Insulin and Sleep – Do Sleep Problems Cause Insulin Resistance?

Last updated: March 6, 2019

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Insulin regulates blood glucose throughout the day and night. Between 4 and 8 am, there is a surge in glucose – however, if insulin is able to do its job properly, it takes care of this situation. Our body consumes the least glucose during REM (rapid eye movement) sleep and the most when we are awake.

Having enough deep sleep, or slow-wave sleep seems to be linked with proper blood glucose regulation by insulin. Many studies have shown that poor sleep negatively affects how insulin is used by the body, and conversely, having plenty of sleep sets insulin-based activity this back in order.

Overview

Insulin is known to help with keeping balance in the levels of glucose in our blood (blood sugar). It is also known that obesity is the main cause for the disruption of this balance, disruption of homeostasis in the body. However, scientists have found that insulin resistance is closely tied to sleep deprivation, that is, total or partial lack of sleep. Not having enough sleep is also risk factor for weight gain, as a tired person is likely to eat a lot more in a bid to regain energy.

What is insulin and what does it do?

Insulin is a hormone – a chemical naturally produced in the body. Hormones carry a message and tell body cells, organs, or our mind what to do. Insulin, in particular, orders cells (for example, from the liver, muscles, and fat) in our body to take glucose from the blood and use it for energy. As the cells consume glucose, its levels in the blood remain healthy. Therefore, insulin is an important factor in our metabolism.

Insulin and diabetes

If the blood glucose levels are too high, due to chronic inactivity, excessive weight, sleep deprivation or genetics, the pancreas may start producing too much insulin. If the body doesn’t respond to insulin the way it should, it develops insulin resistance – which means high blood glucose. This is known as type 2 diabetes.

In type 1 diabetes the body stops insulin secretion altogether and the patients have no other choice but to use insulin shots in order for their body to artificially retain homeostasis. Those suffering from type 2 may also be prescribed with insulin shots.

A significant change in lifestyle – physical activity, diet, healthy sleep habits, weight management, stress reduction – can prevent diabetes or stop its progression. Some people have reported curing their diabetes with a lifestyle change. Of course, doing so without consulting a doctor or specialist is a risk in itself.

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Those who suffer from obstructive sleep apnea (OSA) are usually obese and likely to suffer from both sleep loss and diabetes. OSA patients have difficulty breathing, that is, they stop breathing and wake up several times a night, which prevents them from reaching deeper stages of sleep. This further leads to insulin problems and a higher calorie intake demand, which in turn increase weight and continue the vicious circle.

What does insulin do while we sleep?

Insulin regulates blood glucose throughout the day and night. Between 4 and 8 am, there is a surge in glucose – however, if insulin is able to do its job properly, it takes care of this situation. Our body consumes the least glucose during REM (rapid eye movement) sleep and the most when we are awake.

Having enough deep sleep, or slow-wave sleep seems to be linked with proper blood glucose regulation by insulin. Many studies have shown that poor sleep negatively affects how insulin is used by the body, and conversely, having plenty of sleep sets insulin-based activity this back in order.

How does a lack of sleep affect insulin?

Numerous studies have shown that insufficient sleep or no sleep, even for only one night, disrupts insulin and glucose levels by creating insulin resistance. More such nights caused more problems with glucose. Here we present three such studies.

One night sleep deprivation/restriction

A group of scientists from Cedars-Sinai Medical Center in Los Angeles, CA performed a study on dogs. They compared how sleep deprivation and high-fat diet affect insulin. What they found out was that only one night of sleep deprivation increased insulin resistance by 33%. On the other hand, six months of a high-fat diet with regular sleep increased insulin resistance by 21%.

This means that sleep deprivation did more damage than six months of eating fatty foods. Although this particular study was conducted in dogs, it still shows us the importance of sleep. People who don’t get enough sleep tend to take in more calories than they can burn, because insufficient sleep disrupts appetite-controlling hormones. Therefore, poor sleep, inadequate diet (and even obesity) usually go hand-in-hand.

Another study conducted on nine healthy men and women whose sleep was restricted for only one night (they slept for 4 hours) showed an increase in insulin resistance ‘in the multiple metabolic pathways’ the following day. Researchers have also concluded that in addition to the restricted hours of sleep, there were more factors contributing to insulin sensitivity. The length of sleep prior to the study and the amount of exercise participants had earlier also determined whether the four-hour sleep had have more or less negative consequences.

