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Insomnia, high insulin resistance linked
Knutson KL. Diabetes Care. 2011;34:1171-1176.
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People with diabetes who sleep poorly appear to have higher insulin resistance and a more difficult time controlling their disease.
New data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, an ongoing, longitudinal study of cardiovascular health, indicate an association between poor sleep quality and higher glucose, insulin and estimated insulin resistance in diabetes.
Researchers monitored the sleep of 40 people with diabetes and 115 people without diabetes for 6 days. Wrist actigraphy was used to monitor wrist movements during the night. Poor sleep was determined by both wrist actigraphy measurements and self-reports of sleep disturbances such as insomnia, snoring and sleep apnea. At clinical examinations, researchers collected blood samples to measure insulin and glucose levels.
Among those with diabetes, poor sleepers had 23% higher blood glucose levels in the morning and 48% higher blood insulin levels. Using these numbers to estimate a person’s insulin resistance, the researchers found that poor sleepers with diabetes had 82% higher insulin resistance compared with normal sleepers with diabetes.
The researchers found no association between sleep measures and fasting glucose, insulin or insulin resistance in the participants without diabetes.
“The strength of these associations suggests that the diagnosis and therapeutic treatment of type 2 diabetes should take into account the possible existence of sleep disturbances,” the researchers wrote.
They said the next step is to see if treating poor sleep can improve long-term outcomes and quality of life for people with diabetes. The researchers postulated that the effects of sleep disturbances may be more pronounced in people with diabetes because mechanisms responsible for glucose homeostasis, such as lower cerebral glucose utilization, elevated sympathetic activity, higher evening cortisol, alterations in growth hormone release and elevated markers of inflammation, are already deficient.
“For someone who already has diabetes, adding a sleep treatment intervention, whether it’s treating sleep apnea or treating insomnia, may be an additional help for them to control their disease,” Kristen L. Knutson, PhD, assistant professor of medicine, University of Chicago Medical Center, said in a press release.
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