We all know that getting a good night’s sleep is important to our health, and that includes the health of people with diabetes. But exactly what does “a good night’s sleep” mean? Recently, researchers in the Netherlands investigated that very question and published the results in the journal Diabetes Care.
The researchers collected data on 172 patients with type 2 diabetes (T2D) who were receiving care from the Amsterdam University Medical Center. The researchers’ goal was to learn how different sleep measures affected the subjects’ HbA1c, which is a measure of a person’s average blood glucose (sugar) levels over the previous two to three months.
The investigators looked not only at how long the patients slept, but also at other sleep measures — sleep efficiency, sleep variability, midsleep time, and subjective quality of sleep. Sleep efficiency is defined as the ratio of the total time spent asleep compared to the total time spent in bed (people who are asleep nearly all the time they are in bed are said to be sleeping more efficiently). Sleep variability is a measure of how differently a person might sleep from night to night, and midsleep time is a way of evaluating how late a person goes to sleep and wakes up. Subjective quality of sleep refers to how a person rates the quality of his or her night’s sleep (a person can sleep less than usual but still wake up feeling great).
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The researchers found that the different measures of sleep did in fact have diverse effects on HbA1c. Higher HbA1c levels were seen in people with lower sleep efficiency, higher variability in sleep and midsleep time, worse subjective quality of sleep, and inconsistent sleep duration, but not all of these variables had an equal effect. The factor with the greatest effect was sleep variability (short and long), followed by, in order, total sleep duration, subjective sleep quality, variability in midsleep time and sleep efficiency. Interestingly, the researchers did not find an association between HbA1c and insomnia.
One benefit of their research, the investigators concluded, is the realization that sleep patterns can, through various therapies, be changed and adjusted, which might make it possible to affect the way sleep influences HbA1c. As they put it, “Sleep in general may be a modifiable factor of importance for patients with T2D. The prevention of sleep curtailment may serve as a primary focus in the sleep-centered management of T2D.”