Diabetes Forecast

You Snooze—You Don’t Lose

How to make sleep work for your health: answers to 6 key questions

By Erika Gebel Berg, PhD , ,

Steve Cole Images/Getty Images

Sleep isn’t just for the brain. In study after study, people who sleep seven to eight hours at a time are at the lowest risk for premature death and disease.

What if you could lose weight, improve your memory, and boost your heart health just by lying around? You can! Sort of. Science is revealing that sleep is critical for every system in your body. A lack of sleep confuses your biological rhythms, possibly contributing to the development of type 2 diabetes and other conditions by disrupting the hormone patterns that regulate blood glucose, growth, and appetite.

Compared with eating five servings of vegetables every day or walking on a treadmill for 30 minutes five times a week, getting enough sleep seems as if it should be easy. Yet many Americans are sleep deprived. Part of the problem is our nonstop, technology-enabled existence. Another issue, perhaps related, is that sleep disorders seem to be on the rise. What we’re learning about the relationship between sleep and health shows that getting enough sleep is well worth the effort. Wondering how to get full slumber benefits? These answers may help put your mind at rest.

How Much Sleep Is Enough?

We all know people who claim they sleep four hours a night and feel like a million bucks. And indeed, some evidence suggests that “if people sleep three to four hours at a time, they can ward off many of the effects of sleepiness,” says Michael Twery, PhD, director of the National Center on Sleep Disorders Research at the National Institutes of Health. “They can operate games that involve driving without making serious mistakes. They can also do calculations.”

 But there’s a catch: Sleep isn’t just for the brain. In study after study, people who sleep seven to eight hours at a time are at the lowest risk for premature death and disease. Twery says this research suggests that it’s the number of sleep cycles we get in a row that keeps the body in good working order. Sleeping overnight, a person typically completes four or five sleep cycles, each consisting of five stages, including rapid eye movement (REM) and deep sleep. While each person’s exact sleep needs may vary, most experts agree that people should sleep in seven- or eight-hour chunks, not in catnaps.

How Do I Know How Much I’m Sleeping?

This is a tougher question than it first appears. “It turns out people aren’t good at telling us whether they are awake or asleep at night,” says Matt Bianchi, MD, PhD, director of the sleep division at Harvard Medical School. How sleepy you are during the day isn’t a good indicator of how much sleep you’re getting either. Bianchi says that if you ask a thousand people with sleep apnea, a serious sleep disorder, if they’re sleepy during the day, “only half say yes.”

One strategy that may help you track your nocturnal behaviors is keeping a sleep diary. Write down what time you go to bed, when you wake up, and whether you got up in the night. If you suspect you’re having sleep issues, consider talking to your doctor about spending a night in a sleep laboratory, where professionals can determine how much you sleep and how long you spend in each stage of the sleep cycle.

Can I Track My Sleep Behavior at Home?

In recent years, a variety of consumer devices, such as the popular Fitbit, have emerged that claim to measure sleep. Unfortunately, “these devices are not up to snuff,” says Bianchi. “They’re based on 30-year-old technology that the medical field has long dismissed as a tool for detecting sleep disorders.” The problem, he says, is that people using such devices may develop a false sense of security that they’re sleeping OK when, in fact, they have sleep apnea or another disorder. “If you have diabetes, the chance that you have something wrong with your sleep is elevated,” says Bianchi. “If you’re concerned, go to your doctor.”

Do I Have Sleep Apnea?

In people with obstructive sleep apnea (OSA), the most common type of sleep apnea, the windpipe closes many times during sleep, causing pauses in breathing. Some evidence suggests that up to 80 percent of people with type 2 diabetes have OSA, which is associated with high blood pressure, heart disease, acid reflux, and car accidents caused by daytime grogginess. While the condition is associated with excess weight, there’s more to it. “The first thing that’s important is there is no prototype,” says Hawley Montgomery-Downs, PhD, associate professor of behavioral neuroscience at West Virginia University. “You cannot look at someone and know they have a problem.”

Risk factors for sleep apnea include smoking, a thick neck, and a sunken chin. But the most common sign of sleep apnea? Snoring, says Montgomery-Downs. “Someone who snores at night should really take a close look at how they are feeling during the daytime.” Taking trips to the bathroom several times a night may also be a sign of sleep apnea—the condition can trigger the stress response that makes you want to urinate. If you suspect sleep apnea, talk to your doctor about getting tested for the condition.

Should I Consider Sleeping Pills?

There are techniques that can improve your sleep without resorting to pills (see “8 Tips for Sound Sleep,” ). If these don’t work and your doctor has ruled out sleep apnea, which has its own treatment, it may be time to talk to your doctor about over-the-counter or prescription sleep aids. Use caution, though: Over-the-counter sleep medications often contain antihistamines, which can cause daytime drowsiness and other side effects. Some prescription medications can have serious side effects, such as sleepwalking. Medications are typically recommended only for short-term use, to help a person get back on a good sleep schedule.

When Should I See a Doctor?

“Healthy people who sleep well don’t fall asleep during the daytime,” says Montgomery-Downs. If you are falling asleep at inappropriate times, it’s time to see a physician. If he or she suspects a sleep disorder, you may be referred to a special sleep center for further testing. Typically, these tests involve sleeping one night at the center, in a private room, while technicians monitor your sleep using devices including electrodes on your face and scalp to detect brain waves, abdominal and chest belts to measure breathing, and a probe placed on your finger to measure the oxygen in your blood. If your sleeping partner says you have a snoring problem, don’t laugh it off. Because people with diabetes are at a heightened risk for sleep apnea, it may be a good idea to talk to a health care provider if you snore.

8 Tips for Sound Sleep



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