Sleep apnoea and diabetes
Obstructive sleep apnoea (OSA) is a condition where a person’s breathing repeatedly stops during sleep. It occurs because of partial or complete blockage of their airway while sleeping. Someone with OSA may stop breathing for anywhere between a few seconds and 90 seconds at a time. These episodes (known as apnoeas) can occur up to hundreds of times each night, depending on the severity of the problem. OSA occurs more commonly in people with diabetes (both type 1 and type 2) and untreated OSA can increase the risk of developing type 2 diabetes. Common symptoms include snoring, pauses in breathing while asleep (often noticed by others), waking up gasping or choking, morning headaches, waking with a dry mouth and excessive daytime sleepiness. If you think you might have sleep apnoea, it is important to see your doctor, who can refer you for further investigations.
the need to get up to go to the toilet overnight because of elevated blood glucose levels. restless leg syndrome, which is more common in people with type 2 diabetes. pain associated with peripheral neuropathy (nerve damage), which is often worse at night. disturbance from insulin pump and continuous glucose monitor alerts and alarms - as helpful as this technology is for alerting wearers to potentially dangerous low and high blood glucose levels, diabetes devices can also be a common cause of sleep disturbance. hypoglycemia (low blood glucose level) – not only can the symptoms wake you up, but you then need to treat the hypo and wait until blood glucose levels have returned to a safe range before going back to sleep. obstructive sleep apnoea (OSA), which is more common in both type 1 and type 2 diabetes. insomnia, which refers to difficulties getting to sleep and staying asleep, has also been found to be more common in people with type 2 diabetes. If your sleep is being disturbed by any of these factors, speak to your doctor or diabetes educator about how you might address them.
How poor sleep can affect your diabetes management
Not only can having diabetes impact your sleep, but poor sleep can have negative effects on your diabetes management. A review of 15 studies in people with type 2 diabetes found that both long and short sleep duration and poor sleep quality were associated with an increased HbA1c level (a measure of average glucose levels over the past 2-3 months). Similarly, in adults with type 1 diabetes, shorter self-reported sleep duration and poor self-reported sleep quality were associated with higher HbA1c levels.
Poor sleep has also been associated with increased fatigue and daytime sleepiness, increased mood disturbances and decreased quality of life, and may affect your ability and motivation to selfmanage your diabetes well.
The importance of sleep for weight management
Many studies have found a link between inadequate sleep and risk of overweight or obesity. Lack of sleep leads to hormonal changes which influence weight, including reduced insulin sensitivity and altered levels of appetite hormones (such as ghrelin and leptin) which influences hunger and appetite. Being tired also makes it harder to get enthusiastic about exercising and eating well.
The bottom line
Lack of sleep and poor-quality sleep can worsen insulin sensitivity, make it more difficult to manage your diabetes and weight, and can increase type 2 diabetes risk in those without diabetes. Having diabetes can also negatively impact your sleep. Getting a good nights’ sleep can help with diabetes management and is essential for your overall health and wellbeing. Prioritising sleep should be an important part of your diabetes management plan.