Could Insomnia Cause Diabetes?

Researchers from Taiwan found that chronic insomnia raises the risk of type 2 diabetes.

insomniaAlthough researchers can't fully explain the link between sleeplessness and diabetes one theory is that not receiving sufficient sleep disrupts how your body metabolizes blood sugar.

If you don't sleep well--constantly tossing and turning and unable to doze off--you know it can make you cranky and fatigued.

However, insomnia has a more serious consequence, too. It can boost your risk of getting type 2 diabetes, even if you are not yet middle-aged, and especially if it persists for years, new research shows.1

Researchers from Taiwan looked at more than 28,000 people with insomnia who didn't have diabetes at the start of the study, following them for an average of six years, and found the increased risk. That rise rose steadily with time, going up to a 50% greater risk in those with persistent insomnia compared to those without the sleep problem.

"It's not just one night that's the problem, it's night after night," says Elena Christofides, MD, FACE, chief operating officer of Endocrinology Associates in Columbus, Ohio, who reviewed the study. Quality sleep is crucial, she says, so that your body will rest and repair itself. The new study findings, she says, make sense and warrant attention.

Here is what else to know.

More on Insomnia, Diabetes

Experts have long known that sleep is important to regulate your body's metabolism and that being deprived of it can have ill effects on regulating your blood sugar and on throwing hormones out of whack so your appetite increases.

For the new study, researchers analyzed data from more than 28,000 men and women who were diabetes-free at the start of the study in 2001 through 2004 but did have a new diagnosis of insomnia.  They compared this group to data from more than a million more people randomly selected from the country's national health insurance data base, as well as more than 57,000 people without insomnia who were matched to the insomnia group by sex and age.

The researchers followed the groups for an average of six years. Overall, the risk of getting a type 2 diabetes diagnosis was 16% higher among those with insomnia than those without. Among those people followed for more than 8 years, the risk of a diabetes diagnosis was 50% higher among those with insomnia than those without.

And those age 40 and below with insomnia were even more likely than older people with insomnia to get a diabetes diagnosis.

The researchers point out the importance of sleep in the study's conclusion, published in the journal Diabetes/Metabolism Research and Reviews: "Therefore, in addition to conventional risk factors such as obesity, diet, and exercise, the strategies for type 2 diabetes mellitus prevention should include the treatment of sleep problems, which would enable more comprehensive type 2 diabetes mellitus care."

Why the Link?

Scientists can't explain with certainty the link between insomnia and diabetes. However, they have a few ideas.

  • Too little sleep disrupts how your body metabolizes blood sugar.
  • Inadequate sleep adversely affects the balance of the hormones leptin (the ''feel full'' hormone) and ghrelin (the hunger hormone). That imbalance can trigger overeating, and being overweight raises diabetes risk.
  • If you don't sleep well, you may search out unhealthy food choices, such as high-fat, high-calorie foods, to keep yourself going, and gain weight.

How To Fix Your Sleep

While you may say, "Easy. Pop a sleeping pill," experts say that is not a wise first step to getting better sleep.

Instead, pay attention to good sleep habits, which your doctor and sleep specialists call sleep hygiene. That list includes these practices:

  • Sleep in a quiet, darkened room, with no street lights streaming in.
  • Avoid the ''blue light'' from your phone, iPad, laptop and TV at night. If you can't bear to power them all off, you can wear blue light-blocking glasses or download apps that do that on cell phones, Dr. Christofides says.
  • Consider melatonin, sold over the counter without a prescription. Melatonin is a hormone that helps your body adjust its internal clock. Even though it is over-the-counter, your doctor should make the dosing decisions, Dr. Christofides says. People require different doses to achieve a good effect.
  • Think about that night-time drink. "A lot of people have insomnia from drinking alcohol in the evenings," says Scott Isaacs, MD, FACE, FACE, medical director of Atlanta Endocrine Associates, who also reviewed the study. "The alcohol (usually wine) helps them fall asleep but then they wake up in the middle of the night when the alcohol wears off." However, he encourages patients to make their own decisions about alcohol.

If insomnia persists despite cleaning up your bedtime act, Dr. Isaacs says he will refer patients to a sleep specialist. Sleep specialists evaluate the problem and decide what other remedies, including the potential use of sleeping pills, may help you get a quality night's sleep.

Dr. Isaacs reports consultant work for Novo Nordisk and Speakers' Bureau work for Novo, Takeda Pharmaceutical Company and Orexigen Therapeutics. Dr. Christofides reports consultant work for Noro Nordisk, Eli Lilly and Chiasma and Speakers' Bureau work for Pfizer, Novo, Eli Lilly, Boehringer Ingelheim, PamLab and Shire. She has received research support and grands from Pfizer, GlaxoSmithKline, Janssen, Sanofi-Aventis, Novo and Lexicon.

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