Good sleep is just as important for health as healthy eating and regular physical activity. If a person suffers from insomnia, experiences a worse performance at work or at school, reduces reaction time to driving and has a higher risk of accidents, and the risk of developing high blood pressure and heart disease increases. According to a new study by researchers in the UK and the United States, insomnia increases the risk of developing type 2 diabetes.
People who have difficulty falling asleep or staying asleep have higher blood sugar levels than people who rarely have sleep problems, according to research led by researchers at the University of Bristol, supported by Manchester, Exeter and Harvard universities, and funded by Diabetes UK. It was published in the journal Diabetes Care.
The results suggest that insomnia might increase the risk of type 2 diabetes and that pharmacological or lifestyle treatments that improve insomnia could help prevent or treat the disease.
Insomnia, lack of sleep, and going to bed later have been linked in previous studies to an increased risk of type 2 diabetes. “More than insomnia itself, what matters is to sleep a few hours. This has long been related to the development of type 2 diabetes,” said Dr. Mirta Averbuch, director of the Somnos center and former president of the Argentine Association of Sleep Medicine, after reading the study, in dialogue with Infobae.
In the new study, the UK and US research team assessed whether these associations are explained by the causal effects of sleep traits on blood sugar levels.
The researchers used a statistical technique called Mendelian randomization to see how five measures of sleep — insomnia, sleep duration, daytime sleepiness, nap, and morning or night preference (chronotype) — were related to mean blood sugar levels evaluated by a measure called HbA1c levels.
The use of Mendelian randomization, which groups people according to a genetic code randomly assigned at birth, allowed researchers to eliminate any bias from the results. The study was conducted with more than 336,999 adults residing in the United Kingdom, and showed that people who reported that they often had difficulty falling asleep or staying asleep had higher blood sugar levels than people who said they had never, rarely or only sometimes these difficulties.
The research team found no clear evidence of an effect of other sleep traits on blood sugar levels. The findings could improve researchers' understanding of how sleep disorders influence the risk of type 2 diabetes. The study also suggests that lifestyle and/or pharmacological interventions that improve insomnia could help prevent or treat diabetes.
James Liu, senior associate researcher at the Bristol School of Medicine and the MRC Integrative Epidemiology Unit, and corresponding author of the work, said: “We have calculated that effective treatment for insomnia could lead to a greater reduction in glucose than an equivalent intervention, which reduces body weight by 14 kg in a person of average height. This means that some 27,300 UK adults, aged 40 to 70, with frequent symptoms of insomnia would be spared diabetes if their insomnia were treated.”
There are currently some treatments for insomnia. For example, UK guidelines for doctors recommend cognitive behavioral therapy for insomnia, and short-term treatment of sleeping pills or treatment with a hormone called melatonin if cognitive behavioral therapy doesn't work.
According to Dr. Faye Riley, director of research communications at Diabetes UK, “we know from previous research that there is a relationship between sleep and the risk of a person suffering from type 2 diabetes, but it has not been clear what comes first, whether bad sleep or increased blood sugar levels, or if there are other factors at play.”
Riley highlighted the results of the study: “This new study, funded by Diabetes UK, gives us an important insight into the direction of the relationship between sleep and type 2 diabetes, suggesting that insufficient sleep may cause higher blood sugar levels and could play a direct role in the development of diabetes type 2. Knowing this could open up new approaches to help prevent or control the disease.”
“However, it's important to remember that type 2 diabetes is a complex disease, with multiple risk factors. Eating a healthy and balanced diet, staying active and getting enough sleep are essential components for good health for everyone, including those at risk of type 2 diabetes or those who have it,” said Riley. He estimated that future studies to evaluate the impact of these treatments for insomnia on glucose levels in people with and without diabetes could establish possible new treatments for the prevention and treatment of diabetes.
For Dr. Averbuch, there is already strong evidence of the association between the few hours of sleep and the risk of diabetes. Therefore, it is essential that people who suffer from insomnia be able to follow recommendations that lead to control the problem. There are three main recommendations, according to Averbuch, people should set regular times to go to bed at night and wake up in the morning. “Vigorous activities and stimulating drinks should be avoided after 19 hours,” he said. “The bed is for sleeping. If you don't fall asleep within 15 minutes, you have to get out of bed and do quiet activities such as reading or listening to relaxing music in dim light. The idea is that the brain associates the bed with sleep. When you feel sleepy again, you have to go back to bed,” he added.
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