Diabetic sleep disorders are getting a lot of attention. Most of that is because the link between sleep loss and type 2 diabetes is showing up in shift workers, sleep apnea sufferers and healthy young people with sleep deprivation.
What is most exciting is that researchers have found a genetic link to the hormone melatonin. It may hold a key to a genetic cause for the tendency to have type 2 diabetes.
Diabetic Sleep Disorders and Slow Wave Sleep
Doctors who study and treat sleep apnea have known for many years that there is a connection between slow wave sleep and health. People who have this sleep disorder get very little to no deep sleep. Doctors named this stage slow wave sleep from the EEG readings that they charted.
Treating sleep apnea gives the sufferer a chance to enter REM (dream sleep), and they found that the slow wave sleep that surrounds REM is just as important. During this stage your body heals itself and resets its regulating hormones for appetite, body temperature and even your metabolic rate (how well you burn calories).
During this sleep you actually burn more fat than you do while you exercise. If all those things are true, it is essential to your health to get a good amount of slow wave sleep.
Here's another fact. Healthy young men and women were tested while they were getting less than 5 hours of sleep a night. In just a few days they showed greater insulin resistance. It was another proof that slow wave sleep is linked to lower glucose levels.
Diabetic Sleep Disorders and Obesity
Studies also showed that people who slept less tended to have a higher BMI. Sleep deprivation greatly increases your risk of obesity. And the connection lies in your hormones.
Short sleep time lowers your leptin, the hormone that signals decrease in appetite and speeding up of metabolism when it senses you have fat stores. Sleep deprived people also have higher levels of ghirelin, the hormone that stimulates hunger. The net result is increased appetite and more storing of calories in fat.
So sleep disorders increase your risk of obesity. People who get over 7 hours of good sleep tend to be less likely to be obese.
Some of the causes are due to behavior. When you are exhausted you will eat to stay awake. And you may think that eating will give you more energy when what you have is a "sleep debt" that you need to pay.
Many of us who are type 2 diabetic think we are getting good sleep because we sleep most of the night. So why do we wake up groggy and feel unrested? Sleep doctors will tell us the problem is almost always obstructive sleep apnea.
If you are getting little or no slow wave sleep, you will fight hunger all day and have a very hard time losing weight. Exercise helps, but if sleep apnea is treated you will get more benefit from the exercise.
Diabetic Sleep Disorders and Diabetes Complications
For type 2 diabetics there are other reasons for sleep loss. Diabetic nocturia from polyuria or from medications gets you out of bed in the middle of the night. Neuropathic pain and super-sensitive feet will make it hard to stay comfortable all night. And there is the annoying restless legs syndrome that plagues diabetics more than nondiabetes.
These problems are helped by tight blood sugar control and plenty of exercise. But many type 2 diabetics must also rely on medications for the neuropathy and restless legs. The trouble is that some of those medications have a side effect of inhibiting slow wave sleep.
You need to tell your doctor if while taking the pills he prescribed you are sleepy during the day and have problems with hunger and staying alert. Everyone responds to medications differently, and you may need a lower dosage or even a different medication. Do not give up until you are getting the benefits and still getting all the slow wave sleep you need.
Diabetic Sleep Disorders and Melatonin
There is a genetic link between type 2 diabetes and melatonin, and it has to do with damage at the DNA level. If the melatonin receptor's DNA is damaged, sleep will be affected along with lower metabolism and lower insulin production. All of that means higher blood sugars and worsened sleep. This combination can lead to type 2 diabetes and obesity.
Your beta cells, the producers of insulin, have the protein that makes melatonin in them. So if melatonin is affected, so is insulin. This is new stuff, so how it will change our treatment as diabetics is not clear.
Your biological clock is regulated by melatonin and serotonin. When light levels are low your brain tells your pineal gland to release melatonin, and you get sleepy. It peaks just before bedtime and then fades. Serotonin is stimulated by light and wakes you up. That's why if you have trouble falling asleep at night or waking up in the morning, a 15-minute dose of sunlight will do wonders.
When tested for it, type 2 diabetics have been found to have less melatonin than nondiabetics, but we can not just take it in a supplement. Melatonin pills are given to people who have confused their days and nights from shift work or jet lag, and blind people take them to help their biological clock work better.
So why do not diabetics take melatonin? For one thing it promises to raise blood sugar levels. For another, it is not a good idea to take a supplement of it over a long period of time because of side effects. Finally, taking melatonin has not done anything to help diabetes at all.
So for now you need to make sure you are not depriving yourself of sleep with bad sleep habits. And if you have signs of obstructive sleep apnea, do not ignore them. Once it has been treated your type 2 diabetic medications may be lowered, and you'll stop the complications that go along with diabetic sleep disorders.
There are other things you can do to help with good sleep. And there are superfoods that you can eat at night to help you sleep. You can find suggestions on my blog about sleep.
Pay your sleep debt with more than 6.5 hours a night and diabetes will be simpler to control, your obesity battle will be easier to win, and you will have more energy for the exercise that just might end the need for diabetic remedies. It is what I wish for all of us.