Diabetes, obesity and sleep: 'It's a vicious cycle'
PAMELA GLINSKIWith chronic insomnia affecting 10 percent of the population and one third of all people in the U.S. reporting some kind of sleep problem, researchers are studying what effect lack of sleep can have on health.
Published: October 6, 2012
Published: October 6, 2012
People that have sleep disorders, do shift work or just don't get enough rest at night may be at higher risk of developing diabetes.
"In one study, young college males were sleep deprived, getting four hours a night, and they actually developed pre-diabetes," said nurse, dietician and certified diabetes educator Brenda Garza, who manages Florida Hospital Heartland Medical Center's Diabetes Center.
By keeping the students from getting deep, restorative sleep, their body's ability to regulate blood-sugar levels was significantly hindered.
"Proper sleep is as important as diet for people with diabetes," said Susan Zafarlotfi, clinical director of the Institute for Sleep and Wake Disorders at Hackensack University Medical Center in New Jersey. She suggested people might benefit from a sleep study if they are diabetic, snore and are overweight.
A 2010 study done at the University of Buffalo Department of Family Medicine found that there seems to be a correlation between sleep patterns, obesity and the onset of diabetes.
Results of the study, published in the "Annals of Epidemolog," found that pre-diabetics who slept less than six hours each work night were three times more like to have higher levels of blood sugar than the test group that slept between six and eight hours.
People who were severely sleep deprived craved calorie-dense foods and had an increase in the hormone that stimulates appetite.
"It is a vicious cycle," said Garza. She went on to explain that when you don't get enough sleep, the hormone ghrelin, which regulates appetite, and the stress hormone cortisol, are affected and can cause even more weight gain.
In 2006, the Institute of Medicine estimated that up to 70 million Americans don't get enough sleep and described sleep disorders as an "under recognized public health issue."
"Sleep apnea and diabetes are interrelated in a few ways," said physician Dennis Bassetti, a board certified sleep specialist. "Treating sleep apnea benefits diabetic control, and good diabetic control should slow down weight gain."
"Obesity is the main risk factor for diabetes," said Bassetti. He added that patients with diabetes show significant improvement after bariatric surgery. Diabetes was "completely resolved in 77 percent and resolved or improved in 86 percent (of cases) who have lost significant weight with bariatric surgery," he said.
Insomnia that lasts more than three months should be taken very seriously, said the director of Highlands Regional Medical Center's sleep lab, Bipin Bhatt, in an interview earlier this year. He explained that, untreated, insomnia could lead to higher rates of high blood pressure, coronary disease and diabetes. He added that shift work or other disruptions to the body's circadian rhythms may also increase health risks.
When a sleep research team at Brigham and Women's Hospital in Boston, Mass., studied 21 healthy adults by making them sleep in varying hours, it was determined that the increased stress of irregular sleep patterns, like shift work, could lead to obesity, heart disease, and diabetes. Once they were allowed to resume their normal sleep patterns their symptoms disappeared.
Garza said that she looks at risk factors like insufficient sleep, high body mass index (obesity), high blood pressure and stress when she is developing care plans for new patients.
Florida Hospital's Diabetes Center, located at 4023 Sun 'n Lake Blvd., in Sebring, offers nutritional counseling, a 10-hour program of educational classes and a diabetes support group that meets the second Monday of each month. Staff focuses on a "step-by-step" plan of self-management training, integrating diet, lifestyle improvements and family support.
Garza said that if most diabetics can get on a "regular schedule" of three meals a day (eating the same amount of carbohydrates at each meal) and eight hours of sleep, they could see an improvement in their health.