Longer sleep restriction

Longer exposure to restricted sleep of 4.5 hours doesn’t make much difference. A study conducted on seven healthy young people who had restricted sleep over four days aimed to examine how subcitaneous (under skin) fat cells responded to insulin. Their diets were strictly monitored to avoid overeating – this way, it was possible to assess insulin resistance caused only by sleep disruption, preventing the diet from being a factor.

After four days and after conducting the adipose tissue biopsy (taking a sample of fat cells from participants), researchers tested the cells. They discovered that cell metabolism in these peripheral tissues was slower, and the cells were 30% more insulin resistant. Such levels of insulin resistance are seen in obese and /or diabetic people.

They also measured overall insulin sensitivity through blood tests, only to find that it has dropped for about 16%. One of the study authors stated that these levels can be compared to metabolically aging a person for 10 to 20 years – such was the effect of four nights of poor sleep.

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According to the National Sleep Foundation, the good news is that if sleep deprivation lasts for several days, the negative effects can be reversed if we have a couple of nights of proper, uninterrupted sleep.

Chronic sleep restriction

Not sleeping enough over a prolonged period of time results in a lower amount of insulin produced after eating while cortisol and other stress hormones are released much more. Stress hormones prevent us from falling asleep and don’t let insulin be as effective as it is supposed to. This was, glucose metabolism is disrupted and blood sugar levels go up. This makes a suitable environment for the development of type 2 diabetes.

How sleep environment affects insulin

A study published in the journal Sleep has looked into whether and how nightly light exposure affects the chances of a person to have diabetes. The researchers were motivated by the widespread use of artificial lights at night, both before and during sleep.

There were two groups of people – one which slept in dark for two nights, and one which slept in dark on the first night and with overhead light on the second. Both groups were allowed to sleep for about 8 hours.

They found that the single night of sleeping with the light on increased insulin levels – this can lead us to ask how artificial light exposure during sleep affects our bodies if we leave the light on over a longer period of time.

You should also reduce the light exposure before bedtime, because the blue light from screens can confuse our body into delaying the production of melatonin, a hormone which makes us sleepy. Therefore, if the lights are strong in our room and we look at screens until bedtime, the chances are high that we will suffer from an inability to fall asleep.

Additional Resources

  1. Brazier Y. Sleep well to avoid insulin resistance. Medical News Today. November 4, 2015. https://www.medicalnewstoday.com/articles/301721.php Accessed January 5, 2019.
  2. Donga E, van Dijk M, et al. Single Night of Partial Sleep Deprivation Induces Insulin Resistance in Multiple Metabolic Pathways in Healthy Subjects. The Journal of Clinical Endocrinology & Metabolism. Volume 95, Issue 6, 1 June 2010. https://academic.oup.com/jcem/article/95/6/2963/2598810#52732609 Accessed January 5, 2019.
  3. Broussard J. L, Ehrmann D. A, et al. Impaired Insulin Signaling in Human Adipocytes After Experimental Sleep Restriction: A Randomized, Crossover Study.  Annals of Internal Medicine. October 16, 2012. http://annals.org/aim/article-abstract/1379773/impaired-insulin-signaling-human-adipocytes-after-experimental-sleep-restriction-randomized Accessed January 5, 2019.
  4. Mason I, Grimaldi D, et al. Impact of Light Exposure during Sleep on Cardiometabolic Function. Sleep. April 27 2018. https://academic.oup.com/sleep/article-abstract/41/suppl_1/A46/4988151?redirectedFrom=fulltext Accessed January 5, 2019.
  5. The Link Between A Lack Of Sleep And Type 2 Diabetes. National Sleep Foundation. https://www.sleepfoundation.org/sleep-disorders-problems-list/the-link-between-lack-sleep-and-type-2-diabetes Accessed January 5, 2019.
  6. Breus M. J. Understanding The Connection Between Sleep And Diabetes. The Sleep Doctor. May 8, 2018. https://www.thesleepdoctor.com/2018/05/08/understanding-the-connection-between-sleep-and-diabetes/ Accessed January 5, 2019.
  7. Breus M. J. Understanding The Connection Between Sleep And Diabetes. The Sleep Doctor. May 8, 2018. https://www.thesleepdoctor.com/2018/05/08/understanding-the-connection-between-sleep-and-diabetes/ Accessed January 5, 2019.
  8. Rapaport L. More evidence poor sleep habits may raise diabetes risk. Reuters. July 15, 2016. https://www.reuters.com/article/us-health-sleep-insulin-resistance/more-evidence-poor-sleep-habits-may-raise-diabetes-risk-idUSKCN0ZV2A3 Accessed January 5, 2019.

The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. Read our full medical disclaimer.

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