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October 5, 2020 • Diabetes, Healthy Living

Sleep Loss Triggers Pre-Diabetes

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Even a few nights of poor sleep in healthy individuals results in a transient state of pre-diabetes. That is the eye-opening conclusion of a study that underscores how vital sleep is for metabolic function.
For this study, researchers subjected 19 healthy, young men to four consecutive nights of sleep deprivation (just 4.3 hours of sleep) in a controlled laboratory setting. In addition to carefully controlling what they ate and how much they slept, the researchers followed blood levels of several important metabolic markers. After just three nights of poor sleep, there were “marked changes” in several important metabolic compounds including a significant increase in insulin resistance.With insulin resistance, insulin’s ability to facilitate the absorption of glucose from the bloodstream becomes impaired and sluggish-a hallmark feature of pre-diabetes and often “the final common gateway” to obesity. The researchers noted that although the reduction in insulin action was transient (it only lasted about five hours) it was on par with what is observed in pre-diabetes!

This study is in keeping with the large population studies that consistently show that those who get inadequate sleep are more likely to gain weight and more likely to develop type 2 diabetes. I am personally convinced by the science I have read that sleep is essential for weight control and metabolic health. (Diabetologia, February 2015 DOI: 10.1007/s00125-015-3500-4)

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Here’s what I suggest:

-Strive to get at least seven hours of restful sleep a night. Some people do even better with eight.

-Make the room you sleep in as dark, cool, and quiet as possible. Also keep it free of any electronics that can emit light or noise like a TV, tablet, phone, or computer.

-Avoid vigorous exercise or eating within two hours before bed, as these can stimulate you and prevent restful sleep.

-Try a soothing chamomile tea, meditating, or another relaxing practice that works for you to get your head and body ready for bed. Sex has been shown to encourage more restful sleep.

-Strive to maintain the same sleep and awaken times day to day. According to the sleep experts, this practice is likely the most beneficial of all strategies to improve the quality of your sleep.

-Avoid close exposure to the backlighting from a computer, tablet, or smart-phone in the hour or two before bed. One recent study noted a significant decrease in the release of the sleep-inducing hormone melatonin after exposure to this artificial light.

-Get regular daily exercise. I am convinced that restful sleep is virtually impossible without a certain threshold level of daily physical activity (at least 30 minutes of moderate aerobic activity like brisk walking).

-Minimize the use of prescription sleep aids. They do not allow for restful, “normal” sleep and can predispose one to dependence.

-Spend some time outdoors each day to get exposed to natural light. This is helpful in maintaining normal diurnal rhythms, which are fundamental to health and restful sleep. Morning light (before 10 AM) appears to be particularly beneficial in this regard and has less skin-damaging UV rays.

-Consider consuming a serving any of the following foods closer to your bedtime: kiwi, walnuts, almonds, peanut butter, or tart cherry juice. There is some evidence that these foods may enhance sleep.

-Cut back on your dietary sodium. This decreases nocturnal urination that interferes with restful sleep.

-Minimize use of alcohol. It is well established that alcohol interferes with quality sleep, particularly REM sleep. Ideally, limit alcohol to one or less drinks a night, and avoid any alcohol within three hours of going to bed

-Avoid use of products (ideally after 2PM) containing caffeine or other stimulants, for example, coffees, teas, sodas, energy drinks, etc.


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