Updated July 24, 2006

Getting the Sleep You Need

by David Spero, R.N.

Sleep that knits up the ravell'd sleeve of care,
The death of each day's life, sore labour's bath,
Balm of hurt minds, great nature's second course,
Chief nourisher in life's feast.

—William Shakespeare, Macbeth

You don’t need to be a great poet to describe the healing value of sleep. Nearly everyone knows the dragged-out feeling that comes with a sleepless night and how much better we feel after a restful one. What many people may not realize, however, is that sleep is not just “pleasant” or “refreshing” but necessary for good health.

Sleep gives the body time to relax and repair and is now also understood to play a role in learning. Insomnia, however, is one of the most common complaints in America, and it also has a link to diabetes: Sleep deprivation can make diabetes worse, and diabetes symptoms can make it harder to sleep.

The good news is that sleep problems are nearly always treatable. Usually, you don’t need any medicines or surgery to get to sleep, just some simple behavior changes. This article gives the basic concepts that sleep specialists use to help people get to sleep, stay asleep, and wake up rested. You will also learn what sleep conditions benefit from a doctor’s care.

What is insomnia?
Insomnia isn’t just an occasional rough night or sleeping less than you think you should. The key question to determine if you have insomnia is “how rested do I feel?” If you have all the energy and alertness you want, you don’t have insomnia, no matter how little sleep you get. On the other hand, if you’re tired and drowsy all day, you may have insomnia, even if you’re in bed 12 hours a night. The quality of sleep is as important as the quantity. For example, if you’re struggling for breath all night or your body can’t relax because of stress and tension, you may not feel rested no matter how much you sleep.

There are at least three kinds of insomnia: problems getting to sleep, problems staying asleep, and waking up too early and not being able to go back to sleep. Problems getting to sleep (sleep-onset insomnia) are often due to stress, too much activity or anxiety at bedtime, or bad sleep habits.

Problems staying asleep (sleep-maintenance insomnia) are often due to medical problems described later in this article such as sleep apnea or an enlarged prostate. We all wake up 12–15 times a night, but we usually get right back to sleep without ever realizing or remembering we’ve been awake. It’s insomnia if you can’t get back to sleep easily.

Problems with waking up too early are often a sign of depression, or they may be caused by noise and light in the bedroom.

Insomnia and health
Our fast-paced society takes its toll on sleep. The average American sleeps about 7–7 1/2 hours a night. A century ago, the average was 9 hours. Francis Buda, M.D., cofounder of the Atlanta Center for Sleep Disorders, says, “The American population as a whole is chronically sleep deprived.”

Until recently, though, it was thought that lack of sleep had few long-term health effects. The main concern has been accidents and mistakes due to poor concentration and fatigue. But recent studies at institutions such as the University of Chicago and Pennsylvania State University have shown that sleep deprivation (getting at least two hours less than you want) leads to insulin resistance, increases in appetite, and higher levels of stress hormones in the blood—conditions that can contribute to the development of diabetes. Some researchers believe there may also be a connection between sleep disorders and heart disease.

While sleeplessness can promote diabetes, symptoms associated with high blood glucose, low blood glucose (hypoglycemia), and some diabetes complications can also interfere with sleep. If your blood glucose level is high, you may be in the bathroom urinating every few hours during the night. Hypoglycemia can cause nightmares, night sweats, or headache; hunger that wakes you up to get food; or symptoms associated with daytime hypoglycemia such as rapid heartbeat, dizziness, or shaking. Tracy Kuo, Ph.D., insomnia specialist and clinical psychologist at the Stanford Sleep Disorders Clinic, says that a vicious circle can occur with diabetes and insomnia because “diabetic neuropathy can cause restless legs and pain. Fatigue from a poor night’s sleep may keep some people with diabetes from getting enough daytime activity, which in turn makes it harder to sleep the following night.”

Also in this article:
Sleep Resources

David Spero is the author of The Art of Getting Well: Maximizing Health When You Have a Chronic Illness (Hunter House, 2002). Find out more about his classes and articles at www.davidsperorn.com.

More articles on General Diabetes & Health Issues

Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.