Managing Diabetes Magazine - diabetes
You may be losing
There was a time, not so very long ago, when our ancestors rose and slept with the natural rhythm of the rising and setting sun. Modern technology has given us the luxury of challenging our sleeping patterns. We can try to finish work and get to that soccer game, fly to Paris overnight, or shop for groceries at 3 am. However, does this pace hurt our health?
Why is sleep so important?
Lack of quality sleep is now being linked to a number of health issues including:
- high blood pressure
- heart disease and stroke
- weight gain and type 2 diabetes
- heartburn and ulcers
- damage to the immune (defence) system
- increased anxiety and depression
- less concentration and impaired short term memory
- altered judgment and response time.
Our society has come to think of getting little sleep as a badge of honour. The average amount of sleep has dropped from eight hours a night in 1960 to just 6.7 hours in 2007. Sleep deprivation may impact our health for generations to come.
Diabetes and sleep deprivation
A late ‘80s study found women who slept five hours or less per night were a third more likely to gain major weight than those who slept seven hours. They were also more likely to become obese.
A more recent study limited the sleep of healthy individuals to four hours per night for six nights. The short amount of time spent sleeping affected the ability to process carbohydrates effectively. Eventually, this would lead to a pre-diabetes state.
Why does this happen? The hormone leptin normally sends a signal to the brain that tells you your stomach is full. Lack of sleep results in a drop in leptin, leading to increased hunger. Ghrelin, a hormone that stimulates hunger pangs, increases. Lack of sleep also produces more of our stress hormone cortisol, which enhances fat storage.
Fatigue caused by lack of sleep often leads to poor food choices. We crave foods that immediately boost our energy levels. Unfortunately, these are often high-carbohydrate, high-glycemic index foods, including simple processed foods such as cakes, cookies, and breads.
Such foods release serotonin, which improves our mood. However, it also triggers melatonin, making us drowsy and more fatigued. Increased fatigue equals more hunger, higher blood glucose and weight gain – a no-win situation.
If you feel tired, eat a well-balanced snack with fibre and protein to give an energy lift and a smooth sustained release of blood glucose. Healthy choices include whole grain crackers and cheese, a handful of various nuts and dried fruit, toast and peanut butter, yogurt, and cereal and milk.
What robs us of a good night’s sleep?
The many causes of sleep disruption include:
- depression and anxiety
- chronic pain due to conditions such as arthritis and fibromyalgia
- sleep apnea
- hormone changes (hot flashes and night sweats)
- restless leg syndrome
- shift work and other disruptions in our sleep/wake cycle
- smoking, caffeine, drug and alcohol use
- high and low blood glucose.
Getting a good night’s sleep
Try to keep blood glucose levels within your goal range. This helps avoid the frequent nighttime trips to the bathroom often associated with high blood glucose levels. If your blood glucose dips at night, identify the causes. Then, take steps to prevent low blood glucose and the disruptive symptoms that come with it.
Some medical issues are best discussed with your family doctor and may require further tests and treatment. Among people with diabetes, there is a higher incidence of depression. If depression is a factor, treatment might consist of medication as well as counselling.
Finding your dreams again
Changing a few habits can resolve some sleep issues.
- Establish a routine. Go to bed and wake up at the same time each day. This allows your levels of melatonin (a hormone governing your sleep/wake cycle) to rise at the same time each day. If you are up late on weekends, try to wake at the same time in the morning. You can always nap later. If you do shift work, rotate from days to evenings to nights if possible.
- Reserve your bedroom for sleeping and hanky-panky. Unwelcome guests are your TV, stereo, Blackberry, computer, and any and all take-home work.
- Avoid caffeine stimulants such as coffee, tea and chocolate from late afternoon on. Alcohol may lull you to sleep at first, but disrupts sleep patterns. It can also stimulate menopausal ‘hot flashes.’ Try a cup of warm milk or another non-caffeinated drink at bedtime. Even a light snack may be soothing.
- Exercise in early to mid-afternoon. This enhances sleep with the naturally occurring release of relaxing chemicals known as endorphins. Exercising too close to bedtime can act as a stimulant.
- Keep your bedroom dark, cool, well ventilated and quiet. A comfortable mattress and bedding are musts. Remove sources of allergens if these affect you. For instance, wash the bed linens in hot water regularly to get rid of dust mites.
- Turn your clock so that it faces away from you. Worrying about what time it is will not get you to sleep any faster.
- Find and use activities that lull your brain and body into never-never land. A warm bath, a good book, or relaxing music often do the trick.
- Balance and time your supper meal. Avoid eating a heavy meal or spicy foods close to bedtime. These may be difficult to digest, causing reflux and keeping you up at night.
- Wear comfortable, loose fitting warm socks to bed to promote sleep. Diabetic neuropathy (nerve damage) or vascular (blood vessel) disease may result in cool hands and feet.
- Take your medications as prescribed by your doctor. Sensitivity to pain is heightened at night, so you may need pain relief to get to sleep.
- If your mind is racing, write down your concerns. Put them aside to deal with tomorrow, once you have ‘slept’ on them. If that does not work, set aside a specific period of time to ponder issues earlier in the day, and restrict yourself to that time.
Lack of sleep can be stressful in and of itself. If you cannot fall asleep within 15 minutes, do not fret – get up, do something relaxing, and try again.
Sleep: how much is enough?
The proof is in how you feel.
Do you awake refreshed only to doze off during the day? Do you find yourself craving carbohydrates or sweets in the morning?
It may just be that you are not getting the seven to nine hours of sleep required by most people.
Napping may be an option as long as it does not interfere with your ability to sleep at night. Good rules to follow are no naps after four in the afternoon and no longer than twenty to thirty minutes. Napping longer may result in initial grogginess, sleepiness and confusion.
Sleep should be a valued, protected time for healing and regenerating your mind and body. By not snoozing, you may be missing out on more than a good night’s sleep.
While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specified medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physician promptly. © Copyright 2015, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 2S6 [DI_MDcd14]