Sleeplessness

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    Diabetics who sleep badly are at greater risk of dying prematurely, study suggests

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    Original Article | CNN Health By Sandee LaMotte, CNN

    (CNN)People with diabetes who had trouble falling or staying asleep were 87% more likely to die of any cause over the next nine years than people without diabetes or sleep problems, a new study finds.

    Poor sleep linked to weight gain in 2-year smartphone sleep tracking studyKnutson and her team also compared people with diabetes who slept well to people with the condition who often experience poor sleep.”People with diabetes who slept badly were 12% more likely to die over a nine-year followup period than people with diabetes who slept without frequent sleep disturbances,” Knutson said.The study is the first to look at the combination of diabetes plus sleep disturbances and mortality risk, she added.

    Known link between diabetes and sleep problems

    A study of this type can only show association and not causation, said sleep specialist Dr. Raj Dasgupta, an assistant professor of clinical medicine at the Keck School of Medicine at the University of Southern California, who was not involved in the research.Enter your email to subscribe to the Results Are In Newsletter with Dr. Sanjay Gupta.“close dialog”

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    Sign Me UpNo, ThanksBy subscribing you agree to ourPrivacy PolicyWhile the study’s findings are disturbing, he said, they are not surprising.”Diabetes is a deadly disease and it can be easily affected by sleep — or the other way around,” Dasguta said. “Are you getting poor sleep because your diabetes is poorly controlled or is the poor sleep making your diabetes worse?”For example, Dasgupta said, people with Type 2 diabetes, the most common type, tend to be overweight and may suffer from obstructive sleep apnea, when throat muscles relax and close the airway, thus disrupting sleep.

    Get better sleep by cuddling up with your partner“People with Type 2 diabetes are also predisposed to kidney issues and make multiple trips to the bathroom in the night because they’re always urinating, especially if their diabetes is poorly controlled,” he added. “They can also have damage to blood vessels which causes leg pain called neuropathy, and It’s hard to go to sleep because of that pain.”It’s also possible that poor quality sleep may impact the body’s ability to regulate blood sugars, thus contributing to the development of diabetes, Knutson said.”There’s experimental work which shows that if you take healthy people and disturb their sleep you see impairments in insulin sensitivity,” she said. “There could be a bidirectional association between the two, so if you have sleep issues for a long period of time it may actually lead to the development of diabetes.”

    What to do?

    Acknowledge and tackle your sleep problems, regardless of whether or not you have diabetes, Knutson said. Sleeping poorly is a risk factor for premature death from any cause all by itself.

    Sleep hygiene: 8 ways to train your brain for better sleep“If you usually have trouble falling or staying asleep, you need to talk to a physician and really get at the root of the problem. Find out why aren’t you sleeping well and then figure out how to fix it,” she said.Want some tips for better sleep? SIGN UP FOR CNN’s SLEEP, BUT BETTER newsletterIf you have diabetes, “treat your diabetes — that’s the take home message from this study,” Dasgupta said.”Diabetes is something that needs to be managed by your primary care doctor and endocrinologist.”If you’re not sleeping well, it may be harder to manage your diabetes, Knutson said.Get CNN Health’s weekly newsletter

    Sign up here to get The Results Are In with Dr. Sanjay Gupta every Tuesday from the CNN Health team.”It’s not easy to do and then if you’re sleep deprived, maybe you’re just not as good at remembering to take your medication or measure your blood sugars,” she said.A sleep specialist may also need to do a sleep study to see if you have an underlying sleep disorder, Dasgupta said.”When you tell me someone’s waking up quite a bit and they have diabetes, I may not only do need to treat the diabetes, I need to treat sleep apnea or restless leg syndrome or another sleep issue,” Dasgupta added. “Don’t hesitate to get the help you need.”

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    “Insomnia-Like” Sleep Patterns Can Predict Future Stress

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    As part of our outreach efforts to our clients, we will often share informative articles related to sleep and sleep apnea. The following is an insightful piece written for Sleep Review by Sree Roy.

    Inverse: New research suggests fragmented sleep patterns contain a critical message.

    Dipesh Chaudhury is the study’s lead author and an assistant professor of biology at New York University Abu Dhabi. He tells Inverse that this study deepens our understanding of how stress and sleep are related. Typically, we assume that stress leads to poor sleep. But things could also work the other way around, with poor sleep dampening resilience to stress at the same time.

    “Our findings also indicate that those mice that exhibit abnormal sleep prior to stress are more sensitive to future stress exposure. In other words, sleep abnormalities can also be a cause of stress-related disorders,” Chaudhury says.

