Chronic Insomnia Raises Risk for Type 2 Diabetes

Written by Kathleen Doheny | EndocrineWeb.com

Insomnia raises the risk of developing Type 2 diabetes, a new study confirms, and that risk increases with the duration of insomnia.

Younger people, those under age 40, are especially vulnerable to developing diabetes if they have persistent insomnia, according to researchers from the National Taiwan University College of Medicine in Taipei, Taiwan.

“This isn’t a surprise,” says Elena Christofides, MD, FACE, chief operating officer of Endocrinology Associates in Columbus, Ohio, and a member of the editorial board for EndocrineWeb. Insomnia, she says, puts the body in a constant state of stress. “Stress is a known contributor to the development and progression of obesity and diabetes because it causes the body to not be ever able to go into repair and relaxation mode. It is always in reaction mode.”

The new study is published in Diabetes/Metabolism Research and Reviews.¹

Study Details

The researchers looked at data from more than 28,000 men and women who did not have diabetes at the study start. All had been diagnosed with insomnia from January 2001 through December 2004.

The researchers compared that group to the health data from a million randomly selected patients in the national health insurance database, and to more than 57,000 people without insomnia but matched to the insomnia group for sex and age.

They followed the people for an average of six years or until a diagnosis of diabetes.

The findings^1:

• Overall, the risk of diabetes was 16% higher in those with insomnia than in the comparison subjects.
• The risk of getting Type 2 diabetes among those with insomnia was higher among those age 40 years or younger compared to older men and women. The 40 and under group with insomnia was 31% more likely to get diabetes than those 40 and under without insomnia. Those 41 to 65 with insomnia were 24% more likely to get diabetes than the same age range without insomnia, and those 66 and older with insomnia were just 6% more likely to get the disease than those of the same age without the sleep disorder.
• Duration of insomnia mattered. Compared with those who didn’t have insomnia, those with it and followed for at least 8 years had a 50% higher risk of getting diabetes. Those who suffered from insomnia for four years or less had a 14% higher risk than those without insomnia.¹

Explaining the Link

Exactly why insomnia leads to a greater diabetes risk is not known for sure, but the experts have a few speculations. Sleep deprivation is linked with glucose metabolism, the researchers say, and also with changes in the balance of the hormones leptin and ghrelin, which may affect appetite and hunger and trigger overeating.

Not sleeping well can also lead to irregular eating habits, such as preferring high-calorie, high-fat foods, the experts say. Sleep deprivation can also reduce your insulin sensitivity, which affects how well your body can use insulin to reduce elevated blood sugar levels.¹

Experts’ Perspective

“It’s not just one night [with insomnia] that’s the problem,” Dr. Christofides says. “It’s night after night. Quality sleep allows your body to go into rest and repair mode instead of active mode.”

What is especially noteworthy in the new study, she says, is that the risk of diabetes sets in early in those with chronic insomnia—under age 40.

“This study adds to a growing body of research linking inadequate sleep with obesity and Type 2 diabetes,” says Scott Isaacs, MD, FACP, FACE, medical director of Atlanta Endocrine Associates and a member of the editorial board for Endocrine Web. “Good sleep is an essential component to overall health and well-being,” he says.

Insomnia Relief

Good sleep practices, or ”sleep hygiene,” as physicians call it, can help minimize insomnia, experts agree.

“Pills are usually not the best solution,” Dr. Isaacs says. There are many measures to take before resorting to pills, Dr. Christofides agrees.

She suggests herbal teas, such as chamomile or valerian root, to coax sleep.

Avoiding or blocking the ”blue” light put out by electronics can also help, she says. The light that electronics, such as your cell phone or tablet or laptop, put out, ”directly interfere with the circadian clock in the brain,” she says. She suggests wearing blue-light blocking glasses starting from about 5 p.m. until bedtime.

Or, apps available on both iPhone and Android devices can be used to reduce blue light emissions, she says.

Other sleep hygiene tips:

•   Keep pets off the bed. “They’re so disruptive,” Dr. Christofides says.
•   Block out all light, such as street lights, from your bedroom.
•   If your bed partner is disruptive, consider a split bed.
•   Ask your doctor about melatonin, which can coax sleep. The dose must be individualized.

Good sleep doesn’t just happen, Dr. Isaacs says. “Good sleep takes effort just like diet and exercise for weight loss,” Dr. Isaacs says.”But if you put in the effort, your sleep will improve.”

And if it doesn’t, Dr. Isaacs says, he will refer patients to a sleep specialist to work on the problem further.

Dr. Isaacs reports consultant work for Novo Nordisk and Speakers’ Bureau work for Novo, Takeda Pharmaceutical Company, and Orexigen Therapeutics. Dr. Christofides reports consultant work for Novo Nordisk, Eli Lilly and Chiasma and Speakers’ Bureau work for Pfizer, Novo, Eli Lilly, Boehringer Ingelheim, PamLab, and Shire. She has received research support and grants from Pfizer, GlaxoSmithKline, Janssen, Sanofi-Aventis, Novo and Lexicon.