Counsel patients about sleep debt's role in diabetes
Forty years ago Americans were sleeping about two hours more per night than we do now. Most of us average about 6.9 hours of sleep per night on weeknights and 7.4 hours per night on the weekend. We are also a culture that is grossly overweight with 75 million adults considered obese. Many obese adults have been or will be diagnosed with diabetes, and researchers are continuing to examine the effects of slept debt on the metabolic process.
Chronic sleep deprivation lowers the resting metabolic rate, results of a recent study suggest, which can lead to a defect in insulin resistance, and may explain one reason why diabetes prevalence is increasing.
Sleep has also been shown to effect endocrine function, including leptin and ghrelin -- the two key hormones involved in appetite regulation. Sleep loss up-regulates ghrelin, which signals appetite, and lowers leptin, which curbs hunger. Outcomes from a number of other studies, listed in the chart below, have also linked short sleep duration with diabetes.
Sleep deprivation has an effect on many body functions. It can decrease immunity and cause elevated inflammatory markers, and patients who don't get enough sleep have a higher risk for depression, hypertension and dyslipidemia. Imaging studies show that lack of sleep can also decrease neurobehavioral performance, including our ability to learn and process memories.
There is no doubt that sleep deprivation has an impact on body organs and systems. Encourage your patients to get more sleep, and discuss sleep hygiene and the importance of sleep on health and wellbeing. Be sure to explain the impact sleep deprivation can have on insulin levels with patients who have diabetes or prediabetes. Ask these patients how many hours of sleep they get each night, and encourage them to sleep at least seven to eight hours per night on a regular basis.
Sharon M. O'Brien, MPAS, PA-C, works at Presbyterian Sleep Health in Charlotte, N.C. Her main interest is helping patients understand the importance of sleep hygiene and the impact of sleep on health.