The Connection Between Sleep And Type 2 Diabetes Prevention: Connecting the Dots Between Restful Sleep and the Warding Off of Type 2 Diabetes

Introduction

Good-quality sleep is vital for overall health and well-being. As well as allowing the body to repair itself, there is strong evidence to suggest that it helps to prevent weight gain, heart disease and the duration of illnesses.

Getting enough good-quality sleep can help to lower the risk of type 2 diabetes; not getting enough can increase that risk.

In this article, we’ll examine the connection between sleep and type 2 diabetes. We’ll discuss how that connection can be used to help prevent the condition.

Understanding diabetes and its risk factors

‘Diabetes’ is a general term that covers a group of separate health conditions. The main three are: type 1 diabetes, type 2 diabetes and gestational diabetes (which occurs in some pregnancies).

When we eat, carbohydrate is broken down into glucose in the blood. In a person who does not have diabetes, their pancreas releases insulin, which transfers the glucose from their blood into the muscle cells to be used as energy.

People living with type 1 diabetes do not produce insulin. In type 2 diabetes or gestational diabetes, insulin is only produced in small amounts or does not work properly. This results in glucose building up in the bloodstream, which can eventually damage blood vessels and nerves.

There is an associated condition called pre-diabetes, where a person’s blood glucose levels are higher than recommended but not high enough to be diagnosed as type 2 diabetes. Pre-diabetes is serious: it increases the risk of developing type 2 diabetes by between 10 and 20 times. However, in up to 58% of cases, the onset of type 2 diabetes can be prevented or delayed, notably through the adoption of sustainable healthy habits.

The role of sleep in overall health

Sleep is essential to every process in the body. It affects our physical and mental functioning as well as our ability to fight disease, including chronic disease such as type 2 diabetes.

Sleep can be divided into two types—rapid eye movement (REM) sleep and non-REM (NREM) sleep. REM sleep occurs about an hour after falling asleep.

NREM sleep consists of three sub-stages:

N1: this stage is the transition from wakefulness to sleep, and generally lasts only a few minutes.
Stage N2: this comprises the largest percentage of total sleep time. It is a comparatively light stage of sleep from which is easy to be awakened.
Stage N3: the deepest sleep stage, during which the body performs most tasks that are important to our health.

The sleep-diabetes connection

It is thought that poor or insufficient sleep can cause insulin resistance, which is a key element in the development and progression of pre-diabetes. Poor sleep also affects the hormones that control appetite, which can lead to overeating and consequent weight gain.

Research has shown that pre-diabetes and sleep apnoea (a disorder where breathing is interrupted repeatedly during sleep) are linked, and that the link works both ways. The risk of pre-diabetes can rise as a result of sleep apnoea-related insulin resistance (which is where our cells do not react well to the hormone); and the changes in metabolic processes caused by pre-diabetes can make sleep apnoea symptoms worse.

Poor sleep quality in people with pre-diabetes has been associated with the increased blood glucose levels that can lead to type 2 diabetes.

The impact of sleep on the prevention of type 2 diabetes

Poor or insufficient sleep can be improved by sleep hygiene practices (habits that help you get a good sleep).

These include:

eating a healthy diet
exercising regularly during the day
not eating big meals late at night
consistently going to bed and getting up at the same times
getting up at your usual time if you’ve had a bad night’s sleep
not smoking or drinking alcohol, tea or coffee for at least six hours before going to bed
not having a phone or computer in the bedroom
creating a relaxing bedtime routine that starts at least one hour before you go to bed
having a cool, quiet and dark bedroom
making sure your mattress and pillows are comfortable.

When these practices result in better-quality sleep, the risk of sleep-related insulin resistance declines.

Sleep duration and diabetes risk

Getting too much or too little sleep is associated with an increased risk of type 2 diabetes.

The ideal amount of sleep varies by age. For most adults, getting 7 to 9 hours of uninterrupted sleep is recommended.

Sleep quality and diabetes risk

The term ‘sleep quality’ refers to how restorative and restful a person’s sleep feels. The measure of sleep quality varies from person to person, but it can be assessed in a general sense by taking into consideration these four factors:

sleep latency (how long it takes you to fall asleep)
sleep waking (how often you wake up during the night)
wakefulness (how much time you spend awake during the night after you first go to sleep)
sleep efficiency (the amount of time you spend actually sleeping).

