Archive for May, 2011

Sleep and Diabetes: Quality Matters NOT Quantity!!!!

May 30, 2011

Go to fullsize imageLack of sleep causes stress. Stress increases stress hormones that can increase glucose. Understandably,lack of sleep equals risk for diabetes.  I used to believe from previous studies that a duration of sleep less than 7 hours increases ones risk to develop diabetes. 

 Now comes a new study published in Diabetes Care March 2011, that tell us Quality is important than Quantity…

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OBJECTIVE To examine whether sleep duration and quality are associated with fasting glucose, fasting insulin, or estimated insulin resistance in a community-based sample of early middle-aged adults.

RESEARCH DESIGN AND METHODS This was an ancillary study to the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Habitual sleep duration and fragmentation were estimated from 6 days of wrist actigraphy collected in 2003–2005. Insomnia was defined as self-reported difficulty falling asleep or waking up in the night three or more times per week plus average sleep efficiency of <80% based on actigraphy. Fasting blood samples to measure glucose and insulin were collected after the sleep measures during the CARDIA clinical examination in 2005–2006. Insulin resistance was estimated using the homeostatic model assessment (HOMA) method. Analyses were cross-sectional and stratified by the presence of diabetes.

RESULTS There was no association between sleep measures and fasting glucose, insulin, or HOMA in the 115 subjects without diabetes. Among the 40 subjects with diabetes, after adjustment for covariates, 10% higher sleep fragmentation was associated with a 9% higher fasting glucose level, a 30% higher fasting insulin level, and a 43% higher HOMA level. Insomnia was associated with a 23% higher fasting glucose level, a 48% higher fasting insulin level, and an 82% higher HOMA level.

CONCLUSIONS The observed association between poor sleep quality and higher glucose, insulin, and estimated insulin resistance among subjects with diabetes warrants further examination of the effect of sleep disturbances on glucose control in type 2 diabetes.

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In the study, sleep duration was assessed as the amount of sleep obtained per night while sleep fragmentation was based on the periods of restlessness and movements that the pateints had during the night.

What is interesting in the study was that there was no association between sleep duration and glucose metabolism in groups with or without diabetes.  This is in contrast to earlier studies which showed otherwise. 

However sleep fragmentation was signicantly associated with increasing blood sugar so that for every 10% higher sleep fragmentation,  there was an associated 9% higher fasting glucose and higher insulin level suggesting insulin resistance.  What is important is that sleep fragmentation WAS not associated with higher glucose if one is NOT a diabetic.  Meaning, sleep disturbance is a risk factor  for poor blood sugar control among diabetics!

In conclusion, the authors assessed that POOR sleep and NOT Short Duration is associated with poor glucose control!!!  That intervention to warrant investigations of causes for poor sleep can help make diabetics have better control.

So do you snore? and probably stop breathing often?

Ask your partner… and better have your sleeping pattern assessed as this may lead to better control of your blood sugar if corrected!

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