The exciting first-ever implantable continuous glucose monitor CGM Eversense can now be worn for 6 months straight. A Quiz for Teens Are You a Workaholic? How Well Do You Sleep? Health Conditions Discover Plan Connect. Diabetes Mine Influencer Tips for Sleeping Better with Type 1 Diabetes.

Medically reviewed by Angela M. Bell, MD, FACP — By Wil Dubois on April 6, Share on Pinterest. Rein in the blood sugar. Reconsider your CGM alarm settings. Try banning electronics from the bedroom. Try using sleep tech. Journal the stress that interferes with sleep.

Stop caffeine early. Set the stage for sleep. Establish a routine. Be careful with workouts right before bed. What about sleep meds with type 1 diabetes? Bonus sleep tip. How we reviewed this article: History. Apr 6, Written By Wil Dubois. Medically Reviewed By Angela M.

Bell, MD, FACP. Share this article. Read this next. Omnipod 5: First Tubeless Automated Insulin Delivery System with Smartphone Control Insulet's Omnipod 5 becomes the first commercially available Automated Insulin Delivery AID system with no tubes and smartphone control.

READ MORE. Advocates Take a Stand Against Diabetes Stigma The diaTribe Foundation has launched a new resource hub to help people with diabetes fight stigma. one day, then recover the next day, and then have to leave very early in the morning another day. A related behavior is social jet lag, which refers to being sleep-deprived during the week, then trying to catch up during the weekend—a behavior common among adolescents and young adults.

Studies show that many sleep problems are associated with insulin resistance, prediabetes, and diabetes and have a significant impact on glucose tolerance. For example, there is experimental evidence that if you take healthy volunteers and force them into a schedule where sleep does not occur consistently during the night, the result is a decrease in glucose tolerance and insulin sensitivity.

The point here is that a modern lifestyle has brought about sleep irregularity, which adds to the risk factors for developing diabetes. OSA affects about two-thirds of people with type 2 diabetes.

Its severity affects glycemic control in people who have diabetes—the more severe the OSA, the lower the insulin sensitivity. Q: Can sleep problems or a sleep disorder increase the risk for developing type 2 diabetes?

A: Yes. Multiple studies have shown that repeated awakenings during the night, insufficient sleep, excessive sleep, and irregular sleep all promote glucose intolerance. Furthermore, if a person has prediabetes or diabetes, poor sleep will worsen the condition.

Sleep problems are also an issue for people with no other diabetes risk factors. Studies on mostly young, healthy adults without obesity or any diabetes risk factors have examined the effects of reduced sleep under controlled conditions in a laboratory.

So, there is reliable evidence that insufficient sleep has an adverse effect on glucose tolerance and can bring people who are otherwise healthy to developing prediabetes. As for people with sleep disorders, we know that moderate to severe OSA is a risk factor for developing type 2 diabetes.

The increased prevalence of sleep disorders such as OSA parallels the rise in rates of obesity, and these two epidemics contribute to the dramatic increase in the prevalence of diabetes. Q: In people with type 2 diabetes, can treating sleep disturbances and disorders improve glycemic control?

A: We are still at the beginning of studying the impact of correcting sleep disturbances on glycemic control. We don't have many intervention studies yet. There have been a few studies of short sleepers who were asked to extend sleep for brief periods; extending their sleep duration improved their insulin sensitivity.

There have also been some studies showing that extending bedtime in short sleepers may reduce hunger and appetite and promote weight loss.

We need more studies in larger groups. The one sleep disturbance that has been well studied is OSA. A number of studies have looked at continuous positive airway pressure CPAP to see whether this treatment can reduce glucose levels and improve glycemic control.

The results have been mixed. Some clinical trials of CPAP compared with placebo treatment showed an effect on glucose metabolism or insulin sensitivity, but others did not.

The major issue is that if you do a study under real-life conditions, compliance with CPAP is generally poor. People wear their device for a few hours on most but not all nights, and that is considered excellent compliance. In laboratory studies, compliance can be optimized.

In a proof-of-concept study, we treated patients with type 2 diabetes for 1 week. They had to sleep in the laboratory every night with the CPAP device, which was fitted as well as possible. Every little problem with the CPAP device was solved by the sleep technicians.

After 1 week, we observed a decrease in morning glucose levels by about 12 milligrams per deciliter, which is clinically significant. It's the equivalent of what you can achieve with one drug.

Overall, the mixed results affect what happens in the clinic. CPAP devices have improved enormously, and there are devices now that are much more comfortable, smaller, lighter, quieter, and easier to tolerate. There are also dental appliances that can reduce the severity of OSA.