Factors affecting sleep quality

Sleep quality can be affected by both internal and external factors. The former include physical pain, stress, mental health issues and sleep disorders. External factors include light, noise, the environment you’re sleeping in, and caffeine or alcohol consumption.

Physical activity and its influence on sleep and diabetes prevention

Exercise can be very beneficial to the prevention of type 2 diabetes. It improves insulin sensitivity (the opposite state to insulin resistance), reduces blood glucose levels, and enhances mobility and mental wellbeing. Regular exercise can help maintain a healthy weight, lower blood pressure and reduce the risk of heart disease. It also promotes mental health by making it easier to manage stress and improving sleep quality.

The Australian Government guidelines recommend that adults do at least 30 minutes of moderate intensity physical activity most days. Moderate intensity exercise is any activity that causes your heart to beat faster and makes you breathe harder. Examples of moderate intensity exercise are:

cycling
brisk walking
gardening.

Resistance training also supports weight management by improving the body’s muscle mass and increasing your metabolism. Resistance training is any activity that makes your muscles work harder than usual, increasing their strength, size, power and endurance.

Dietary choices and sleep

Diet can significantly impact sleep quality. Consuming unhealthy amounts of sugar is associated with less restorative sleep, due to fluctuations of high and low blood glucose.

Eating within three hours of your bedtime increases the likelihood of sleep disruptions.

Stress management and sleep

Good-quality sleep helps us to manage stress; when we don’t get good-quality sleep, we tend not to deal with stress as well.

There is a clear link between stress, sleep problems and diabetes risk. Consistently poor sleep has been shown to lead to glucose intolerance (difficulty breaking down glucose) and insulin resistance (where our cells do not react well to insulin), both of which lead to an increase in blood glucose levels that can significantly affect a person’s risk of developing type 2 diabetes.

Stress can be managed. One of the most effective techniques is mindfulness, where you attempt to focus on the present moment and accept it without judgment. This focus can be achieved through practices such meditation, yoga and deep-breathing exercises.

Physical activity is an excellent stress reliever. It causes the release of endorphins, which increase feelings of well-being, and can be a healthy distraction from stressful thoughts. Healthy eating also plays a role in managing stress. Consuming a balanced diet rich in fruits, vegetables, lean proteins, and whole grains can help you feel better physically and emotionally.

Social support is crucial: spending time with people who make you feel good can significantly reduce stress levels.

Monitoring sleep and health

Monitoring your sleep patterns with equipment such as trackers can help you establish how much quality sleep you’re getting. These devices work by measuring parameters such as your breathing rate, heart rate and how much you move around while sleeping. This information can be used to improve the quality of your sleep.

However, while sleep trackers can provide useful insights, they are not a substitute for professional medical advice. If you’re experiencing persistent sleep problems, it’s beneficial to seek advice from a healthcare provider. They can provide a more accurate diagnosis and, if appropriate, suitable treatment options. These include cognitive behaviour therapy (CBT), a type of psychotherapy that’s based on the idea that how you think affects how you feel, or medication.

Conclusion

There is a clear connection between sleep and type 2 diabetes. Poor-quality sleep can contribute to the development of insulin resistance, which affects blood glucose-level management. That in turn can lead to pre-diabetes, which can lead to type 2 diabetes.

By contrast, good-quality sleep is one of the factors that support the prevention of type 2. Others include eating a healthy diet, doing the recommended amount of exercise, maintaining a healthy weight and managing stress.

But it’s not easy doing all that on your own. Most of us know that we have to eat well, exercise more and lose weight, but it’s easier said than done, and it takes time. Joining a healthy lifestyle program can be highly beneficial in this as it provides you with the support of expert health professionals.

Life! is a free healthy lifestyle program that helps you improve your eating habits, increase your physical activity and manage stress. You can choose from a group course or our telephone health coaching service.

The Life! program will support you to reduce your risk of developing type 2 diabetes, heart disease and stroke.

Life! is run by experienced health professionals, including dietitians and exercise physiologists, who guide and support you to make realistic healthy lifestyle changes that suit your needs. The program includes 7 sessions delivered over a 12-month period.

Since 2007, over 75,000 Victorians have learnt more about living a healthy life with the Life! program. It is the largest prevention program of its kind in Australia.

Life! is funded by the Victorian government and managed by Diabetes Victoria.

You can check your eligibility for the Life! program by taking a quick online test here.