Both the quantity and quality of sleep play important roles in healthy living.1 Although sleep and diabetes have a complex relationship, various studies suggest a bidirectional association and recognize that good sleep can help with diabetes management.2
Sleep Disorders Are Common in Diabetes – Sleep disorders such as insomnia, obstructive sleep apnea (OSA), and restless legs syndrome (RLS) are more prevalent in diabetic individuals than in the general population.2,3 Diabetes-related comorbidities such as obesity, neuropathic pain, nocturnal hypoglycemia, and increased sympathetic activity may contribute to the development of these disorders. Among individuals with type 1 diabetes mellitus (T1DM), approximately 30-50% report poor sleep and >50% have moderate to severe OSA.2 Among individuals with type 2 diabetes mellitus (T2DM), an estimated 39% is affected by insomnia, 24-86% by OSA, and 8-45% by RLS.
Sleep Disorders Are a Risk Factor for T2DM – Studies suggest that sleep disturbances may be linked to the development of T2DM through various mechanisms, including accelerated loss of pancreatic b-cell function, increased levels of cortisol (a stress hormone associated with central adiposity and insulin resistance), increased inflammation, increased food consumption and weight, and decreased physical activity.2,4
Sleep Disorders Are Linked to Poor Glycemic Control in T1DM and T2DM – Sleep deprivation is also associated with greater risk of developing impaired glucose tolerance and diabetes,5 and insomnia is linked to increased hemoglobin A1c levels in T2DM.3 Experimental short-term sleep deprivations have shown to decrease insulin sensitivity.4,6,7 In addition to the physiological changes, sleep disturbances have been linked to decreased engagement in diabetes self-management, posing barriers to achieving glycemic targets.2,8
The Burden of Diabetes Management Can Disrupt Sleep – Individuals with T1DM and T2DM commonly experience diabetes distress, characterized by feeling overwhelmed with the burdens of self-care and concerns and guilt over complications.9,10 This emotional distress, especially fears of developing hypoglycemia or other diabetes-related complications at night, can often disrupt sleep.2,8 Diabetes technology has been cited to both alleviate and aggravate the burdens; some have described devices such as continuous glucose monitors to disrupt sleep with alarms and malfunctions, while others experienced improvements in sleep as they trust the devices to notify them of issues during nighttime.
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