When talking about attaining excellent control of diabetes, oftentimes diet and exercise come up, but few people realize how important it is for glucose control and weight loss to get a good night’s sleep. The LCDA has categorized good sleep as the #3 Essential. Sleep is not an option in life, as is as valuable to humans as is air, water and food. The ideal sleep is 7-8 hours each night, but from 6-9 hours is also acceptable. Less than six or above nine hours is too much (except in pediatric patients, who should sleep at least that long, and usually longer).

Why is sleep so important to diabetic patients? In terms of diabetes, several hormones are affected by sleep. Ghrelin, the “glutton” hormone, is a hormone that is produced in the stomach and duodenum, and it signals hunger and a need to eat. When a diabetic patient does not get enough sleep, the levels of ghrelin rise, causing more hunger, and especially for high carbohydrate foods. Leptin, a hormone made in fat cells, does the opposite; it signals that we are less hungry and don’t need to eat so much. Unfortunately, when one gets too little sleep, leptin levels go down, so our appetite control is not as effective. Also, sleep deprivation and living on caffeine, pushing our tired selves through the day, is a stress to the body, and that causes the adrenals to release more cortisol. Cortisol causes the liver to release more glucose into the body, raising glucose levels, especially in the morning.

A shocking study showed that getting less than 5 hours of sleep a night can increase one’s risk of becoming obese by 235%! That’s a very important fact to know. And the National Sleep Foundation noted a study showing up to 45% of Americans reported during a week that poor or insufficient sleep affected their daily activities at least once. That’s a large part of the American population that suffers regularly from poor sleep.

Poor sleep is not enough sleep, waking from sleep and not being able to return to sleep, frequent waking even if a person can return to sleep. Around 4% of Americans, around 16 million or so, take regular sleep medications.

What causes poor sleep—many factors! Caffeine, anxiety/depression, too many lights on in the home at night, irregular bedtimes, using the computer/cell phone before bed, violent or disturbing TV before bed, alcohol ingestion, hypoglycemia, reactions to prescription medications, all are common reasons. There are many ways an integrative medical practitioner can work with a patient to establish good “sleep hygiene,” setting up protocols to enable the patient to get good sleep nightly without relying on medications.

One particular concern with sleep is ensuring a pre-diabetic or diabetic patient does not have Obstructive Sleep Apnea (OSA). Obstructive Sleep Apnea is a very serious condition where the upper airway is partially or completely blocked during sleep, interfering with continuous smooth breathing. As a result, repetitive episodes of shallow or stopped breathing occur, lowering the amount of oxygen in the blood. These episodes can last from 20-40 seconds. Obesity is the most common cause of OSA in pre-diabetic and diabetic patients and losing weight can be curative. Some signs and symptoms include snoring, tiredness during the day, waking with a headache, dry mouth or sore throat, depression, poor concentration, or waking up feeling choked or gasping. Sleeping with untreated OSA increases the risk of a heart attack, high blood pressure, stroke, diabetes, clinical depression, weight gain and obesity.

Any person with the least likely risk of having OSA should have a full sleep study through a sleep center. The LCDA recommends full sleep studies over smart phone apps that state they analyze sleep. OSA is too dangerous and must be diagnosed by sleep specialists.

There are many types of treatment for OSA: machines that help force open the airway, such as a CPAP or Auto CPAP, nasal device, or oral appliances. A sleep specialist can help a patient choose the best one for them.

The LCDA understands that getting good sleep is vital to helping prevent the onset of diabetes, and ensuring excellent control of diabetes. Good sleepis also necessary to help control the appetite, promote weight loss and reduce the risk of cardiovascular disease.

To learn more about getting good sleep, please JOIN the LCDA.