Despite these advances, most health care professionals do not say, "You have to treat your sleep apnea because it's making your diabetes worse. Chronic circadian misalignment has been proposed to correlate with metabolic and cardiovascular dysfunction [ 12 — 16 ]. However, whether disruption of the sleep-wake pattern, i.

Subjects were recruited from consecutive Japanese outpatients with metabolic lifestyle-related diseases e. Disease-related exclusion criteria included pituitary diseases, mental disorders, and malignant diseases. The study was approved by the Medical Ethics Committee of Osaka University.

All participants were Japanese and each gave a written informed consent. The questionnaire on sleep patterns consisted of the following 8 questions: bedtime on weekdays and holidays at half-hour intervals ; waking time on weekdays and holidays at half-hour intervals ; arousal yes or no ; daytime sleepiness yes or no ; insomnia due to work yes or no ; insomnia due to mental stress yes or no.

Systolic- and diastolic- blood pressures were measured with a standard sphygmomanometer after at least 5-min rest. After overnight fasting, venous blood samples were collected while the subject was in the supine position for measurements of blood glucose, glycoalbumin, hemoglobin A1c HbA1c , triglyceride, high-density lipoprotein-cholesterol HDL-C , uric acid, and creatinine.

Low-density lipoprotein-cholesterol LDL-C was calculated with the Friedewald equation. Diabetic retinopathy, nephropathy and peripheral neuropathy were diagnosed as reported previously [ 17 ].

All values were expressed as mean±SEM. Differences in frequencies were compared by the χ 2 test. All analyses were performed with the JMP Statistical Discovery Software 9.

Subjects with lifestyle-related diseases were divided into two groups; with T2DM and non-T2DM. The baseline characteristics of the two groups are listed in Table 1.

T2DM subjects had significantly higher BMI, lower serum HDL-C levels, higher prevalence of hypertension, than non-T2DM subjects. Figure 1 is a histogram of reported bedtime on weekdays and holidays in T2DM and non-T2DM subjects.

Figure 2 is a histogram of waking time on weekdays and holidays in T2DM and non-T2DM subjects. There was no significant difference in the estimated sleep duration on weekdays and holidays between the two groups Figure 3. In bedtime analysis, the lowest HbA1c levels were 6. In waking time analysis, the lowest HbA1c levels were 6.

In sleep duration analysis, the lowest HbA1c levels were 6. Mean HbA1c levels at various bed and waking times, and according to sleep duration on weekdays top and holidays bottom. Data are mean±SEM. However, there were no significant differences in the frequency of arousals at night or percentages of subjects with work- and mental stress-related insomnia between the two groups.

The major findings of the present study were that T2DM subjects retired to bed later and woke up later, and suffered from daytime sleepiness, compared with non-T2DM subjects.

Comparison of the above data and the present findings confirm that the Japanese T2DM subjects tended to retire to bed relatively later than the rest of the population. The circadian system is linked to various processes that control both sleep and metabolism.

The sleep-wake cycle and fasting-feeding behavior are considered to be regulated by the circadian clock [ 14 — 16 ]. Experimental models of the clock gene have demonstrated the development of metabolic disorders, such as obesity and T2DM, after disruption of the circadian rhythms [ 18 — 22 ].

However, whether abnormal glucose metabolism has any impact on the circadian rhythm remains unclear. A vicious cycle may ensue in the disrupted glucose metabolic pathways, leading to lengthening of the circadian oscillation abnormality. Scheer et al. Further studies are required to investigate circadian variation of neurohumoral factors in blood.

In this regard, the present work is a cross-sectional study, making it difficult to establish a cause-effect relationship. Sleep management, e. Further prospective interventional studies should be conducted in the future to investigate this relationship. A gradual decrease in self-reported sleep duration seems to have occurred with the dramatic recent increase in the incidence of obesity and diabetes, including a close relationship between sleep cycle and diabetes [ 23 — 25 ].

However, the present study found no significant difference in the sleep duration between the diabetics and non-diabetic subjects Figure 3.

However, records of bedtime and waking time were based in the present study on information provided by the subjects, and therefore the sleep duration may be inaccurate.

Taken together, irregular sleep-wake patterns as well as short and long sleep may enhance glucose dysmetabolism. The present study demonstrated late bedtime and late wake-up time, with daytime sleepiness in T2DM subjects, compared with non-T2DM subjects.

Early retirement to sleep and early morning rise seems potentially simple and useful therapeutic target for diabetes. There are several limitations to this study. First, all outpatients in this study were Japanese and any differences from other ethnicities are unknown.

Second, there is bias in single center studies. Our study included only a limited number of subjects and further multi-center studies of larger samples should be conducted in the future. Finally, the percentage of non-employees among diabetics was Diabetics often perform the capillary blood sugar self-test before go to bed.

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