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If you have diabetes, you already know that you require to keep a very close eye on how much sugar you eat. It’s the one food that most reliably raises blood sugar, and it is highly associated with obesity, to boot.
What may be less obvious is the relation between sugar consumption and sleep quality.
Sleep is surprisingly important for women and men with diabetes: poor sleep increases insulin resistance and, when chronic, is associated with all sorts of negative health outcomes. A bad night of sleep also seems to make us crave sugary junk food – exactly the food that just makes diabetes even tougher to manage.
A new learn about from Brigham Young University is just the latest of many to find that there is a very real connection between sugar intake and inadequate sleep. In this experiment, ninety-three adolescents were randomized to five consecutive nights of healthy sleep (9.5 hours “sleep opportunity”) or short sleep (6.5 hours); researchers then tracked what they ate.
The teens with less sleep – they averaged 2 hours and 20 minutes fewer – ended up eating more added sugar, more carbohydrates, more sweetened beverages, and fewer fruits and vegetables. Most of the difference between the two groups was attributed to late-night snacking. The study wasn’t designed to explain why the exhausted teens were snacking more, but its lead author speculated that “tired teens are looking for quick bursts of energy to keep them going until they can go to bed.”
There is also some evidence that poor sleep causes the metabolism to operate less efficiently. A small but thought-provoking 2010 study took 10 overweight adults and asked them to eat the same diet for two weeks. Half were told to sleep 5.5 hours per night, the other half 8.5 hours. Remarkably, the dieters that got plenty of sleep lost 55% more fat than the sleep-deprived group, suggesting that lack of sufficient sleep can really sabotage a weight loss effort.
It seems clear that a lack of sleep prompts people to make unhealthy food choices, and perhaps also to blunt the impact of good food choices. Does it work the opposite way, too? Does eating poorly diminish sleep quality?
Scientists appear to have paid somewhat less attention to this question. At least one study found diets with high saturated fat, low fiber, and high sugar were associated with light sleep and more frequent nocturnal arousal. The authors concluded that “it is possible that a diet rich in fiber, with reduced intake of sugars and other non-fiber carbohydrates, may be a useful tool to improve sleep depth and architecture in individuals with poor sleep.”
If it’s true that bad food leads to bad sleep, it suggests that there may be a vicious cycle at play – poor sleep causes us to reach for unhealthy foods, which just causes more poor sleep. For people with diabetes, this seems even more likely to be true, given the way that suboptimal eating choices can lead to nighttime glucose management problems.
There needs to be more study to tease out correlation from causation, and figure out if suboptimal sleep habits are causing suboptimal dieting habits, or vice versa, or both. But in the meantime, it must be unsurprising that so many surveys of sleep habits and diets, whether they examine Danish school children or middle-aged Japanese women, find that poor diets and poor sleep go hand in hand.
Poor Sleep and High Blood Sugar
Of course, people with diabetes always have to be thinking about their blood sugar, too. High blood sugar – a direct result of sugar consumption – is also correlated with poor sleep, even in people without diabetes. Poor sleep habits interrupt a complex range of hormonal and metabolic changes, resulting in increased inflammation and insulin resistance, both of which can help cause high blood sugar.
The causation appears to go in both directions here, too, as high blood sugar and insulin resistance are thought to contribute to common sleep problems such as sleep apnea and sleep-disordered breathing.
According to the experts at the National Institute of Diabetes and Digestive and Kidney Diseases, there is little direct evidence as of yet that improving sleep can lead directly to improved glucose metabolism. But the subject has lately become an area of intense interest: “the efficacy and effectiveness of interventions that optimize sleep and circadian function to prevent the development or reduce the severity of these metabolic disorders need to be urgently evaluated.”
There is a great deal of evidence linking poor sleep habits with poor diet and with suboptimal metabolic function, although the details of the interactions are not always clear. Many studies show that poor diet is associated with lack of quality sleep, and that lack of quality sleep is associated with insulin resistance and diabetes risk factors.
If you’re trying to optimize your diabetes management, don’t forget about sleep! It’s just one more reason to lay off the sugar today. And a night without enough sleep might make it more likely for you to reach for sweet junky food tomorrow, which might just make it less likely that you’ll get enough sleep tomorrow night, sparking an unhealthy cycle.