    A BAD NIGHT’S SLEEP COMES WITH A HOST OF CONSEQUENCES, some of which aren’t obvious right away. This is especially true when stressful situations — like a year defined by a pandemic — hit. Research suggests specific abnormal sleep patterns may decrease one skill that’s crucial to weathering the storm.

    In a mouse study published Tuesday in Frontiers in Neuroscience, scientists found fragmented sleep patterns – a pattern of sleep marked by more awakenings and shorter bouts of non-rapid eye movement sleep –could predict how mice responded to future stress. Mice with regular sleep patterns were resilient to bullying, while those with fragmented sleep patterns weren’t equipped to deal with the abuse.

    WHAT DOES A “DISRUPTED SLEEP PATTERN LOOK LIKE?

    “Our findings also indicate that those mice that exhibit abnormal sleep prior to stress are more sensitive to future stress exposure. In other words, sleep abnormalities can also be a cause of stress-related disorders,” Chaudhury says.

    Chaudhury’s study was based on the sleep and stress patterns of 22 mice who had electrodes implanted into their brains. Those electrodes could measure the amount of time each mouse spent in each stage of sleep.

    Like humans, mice move through sleep stages including rapid eye movement sleep (REM) — when most dreaming happens in humans — and lighter, non-REM stages.

    Every mouse was exposed to chronic social defeat — 15 consecutive days of being attacked by aggressive mice identified at the outset of the study. The researchers found that they could break the mice up into two groups: mice who were resilient, bouncing back from bullying ready to socialize, and ones that succumbed, and retreated from others.

    WHAT WAS DISCOVERED

    The scientists found there were significant differences in the sleep patterns of each group of mice beforethey were exposed to the bullying.

    The mice in the non-resilient group showed signs of fragmented non-REM sleep. They woke up more during sleep periods (mice sleep during the day) and had were shorter NREM bouts, on average, than those seen in the resilient mice.

    “In essence, the susceptible mice exhibit insomnia-like traits even before exposure to stress,” Chaudry says.

    Ultimately, these patterns could predict which group the mice ended up in with about 80 percent accuracy, suggesting that it could have been one reason they were less resilient when stress took hold.

    WHAT DOES THIS MEAN FOR HUMANS?

    This study taps into a robust area of research on human mood disorders. Depression and sleep are intertwined in a way that makes it hard to distinguish cause and effect. Disturbed sleep is often seen in depressive patients, but those who experience insomnia are also more likely to develop depression in the first place.

    Though this study focuses on stress, it suggests that sleep may pose an even more central role in mood disorders – or in this case, resilience to stress. Before the stressful situation occurs, sleep patterns may contain early warning signs.

    These results are early-stage, Chaudhury cautions. A mouse brain (and a mouse’s stress) is quite different from a human’s. But he is optimistic that the idea that sleep signatures could be a prediction of stress — specifically the way the brain transitions in and out of non-REM sleep — will hold true in humans.

    He imagines monitoring the sleep patterns of people who have particularly high-stress jobs, like first responders or frontline workers. Even if signs of stress have yet to show themselves, a disrupted sleep pattern could be the sign of a vicious cycle (stress leading to worse sleep, leading to less resilience to stress) about to go awry.

    “By having simple non-invasive markers of stress susceptibility, such as EEG sleep patterns, it may be possible to develop strategies to protect the more vulnerable people,” Chaudhury says.

    Abstract: There is a tight association between mood and sleep as disrupted sleep is a core feature of many mood disorders. The paucity in available animal models for investigating the role of sleep in the etiopathogenesis of depression-like behaviors led us to investigate whether prior sleep disturbances can predict susceptibility to future stress. Hence, we assessed sleep before and after chronic social defeat (CSD) stress. The social behavior of the mice post stress was classified in two main phenotypes: mice susceptible to stress that displayed social avoidance and mice resilient to stress. Pre-CSD, mice susceptible to stress displayed increased fragmentation of Non-Rapid Eye Movement (NREM) sleep, due to increased switching between NREM and wake and shorter average duration of NREM bouts, relative to mice resilient to stress. Logistic regression analysis showed that the pre-CSD sleep features from both phenotypes were separable enough to allow prediction of susceptibility to stress with >80% accuracy. Post-CSD, susceptible mice maintained high NREM fragmentation while resilient mice exhibited high NREM fragmentation, only in the dark. Our findings emphasize the putative role of fragmented NREM sleep in signaling vulnerability to stress.