How an Excess or Lack of Sleep Impacts Diabetes Type 2

Did you know that how much you sleep could impact your diabetes?

Recent studies reveal that both lack of sleep and oversleeping can increase the risk of serious complications in people with type 2 diabetes (T2D). If you’re living with T2D or want to reduce your risk of developing it, understanding the connection between sleep and diabetes is essential. Let’s explore the science and see why finding the right balance in your sleep schedule is the key to better health.

What Happens When Sleep Is Out of Balance?

A study presented at the 2024 European Association for the Study of Diabetes (EASD) Annual Meeting found a clear link between sleep duration and small blood vessel damage, known as microvascular complications, in people with T2D. These complications can cause significant health problems, including vision loss (retinopathy), kidney disease (nephropathy), and nerve damage (neuropathy).

Researchers tracked the sleep patterns of 396 participants with T2D, averaging 62 years old, using wearable devices over ten days. Participants were categorized into three groups based on their sleep duration: short sleepers (less than 7 hours), optimal sleepers (7–9 hours), and long sleepers (9 hours or more).

The results were eye-opening. Among short sleepers, 38% showed signs of microvascular damage, while 31% of long sleepers were also affected. In contrast, only 18% of those who slept an optimal amount experienced these complications. What’s more, short sleepers had a 2.6 times greater risk of microvascular disease, while long sleepers faced a 2.3 times higher risk. For people aged 62 and older, the risk for short sleepers skyrocketed to 5.7 times compared to those with optimal sleep durations.

The Vicious Cycle of Sleep and Diabetes

The relationship between sleep and T2D isn’t just one-way—diabetes can worsen sleep, and poor sleep can make managing diabetes harder, as proven by a systematic review by Darraj. This bidirectional relationship creates a vicious cycle that’s tough to break.

Darraj’s review published in PMC sheds light on this interplay. People with T2D often experience disrupted sleep, including difficulty falling asleep, frequent awakenings, and waking up feeling unrefreshed. These issues stem from common diabetes-related conditions like nocturia (frequent nighttime urination), pain from neuropathy, and fluctuating blood sugar levels.

At the same time, poor sleep quality can worsen blood sugar control. Irregular or insufficient sleep disrupts the body’s circadian rhythm and impairs glucose metabolism, leading to insulin resistance—a precursor to diabetes. The impact of short sleep durations on diabetes and obesity risk has also been documented. Research led by Grandner has found that people who sleep less than five hours a day are at risk for both diabetes and obesity.

Conditions like obstructive sleep apnea (OSA) further increase the risk of developing metabolic diseases like T2D. Together, these factors highlight the importance of addressing sleep issues as part of comprehensive diabetes care. Treating OSA with interventions like CPAP (continuous positive airway pressure) therapy can improve both sleep quality and metabolic health, potentially reducing the risk of developing diabetes.

Insomnia, another prevalent sleep disorder, can also contribute to metabolic dysregulation. Cognitive-behavioral therapy for insomnia (CBT-I) is a highly effective treatment that can help individuals establish healthier sleep patterns. Medications may also be considered in some cases, though they should be used under medical supervision.

Healthcare providers should prioritize routine screenings for sleep disorders, especially in people with risk factors for diabetes, such as obesity, family history, or sedentary lifestyles. Early identification and treatment of sleep disorders could serve as a preventative measure, improving overall health and lowering the risk of diabetes and related complications.

Why Sleep Matters in Diabetes Management

Why does sleep play such a big role in diabetes management?

It comes down to how sleep affects your body’s ability to regulate blood sugar. During deep sleep, your body repairs tissues, regulates hormones, and resets your metabolism. Disrupted or insufficient sleep interferes with these processes, making it harder for your body to manage insulin and glucose.

For people with T2D, this means that poor sleep can directly impact their ability to control blood sugar levels. Over time, unmanaged blood sugar can lead to complications like microvascular damage, which can cause permanent harm to organs and tissues.

On the flip side, achieving good-quality sleep can improve emotional regulation, energy levels, and overall health, making it easier to stick to healthy habits like eating well and exercising regularly—both of which are crucial for managing diabetes.

How to Improve Sleep Quality With T2D

If you’re living with T2D, optimizing your sleep habits can make a significant difference in your health. Here are some practical steps to help you improve your sleep.

1. Stick to a Sleep Schedule

Strive to go to bed and wake up at the same time every day. Consistency helps regulate your body’s internal clock.

2. Create a Relaxing Bedtime Routine

Wind down before bed with calming activities like reading, meditating, or taking a warm bath. Avoid screens for at least an hour before sleep, as the blue light can interfere with your melatonin production.

3. Manage Blood Sugar Levels

Fluctuating blood sugar can disrupt your sleep. Work with your healthcare provider to fine-tune your diabetes management plan, including your medication schedule and meal timing.

4. Treat Underlying Sleep Disorders

If you have symptoms of obstructive sleep apnea (e.g., loud snoring or feeling excessively tired during the day), talk to your doctor about getting tested. Treatments like BiPAP (bi-level positive airway pressure) therapy can improve both sleep and blood sugar control.

5. Optimize Your Sleep Environment

Keep your bedroom cool, dark, and quiet. Invest in a comfortable mattress and pillows, and make sure your sleeping space is free of distractions.

Sleep as a Cornerstone of Health

The findings from these studies are a wake-up call—literally and figuratively. Sleep is often overlooked in diabetes management, but it’s just as important as diet, exercise, and medication. By making sleep a priority, you can reduce your risk of complications, improve your quality of life, and make managing diabetes a little easier.

Whether you’re sleeping too little or too much, finding the right balance is crucial for managing type 2 diabetes. Both extremes are linked to increased risks of complications, particularly microvascular damage. Striving for 7 to 9 hours of quality sleep per night could help break the cycle of poor sleep and diabetes.

Remember, sleep is not a luxury—it’s a necessity! If you’re dealing with diabetes and sleep issues, don’t hesitate to talk to the experts at Nightly. Together, you can develop a plan to improve your rest and, ultimately, your overall well-being.

Ready to learn more about your sleep issues? Take this free sleep apnea quiz now!

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