The most common factors believed to contribute to diabetes (and type 2 diabetes) are a
decreased amount of physical activity and access to highly palatable
processed foods. However, there is growing evidence that another aspect
of our modern lifestyle, short sleep duration, is also contributing
toward the "diabetes epidemic".
The study, authored by James E. Gangwisch, PhD, of Columbia University
in New York, explored the relationship between sleep duration and the
diagnosis of type 2 diabetes over an eight-to-10-year follow-up period between
1982 and 1992 among 8,992 subjects who participated in the
Epidemiologic Follow-Up Studies of the first National Health and
Nutrition Examination Survey. The subjects’ ages ranged from 32 to 86
According to the results, subjects who reported sleeping five or fewer
hours and subjects who reported sleeping nine or more hours were
significantly more likely to have incident diabetes over the follow-up
period than were subjects who reported sleeping seven hours, even after
adjusting for variables such as physical activity, depression, alcohol
consumption, ethnicity, education, marital status, age, obesity and
history of hypertension.
The effect of short sleep duration on diabetes incidence is likely to
be related in part to the influence of short sleep duration upon body
weight and hypertension, said Dr. Gangwisch. Experimental studies have
shown sleep deprivation to decrease glucose tolerance and compromise
insulin sensitivity by increasing sympathetic nervous system activity,
raising evening cortisol levels and decreasing cerebral glucose
utilization. The increased burden on the pancreas from insulin
resistance can, over time, compromise β-cell function and lead to type
two diabetes, warned Dr. Gangwisch.
"If short sleep duration functions to increase insulin resistance and
decrease glucose tolerance, then interventions that increase the amount
and improve the quality of sleep could potentially serve as treatments
and as primary preventative measures for diabetes," said Dr. Gangwisch.
It is unknown as to how long sleep duration contributes to diabetes,
although increased time in bed to compensate for poor sleep quality is
one possible explanation, noted Dr. Gangwisch.
Recent estimates show that at least 171 million people worldwide suffer
from diabetes, and that, by the year 2030, this number is projected to
Lawrence Epstein, MD, medical director of Sleep HealthCenters, an
instructor of medicine at Harvard Medical School, a past president of
the American Academy of Sleep Medicine (AASM) and a member of the AASM
board of directors, said that this study is one of several large
studies that have shown that people who don’t get enough sleep have
higher rates of diabetes.
"Restricting sleep to four hours a night for only a few days causes
abnormal glucose metabolism, suggesting the mechanism for increased
rates of type 2 diabetes in sleep deprived individuals," said Dr. Epstein.
"Additionally, sleep disorders that disrupt sleep, such as obstructive
sleep apnea, also increase the likelihood of developing diabetes.
Treating the sleep disorders improves glucose metabolism and diabetes
control. These studies underscore the fact that sleep is integral to
On average, most adults need seven to eight hours of sleep each night
to feel alert and well-rested. Adolescents should sleep about nine
hours a night, school-aged children between 10-11 hours a night and
children in pre-school between 11-13 hours a night.
The AASM offers the following tips on how to get a good night’s sleep:
- Follow a consistent bedtime routine.
- Establish a relaxing setting at bedtime.
- Get a full night’s sleep every night.
- Avoid foods or drinks that contain caffeine, as well as any medicine that has a stimulant, prior to bedtime.
- Do not go to bed hungry, but don’t eat a big meal before bedtime either.
- Avoid any rigorous exercise within six hours of your bedtime
- Make your bedroom quiet, dark and a little bit cool.
- Get up at the same time every morning.
SLEEP is the official journal of the Associated Professional
Sleep Societies, LLC, a joint venture of the AASM and the Sleep
a patient education Web site created by the AASM, provides information
about various sleep disorders, the forms of treatment available, recent
news on the topic of sleep, sleep studies that have been conducted and
a listing of sleep facilities.
Posted by Laura Brooks