Insulin, Blood Sugar & Your Sleep

KEY TAKEAWAYS

• Blood sugar (glucose) levels naturally fluctuate at night as part of the healthy circadian rhythm. Sleep is intrinsic to our overall health and well-being, including optimising insulin sensitivity for the regulation of blood glucose levels.

• Not getting enough sleep has been linked to an increase in the incidence of obesity and Type 2 diabetes, which occurs after many years of insulin resistance and elevated blood sugar levels.

• The relationship between sleep and blood sugar is complex – but getting a good night’s sleep is imperative for your health. This includes preventing snoring.

Healthy blood glucose (sugar) levels are essential for our health, and sleep plays a critical role in controlling blood sugar levels. Sleeping can both increase and decrease blood glucose levels.

Deep, restorative sleep has been found to stabilise and reduce blood sugar levels. Likewise, not getting enough sleep is linked to higher blood sugar levels, and partially disrupted sleep over just one night can increase insulin resistance.

Insulin resistance increases blood sugar levels. It is a precursor to prediabetes and eventually, if not reversed, Type 2 diabetes. It’s important to understand the risks and what to do to promote better health – including through healthier sleep.

What is Insulin Resistance?

Made in the pancreas (an organ in the upper left of the abdomen), insulin is a hormone that regulates and transports glucose (sugar) from the bloodstream to cells, where it is converted into energy. Chronically high blood glucose levels directly lead to high production of insulin. 

1. Insulin resistance develops when the cells in the liver, muscles, and fat can no longer properly process or respond to insulin ->

2. Glucose builds up in the bloodstream and, while more insulin is generated by the pancreas in response, it has little to no impact on glucose levels ->

3. This results in even more insulin being released into the bloodstream ->

4. The body stores the excess glucose in the liver and muscles, but when the storage capacity of these is exhausted, the glucose is converted into fat ->

5. Fat cells drive further insulin resistance – setting up a snowballing effect whereby the problem, unless effectively treated, simply continues getting worse.

Insulin resistance (or insulin dysregulation) is diagnosed via a fasting blood test – it is characterised by normal blood glucose levels and normal HbA1C, but elevated fasting insulin levels. 

What are the Health Implications of Insulin Resistance?

It’s possible to have insulin resistance for many, many years without knowing it – and it can begin when one is very young, even in people who are not overweight. While anyone can develop insulin resistance, some people do have a genetic predisposition to the condition. Likewise, Type 2 diabetes tends to run in families. 

In a lot of people, insulin resistance doesn’t cause obvious problems until it has progressed to prediabetes or diabetes. As long as the body’s cells can use the excess insulin produced by the pancreas to absorb glucose in the bloodstream, you can have insulin resistance but not high blood sugar levels when tested clinically. 

Insulin resistance increases the risk of:

• Becoming overweight/obese (especially abdominal fat)
• Prediabetes/Type 2 diabetes
• High triglycerides
• High blood pressure (hypertension)
• Depression 
• Cardiovascular disease/heart attack/stroke
• Other metabolic disorders

Risk factors for insulin resistance include:

• A parent or sibling with Type 2 diabetes
• A sedentary lifestyle/low levels of physical activity
• Carrying excess weight (especially on the waist)
• High blood pressure
• High triglycerides and/or low HDL (“good” cholesterol)
• Polycystic Ovarian Syndrome (PCOS)
• Certain medications (including steroids)
• History of gestational diabetes
• Had a high-birth-weight baby (over 4-4.5 kg)
• Have symptoms of prediabetes/diabetes
• Have had a stroke

Symptoms of insulin resistance may include fatigue, weight gain, extreme difficulty losing weight, food cravings/increased appetite, increased thirst and/or urination, skin tags, and more. Losing weight and exercising more are the first lines of treatment to reverse insulin resistance.

How Does Blood Sugar Impact Sleep – and Vice Versa?

• Sleep and blood sugar levels are inherently linked. Blood sugar levels are influenced by one’s age, the stage of sleep, the amount one sleeps, the time of day one sleeps, and one’s eating habits.

