Reviewed by: HU Medical Review Board | Last reviewed: March 2021. | Last updated: April 2021
Diabetes and sleep disorders are both common problems that can worsen one another. People with diabetes report higher rates of sleep-related conditions, including:1
- Poor sleep quality
- Excessive daytime sleepiness
- Higher use of sleeping drugs
Diabetes symptoms such as nerve damage and increased urination at night can also add to sleeping problems.1
Understanding the link between diabetes and sleep problems can help you address these issues. This can help you get the rest you need each night and improve your health.
Can sleep problems cause diabetes?
Studies have shown that sleep problems alone can increase your chances of developing diabetes. The common factor between sleep problems and diabetes appears to be insulin resistance.1
Insulin is a hormone your pancreas produces in the body. Insulin helps to make sure that sugar (glucose) enters the cells in your body, where it is then used for energy. Insulin acts as the key to unlocking the cell in order to use glucose. Without insulin, glucose cannot enter the cell the way it should. Instead, glucose stays in the blood. This leads to high blood sugar (hyperglycemia).2
In type 1 diabetes, your body does not make insulin. Insulin must be given in order to get glucose into the cells. In type 2 diabetes, insulin is still made, but the cells of the body do not respond to it in the way they should. This is known as insulin resistance. Insulin resistance leads to increased blood sugar, which can cause many problems in the body.2
There are several ways that sleep disorders can lead to insulin resistance and increase the chance of developing diabetes.
Hunger and appetite
When sleep-deprived, the hunger and appetite center in your body is overactive. This increases your hunger hormone levels (ghrelin). Lack of sleep also decreases the hormone responsible for sending your brain the message that you are full (leptin). The result is your need for that midnight snack and perhaps even overeating the next day.1,3
Quality and total amount of sleep
The quality and total amount of sleep you get affects how your body responds to insulin. Studies have shown that even a 1-week-long period of sleep less than 4 hours per night can increase the risk for insulin resistance. Doctors have linked this to blood sugar (glucose) and insulin. When you do not get the sleep you need, your body can have insulin resistance.1,3
Changes to the circadian rhythm
An internal body clock in your brain controls circadian rhythms in your body. These rhythms rise and fall over the 24 hour day and help you fall asleep at night and wake up in the morning. Shift workers who work at night have changes to their circadian rhythms. Shift workers have a 44 percent increase in the risk of developing type 2 diabetes and insulin resistance changes.3,4
Diabetes and sleep disorders
Sleep disorders are more common in those with diabetes compared to those without diabetes.
Obstructive sleep apnea
Obstructive sleep apnea (OSA) has been closely linked to obesity, insulin resistance, and type 2 diabetes. OSA is a sleep disorder in which a person experiences pauses in breathing or shallow or infrequent breathing during sleep. OSA results in low quality of sleep, along with other health complications. OSA can lead to high blood pressure and heart and lung problems, including death.1,3
People with diabetes have a much greater risk of developing depression compared to those who do not have diabetes. Although depression is not a sleep disorder, it is an important factor that adds to poor sleep in those with diabetes.1
Treatment and diabetes management
As with other complications related to diabetes, treatment for sleep disorders starts with better blood sugar control. Your doctor may prescribe different drugs to better manage your diabetes, which may help with your sleep.1,3
Additional drugs may be needed to help with your sleep. These may include antidepressant drugs if needed.1
If you have OSA, a CPAP device may be needed. This device is worn at night and provides continuous pressure to your airway, keeping it open.1
Additional sleep tips may be useful, depending on the direction of your doctor:
- Maintaining a regular sleep schedule
- Get regular exercise
- Avoid alcohol or caffeine close to bedtime
- Avoid napping during the day if possible