Not getting enough shut eye each night or not sleeping well may contribute to reduced blood sugar control in African Americans with type 2, also referred to as adult-onset diabetes, according to a study published this week. Similar ties between sleep and blood sugar control are likely to exist in other ethnic groups as well, the study team predicts.
"Sleep curtailment has become increasingly prevalent in modern society and it cannot be excluded that this behavior has contributed to the current epidemic of type 2 diabetes," Dr. Eve Van Cauter and colleagues at the University of Chicago write in the Archives of Internal Medicine.
Boosting sleep quantity and quality may be a simple way to improve the health of people with diabetes, they suggest.
The researchers interviewed 161 adult African Americans with type 2 diabetes and found that they slept an average of 6 hours per night. Only 22 percent averaged at least 7 hours of shut eye per night and just 6 percent got at least 8 hours of sleep nightly. Moreover, 71 percent had poor quality sleep.
According to the team, higher hemoglobin A1C levels -- an indicator of poor blood sugar control -- were associated with lower sleep quantity and quality, even after controlling for possible confounding factors like being overweight.
The average A1C level was 8.3 percent, which is much higher than the recommended A1C level of 7 percent or lower. Only 26 percent of study subjects had A1C levels below 7 percent.
Many diabetes patients have painful complications that can disrupt sleep. However, even after the researchers excluded 39 individuals with painful complications, 67 percent reported not sleeping well and their average A1C level was high (8.2 percent).
For subjects without painful complications of their diabetes, a 3-hour "perceived sleep debt" -- that is, the difference between how much sleep they felt they needed and how much they actually got -- was associated with a 1.1 percentage point increase in A1C levels.
For subjects with at least one diabetes complication, decreased sleep quality appeared to be more important. An increase of 5 points out of 21 on a standard sleep quality index was associated with a 1.9-percentage point increase in A1C.
"The magnitude of these effects is comparable to those of widely used oral anti-diabetes agents, note the authors.
"The growing tendency to burn the candle at both ends may be a significant contributor to the current epidemic of diabetes," said Van Cauter. "One way to combat this epidemic may be to repay our mounting sleep debt."
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