• Several physiological factors are at play. Cortisol (the “stress” hormone) increases glucose levels; this rises with sleep deprivation. Cortisol and insulin levels are also impacted by the time of day one sleeps. Moreover, sleep deprivation inhibits insulin sensitivity, impacting glucose levels, increasing inflammation, and affecting numerous other chemicals that influence glucose in the blood.

• Blood sugar levels influence sleep quality. People with higher blood glucose levels tend to sleep poorly. Low blood sugar (hypoglycaemia) can also cause issues including dizziness, hunger, confusion, night sweats, nightmares, and irritability. Even people who are not diabetic can experience episodes of hypoglycaemia – especially if they are insulin-resistant.

• Sleep problems can also impact blood sugar levels.

• Inadequate sleep is linked with clinical biomarkers for Type 2 diabetes.
• Lack of sleep is linked with increased glucose levels, regardless of diabetes status.
• Obstructive sleep apnoea is associated with impaired glucose tolerance and higher fasting glucose levels.
• Disordered breathing during sleep (including snoring) is associated with higher blood sugar levels.
• Diabetic patients who sleep poorly are less able to control their glucose levels.
• Sleeping less than 6 hours per night doubles the likelihood of being insulin resistant.

Diabetes, Sleep, and Snoring 

Prediabetes occurs when blood sugar levels are elevated but not high enough to diagnose diabetes. It is usually the outcome of years of insulin resistance.

Diabetes (Type 2) is a blood sugar disorder that results when the body no longer responds to insulin and can no longer process glucose properly.  

(Type 1 diabetes, on the other hand, is usually suddenly diagnosed in children and young people and is a failure of the pancreas to produce insulin.)

Scientists have linked poor quality sleep with diabetes. 

Sleeping habits impact how efficiently the body’s cells respond to insulin. Lack of quality sleep also impacts the production of other hormones, further affecting blood sugar. 

For example, staying up late drives cortisol production, disrupts the circadian rhythm, and triggers insulin resistance – which can ultimately cause diabetes.

Scientists have also found evidence to suggest that habitual snoring is an additional, independent risk factor for poor blood sugar regulation.

How Can I Reduce My Risk?

• Try to exercise for at least 30 minutes at least 5 days per week – even just a short walk makes a difference.

• Eat a healthy, balanced, nutrient-rich diet and reduce your portion sizes. Limit sugar and simple-carbohydrate foods.

• Limit caffeine, especially later in the day and evening.

• Moderate or say no to alcoholic beverages.

• If you are overweight, try to lose weight. Losing 5-10% of your body weight can help reverse insulin resistance.

• If you work shifts or night work, try to maintain regular sleep times and meal times.

• Optimise your sleep. Implement healthy sleep hygiene practices and a sleep schedule. If you snore, try using an effective mandibular advancement device such as SnoreMD – arguably the best snoring treatment in Australia.

• See your GP for blood glucose and fasting insulin testing. By working with them to implement lifestyle changes, you can potentially reverse insulin resistance and even prediabetes – especially if you start early. If lifestyle changes (diet, exercise, sleep optimisation) on their own don’t work, there are certain medications used for diabetes that may be suitable for treating insulin resistance and preventing it from transforming into diabetes, which is a much more serious issue for health and longevity. Your GP or a specialist endocrinologist will identify the best treatment strategy for you.

• If you are diabetic, take care of yourself and follow your doctor’s recommendations to the letter regarding diet, exercise, and medication.

Minimise Snoring and Optimise Sleep with SnoreMD

Using the SnoreMD snoring mouthguard is an effective, convenient way to minimise or even prevent snoring for a healthier night’s sleep. The benefits of sleeping more deeply, without the breathing disruptions caused by snoring or sleep apnoea, can make an enormous difference to your health and well-being – and may even help you manage or reverse insulin resistance when used alongside beneficial lifestyle modifications such as diet and exercise. It is also beneficial for people with diabetes to help promote better sleep for optimised health. See how this anti-snoring device works and buy SnoreMD now.