The Link Between Diabetes and Insomnia

From verywellhealth.com

Diabetes is a chronic disease that causes a disruption in the metabolism of sugar (glucose) resulting in high blood sugar. In the U.S., 11.3% or 37.3 million people have diabetes, and 23% or 8.5 million people are undiagnosed.

Taking care of your diabetes means addressing behaviours that can contribute to blood sugar control, such as managing stress, eating healthy, and exercising regularly. Adequate sleep is also important. On average, adults need roughly seven to nine hours of sleep, and kids need even more. Research indicates that lack of sleep can increase the risk of diabetes, but can diabetes cause insomnia?

This article explores the relationship between diabetes and insomnia, as well as treatment options.

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THE LINK BETWEEN DIABETES AND SLEEP

Diabetes and sleep are connected—if one is not optimal, the other can be impacted. For example, high blood sugar (hyperglycaemia) can cause increased thirst and urination. When this occurs overnight, sleep is disrupted by frequent trips to the bathroom. A person experiencing low blood sugar (hypoglycaemia) may wake up irritable or from sweating, palpitations, or confusion.

Insufficient sleep disrupts hormonal balance, dropping leptin (satiety hormone) levels and increasing ghrelin (hunger hormone) levels. This hormonal disruption can lead to excess consumption of food, which can increase blood sugar.

Studies show that inadequate sleep is associated with an increased risk of type 2 diabetes. In addition, difficulty falling and staying asleep, daytime drowsiness, and poor sleep quality have been reported by people with type 2 diabetes. Research suggests that the prevalence of insomnia (symptoms) is 39% in people with type 2 diabetes.

SLEEP ISSUES ASSOCIATED WITH TYPE 2 DIABETES

Studies show a relationship between sleep problems and insulin resistance, prediabetes, and diabetes. Insulin is a hormone; its main function is to assist glucose in reaching the cells so it may be used for energy. Lack of sleep can increase insulin resistance (the cells become resistant to insulin) and overtime elevated blood sugars can increase the risk of prediabetes and type 2 diabetes.

People with type 2 diabetes are more likely to have conditions that impact sleep, such as sleep apnoea, peripheral neuropathy, and restless leg syndrome.

Sleep Apnea

Sleep apnoea, also referred to as Obstructive Sleep Apnoea (OSA), affects about two-thirds of people with type 2 diabetes. It is a sleep disorder in which a person's breathing starts and stops throughout the night due to recurrent upper airway collapse and is associated with full-body inflammation and oxidative stress. OSA can cause impaired glucose tolerance with insulin resistance. The more severe it is the greater impact it will have on glycaemic control.

Peripheral Neuropathy 

Diabetic peripheral neuropathy is nerve damage caused by diabetes that impacts the feet, legs, hands, and arms. This is the most common type of neuropathy in people with diabetes and affects about one-third to one-half of people with diabetes.

Peripheral neuropathy can cause pain, numbness, tingling, and a burning sensation. It is associated with sleep disturbances and poor sleep quality. Lack of sleep also increases pain sensitivity. Researchers suggest that because these conditions are connected, they should be treated simultaneously.

Restless Legs Syndrome

Restless legs syndrome (RLS) affects about 21% of people with type 2 diabetes and is the fourth leading cause of insomnia. The compulsion to move the legs typically occurs at night or when at rest. Symptoms of RLS are very similar to peripheral neuropathy and include things such as pain, burning, numbness, tingling, and electrical simulations.

Although frequently unrecognized, RLS impairs sleep quality and is associated with increased drug consumption at night and depressive and anxious symptoms. RLS may be a risk factor for hypertension and cardiovascular disease.

Primary Insomnia

Primary insomnia is defined as difficulty sleeping and staying asleep that typically lasts three weeks or longer. This type of insomnia also makes you feel tired and irritable during the day. Primary insomnia is not caused as a result of a medical condition or medication. There is no known cause.

TREATMENT

Insufficient sleep can impact your quality of life. Management of sleep disorders often requires multiple steps, including relief of symptoms and treatment of the contributing conditions. If you have diabetes, and your sleep is impaired as a result of inadequate blood sugar control, the best thing to do is get your blood sugars in a healthy range.

You will need to investigate why your blood sugar is elevated. Are you exercising enough, taking medication as prescribed, eating a healthful diet? These are just some of the variables that can impact blood sugar control. Reach out to your medical team for support.

If another condition is causing your sleep trouble, you will need to receive treatment for that condition. For example, if you have sleep apnoea, your healthcare provider may recommend a Continuous Positive Airway Pressure (CPAP) machine, Bilevel positive airway pressure (BiPAP), or other alternative treatments.

However, if another health condition is causing your sleep problems, you will want to treat that condition. In some instances, when lifestyle isn't enough, medications can be prescribed to treat underlying conditions.

SUMMARY

People with diabetes are at increased risk of having sleep-related issues. These issues can be caused by a secondary condition associated with diabetes, such as neuropathy or OSA, or as a result of diabetes symptoms, like excessive thirst or urination. If you are having trouble managing your blood sugars and as a result, your sleep is impaired, you should contact your medical team. Improvements in sleep quality can improve your glycaemic control and vice versa.

A WORD FROM VERYWELL

It is not uncommon for people with diabetes to have difficulty sleeping. Sleep disruption can lead to feelings of fatigue and irritability. Sometimes changing your routine, by limiting screens before bed, and reducing caffeine is enough to improve sleep. However, in many instances, treatment of the underlying issue will be necessary. Find the support and education you need to get better rest and feel more energized.

FREQUENTLY ASKED QUESTIONS

• Can diabetes cause chronic insomnia?

  People with diabetes can experience insomnia if their blood sugars are not at goal or if they have another underlying health condition that is affecting their sleep. Depression is another condition associated with diabetes that can seriously impact sleep. If you are experiencing depressive symptoms, you should contact your medical team right away.

• Will insomnia go away on its own?

  Insomnia is defined as a chronic difficulty of falling asleep, staying asleep, or waking up early, despite adequate opportunity to sleep at least three times a week during one month. If you experience difficulty sleeping for a few nights because you are not feeling well, chances are you don't have insomnia. However, if you have chronic sleep issues, the likelihood of it going away on its own is probably not realistic.

• Can a person with diabetes take melatonin?

  Melatonin supplementation is often used as a sleep aid because it plays a role in regulating sleep. Melatonin has also been shown to lower glucose and blood pressure. If you have diabetes and are taking medications to lower your blood sugar or blood pressure, you should discuss the safety of use with your healthcare provider before starting.

• https://www.verywellhealth.com/diabetes-and-insomnia-5218041