Sleep Problems May Cause Weight Gain, Raise Diabetes Risk

Getting enough sleep is one of the most important factors in maintaining good health-it may even help control your weight and your risk of getting diabetes.  There are lots of ideas about why people are gaining weight at such an alarming rate and why at the same time there's a dramatic rise in type 2 diabetes. Americans' diet and lack of exercise are certainly key factors. Here is another possible contributing factor - not enough sleep.

Researchers at the University of Chicago Medical Center studied the effects of sleep deprivation on blood sugar control in nine healthy young adults. They found that interrupting the deepest phase of sleep over and over causes blood sugar levels to rise more than expected. The pancreas needs to send out extra insulin to bring the blood sugar back into line. This pattern is similar to what happens to most people with type 2 diabetes. Blood sugar levels rise just enough to prompt the pancreas to make more insulin. At the same time, body weight tends to rise as the higher insulin levels push more sugar and more calories back into cells.

Then the cells in the body stop responding as well to the insulin. The pancreas needs to make even more insulin to drive the blood sugar into cells. Weight increases even more. Insulin levels keep rising, but blood sugar levels rise even faster.

The result is usually weight gain, insulin resistance, and higher and higher blood sugar levels. This often leads to diabetes.

What changes can I make now? 

Many of us are not getting enough quality sleep. Usually the cause is not setting aside enough hours to get that sleep. Although there is no ideal amount of sleep, most experts suggest that we need eight hours per day, perhaps even a little more.

Sleep quality might also be a problem. For example, people with sleep apnea spend almost no time in deep sleep. If the lack of deep sleep raises blood sugar, this might be another reason that people with sleep apnea are often overweight.

Even if you already give yourself enough time for sleep, you can improve the quality of sleep. Bedtime practices and habits that can affect your sleep are known as "sleep hygiene." Here are some ways to help you get better quality sleep:

• Establish a regular bedtime and a relaxing bedtime routine. Examples might include taking a warm bath or listening to soothing music.
• Use your bed only for sleeping or sex. Avoid reading and watching television in bed.
• If you can't sleep after 15 to 20 minutes, get out of bed and go into another room. Read quietly with a dim light. Don't watch television, since the light from the TV has an arousing effect. When you feel sleepy, get back into bed. Don't delay your scheduled wake-up time to make up for lost sleep.
• Get plenty of exercise. Build up to 45 minutes of moderate exercise nearly every day. Get your exercise early in the day. Try some easy stretching exercises or yoga to relax your muscles and your mind at bedtime.
• Whenever possible, schedule stressful or demanding tasks early in the day and less challenging activities later. This helps to wind down at the end of your day.
• Adjust what you eat and drink.
• Don't go to bed hungry, but don't eat a big meal right before getting into bed. If you want a bedtime snack, keep it bland and light.
• Limit caffeine, and consume none after 2 p.m.
• To decrease middle of the night urination, don't drink any fluids after dinner.
• Avoid alcohol after dinnertime. Although many people think of it as a sedative, it can actually impair your sleep.
• Be sure your bed is comfortable and your bedroom is dark and quiet. Consider a sleep mask or earplugs. Don't let yourself get overheated. Keep the bedroom at a constant, comfortable temperature.
• Don't take long naps during the day. If you need a nap, restrict it to 15 to 20 minutes in the early afternoon.
• Turn the alarm clock around so you won't watch the minutes tick away and worry that you are still awake.
• Practice relaxation breathing. Use slow breaths, especially when you exhale.

Though this was a small study and therefore the results will need to be confirmed, getting enough sleep improves your health in many ways, and therefore should be a priority.

What do you do to make sure you get enough sleep?

Julie K. Silver, M.D., is an assistant professor in the Department of Physical Medicine and Rehabilitation at Harvard Medical School. She is also the Chief Editor of Books for Harvard Health Publications.

Sleep
Need better sleep? Learn how to get it with Improving Sleep: A Guide to a Good Night's Rest. This special report from Harvard Medical School describes the factors that can disturb sleep, the latest in sleep research, and, most importantly, what you can do to get a good night's sleep. It also includes in-depth information on sleep disorders, including restless legs syndrome, narcolepsy, and sleep apnea.