood sugar, helping you manage diabetes and prediabetes. Dr. Alp Sinan Baran, Medical Director of SleepCharge, also presents helpful sleep hygiene tips for a better night’s sleep.
Dr. Baran: Hi, everybody. I’m pleased to be here, and we’re just gonna do a nice, brief presentation on diabetes and how sleep impacts it, and what we can do to, hopefully, prevent this from occurring.
So first, let’s start with a definition. What is type 2 diabetes? Well, first, let’s define diabetes. In general, there’s type 1 and type 2.
Diabetes is a disease of abnormal carbohydrate metabolism characterized by high blood sugar due to impaired insulin production by special cells in the pancreas and resistance to the action of insulin.
Glucose is the basic fuel that our body uses to generate energy to operate. Insulin helps glucose in the bloodstream get into cells where it can be used. If glucose can’t get into cells, it accumulates in the bloodstream causing health problems.
Type 1 diabetes is when the pancreas does not make insulin. This is about five to 10% of diabetes cases.
Type 2 diabetes is when the pancreas does not make enough insulin and there is insulin resistance in the tissues, so insulin does not have the effect that it normally would. This is 90% or more of diabetes cases and it typically occurs during adulthood.
An increase in body weight is a common cause. Over time, diabetes damages the heart, kidneys, eyes, brain and nervous system.
There’s increased risk of many medical problems, including heart attack, stroke, kidney failure and blindness. It’s a very serious chronic disease.
Prediabetes is when blood sugar levels are elevated, but not high enough to qualify for diabetes. Unless this is addressed, it can progress to Type 2 diabetes, and the good news is, it can be prevented.
Many people know that obesity is a major cause of type 2 diabetes. Did you know that insufficient sleep or poor quality of sleep can also play a role, too? Poor or insufficient sleep has three effects that raise blood sugar: reduced insulin production, increased insulin resistance and increased cortisol, which increases the blood glucose level.
When you’re sleep deprived, or when sleep is insufficient, or, in poor quality, it affects our eating behavior, making us more hungry, and eating more, and makes us eat foods higher in sugar, craving these foods more.
Deep sleep, It’s good for our health in many ways. This is what makes us feel rested. Our brain clears out waste products most efficiently in deep sleep and it promotes better regulation of blood glucose.
When we are deprived of deep sleep, whether it’s due to just not sleeping enough or having a sleep disorder that causes reduced sleep quality, our glucose regulation is impaired.
Also when rested, our behavior improves due to the physiologic regulation of hunger hormones, and we’re more likely to be motivated to be active and exercise.
When we’re fatigued, sleepy, sleep deprived, exercising is the last thing anybody wants to do.
There are three ways that sleep can be compromised.
The obvious one is duration, not enough sleep.
The study referenced in this slide used five hours as the cutoff, but other studies have shown increased risk with less than seven hours of sleep, as well. The shorter the sleep time, the higher the risk of getting diabetes, and, of course, the other detrimental effects of poor sleep and insufficient sleep.
Timing, irregular sleep times, reduce the ability to sleep well and affect the normal distribution of sleep stages.
We have a brain timekeeper that has a set point. It can adapt to change but only about one hour, plus or minus one hour, per day. So if there are major changes in the sleep schedule day-to-day, our brain just can’t keep up with that. And sleep quality is going to suffer as a result of the timing issue.
Sleep quality in general, there are sleep disorders that fragment sleep, such as obstructive sleep apnea. And these don’t let you get into the more restful deep stages of sleep because of all the interruptions that are occurring.
And these interruptions are, usually, most of these are so brief that we’re not aware of them, lasting just a few seconds.
So your sleep can be very fragmented, but you may think that you only woke up a few times, or perhaps not even at all, because anything, less than a few minutes in duration of an awakening, just goes by unnoticed. I mean, we’re not conscious of it and we don’t remember it.
So any one of these factors is, by itself, very important, but when there’s more than one inaction, things clearly become worse.
I think most people know that weight management, dietary changes and exercise are important for good health in general and for diabetes prevention, but it is also very important to get enough sleep and good sleep, and diagnose or treat sleep disorders that may be working against you.
Alright, some general rules of sleep hygiene. Many of these, I think, are common knowledge and they’re all very important but I’ll take the opportunity to elaborate on caffeine and alcohol because there are some misconceptions there, and I just want to make sure that we get that information across.
Caffeine is an enemy of sleep and it sticks around in your bloodstream for a long time. The half-life of caffeine in the blood of healthy individuals is about five hours, which means it takes five hours to clear half of it, and then another five hours to clear the remaining half and so on.
So it can really linger on for a while. The more caffeine you consume and the later you consume it, the more it can interfere with sleep.
I recommend no more than two caffeinated beverages per day, the last one, no later than the early afternoon, And if you feel like you’re consuming too much caffeine and you need to cut down, be sure to do it gradually to avoid caffeine withdrawal, which can be pretty uncomfortable especially with headaches. I would suggest reducing by no more than one cup per day, starting with the later cups of caffeinated beverage in a day as the first ones to go.
Many people think that alcohol helps you sleep better. Well, at first, it does, but after a few hours as the blood level starts to decline, sleep becomes fragmented and the overall effect is negative.
It also worsens sleep apnea and certain other sleep disorders that we call parasomnias. So, it is detrimental to sleep in a variety of ways.
As I mentioned earlier, sleep apnea causes sleep fragmentation, which is really the equivalent of insufficient sleep. You can have a normal duration of sleep, but if it’s fragmented, the value of that sleep goes down and it’s the equivalent of a really shorter duration.
And another point here that maybe I can comment on is the bright light exposure. Bright light tends to alert us and actually stimulates a part of our brain, that timekeeper that I mentioned earlier.
It’s called a suprachiasmatic nucleus; it has a direct connection to our eyes. And bright light tends to alert us and makes us think that it’s time to keep going and not go to sleep. So bright light exposure in the evenings and at night is best avoided. Early in the morning is fine. And, actually, early morning, bright light exposure is one good way to keep people on a good sleep schedule and just keep things on track.
And I’ll make one more comment here, also, it’s very important to have a winding down time prior to bedtime. You don’t want to be going full speed ahead with whatever you may be doing, certainly not exercising near bedtime. You need to allow at least three hours between finishing exercising and bedtime. That’ll also prevent you from falling asleep.
But, also, even if it’s not exercise, just any engaging activity, should be halted at least half an hour or so prior to bedtime, to let you wind down and get ready to go to bed and go to sleep. You can’t just be, you know, doing something in an actively engaged manner and then go straight to bed and expect to fall asleep quickly.
So all these little things matter, and it does all add up, But, sleep hygiene is one of the first steps in making sure that sleep is on track. And it’s the fundamental building blocks of good sleep. That’s where it all starts.
So how can SleepCharge help you? Sleep is so important in so many ways. So check out the Sleep CheckupTM. It’s a good way to get some information, more information about sleep and learn some additional facts about sleep. And if you have a sleep disorder, you’ll be in good hands with SleepCharge.
We have a team of board-certified sleep specialists who are available for consultation, depending on eligibility and medical necessity, but it’s a great resource. Certainly, I would strongly advise looking into it.
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