Journal of Sleep Disorders & Therapy
Open Access

Silent Epidemic Too Little Sleep and the Risk of Diabetes

David Thomas^{* *}Correspondence: David Thomas, Department of Neurology, Mayo Clinic and Foundation, Rochester, MN, USA, Email:

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Description

In our fast-paced society, sleep is often sacrificed in favor of work, social commitments, and screen time. However, mounting evidence suggests that insufficient sleep is not merely a consequence of modern life but a significant risk factor for various health conditions, including type 2 diabetes. In this article, we delve into the intricate relationship between too little sleep and the heightened risk of developing type 2 diabetes, exploring the underlying mechanisms and implications for public health.

Understanding the link between sleep and type 2 diabetes

Type 2 diabetes is a chronic metabolic disorder characterized by insulin resistance and impaired glucose regulation [1]. While genetic predisposition and lifestyle factors such as diet and physical activity play important roles in the development of type 2 diabetes [2], emerging research indicates that insufficient sleep is also a significant contributor to the disease.

Numerous epidemiological studies have demonstrated a clear association between short sleep duration, poor sleep quality, and an increased risk of type 2 diabetes [3]. Individuals who consistently sleep less than the recommended 7-9 hours per night are at greater risk of developing insulin resistance, impaired glucose tolerance, and ultimately, type 2 diabetes.

Mechanisms underlying the sleep-diabetes connection

Several interconnected pathways may explain the link between too little sleep and the heightened risk of type 2 diabetes:

Insulin sensitivity: Sleep plays a critical role in regulating glucose metabolism and insulin sensitivity [4]. Insufficient sleep disrupts the delicate balance of hormones involved in glucose regulation, including insulin and cortisol, leading to impaired insulin sensitivity and glucose intolerance.

Appetite regulation: Sleep deprivation disrupts the balance of appetite-regulating hormones, increasing hunger and appetite while reducing feelings of fullness and satiety [5]. This dysregulation of hunger hormones, such as leptin and ghrelin, may lead to overeating, weight gain, and subsequent insulin resistance.

Inflammation and oxidative stress: Chronic sleep deprivation is associated with increased inflammation and oxidative stress, both of which are implicated in the pathogenesis of insulin resistance and type 2 diabetes [6]. Elevated levels of inflammatory markers and oxidative damage may impair insulin signaling pathways and promote insulin resistance.

Disruption of circadian rhythms: Sleep disturbances, such as irregular sleep schedules, shift work, and jet lag, disrupt the body's internal circadian rhythms, which regulate various physiological processes, including glucose metabolism [7]. Disrupted circadian rhythms can lead to desynchronization of metabolic processes, increasing the risk of metabolic disorders such as type 2 diabetes.

Sympathetic nervous system activation: Sleep deprivation activates the sympathetic nervous system, leading to increased production of stress hormones such as adrenaline and noradrenaline. Heightened sympathetic activity can impair insulin sensitivity, promote gluconeogenesis (the production of glucose from non-carbohydrate sources), and contribute to hyperglycemia.

Implications for public health

The growing body of evidence linking insufficient sleep to the risk of type 2 diabetes has significant implications for public health:

Preventive strategies: Recognizing the role of sleep in diabetes risk offers opportunities for preventive interventions. Public health campaigns promoting healthy sleep habits and raising awareness of the importance of sufficient sleep may help mitigate the risk of type 2 diabetes on a population level [8].

Screening and intervention: Healthcare providers should consider assessing sleep duration and quality as part of routine health screenings, especially in individuals at risk for type 2 diabetes. Early identification of sleep disturbances allows for timely intervention, potentially reducing the risk of diabetes and its complications.

Integrated approaches: Addressing sleep disturbances should be integrated into comprehensive diabetes prevention and management programs. Multidisciplinary approaches that combine lifestyle interventions, such as dietary modification and physical activity, with sleep hygiene education and behavioral interventions, may yield greater benefits in reducing diabetes risk [9].

Workplace policies: Employers should recognize the impact of work schedules and job-related stress on sleep quality and employee health. Implementing policies that promote flexible work schedules, limit shift work, and prioritize employee well- being may help mitigate the adverse effects of sleep deprivation on diabetes risk.

Community support: Community-based initiatives aimed at promoting healthy sleep habits and reducing sleep disparities can play a crucial role in diabetes prevention efforts. Education programs, support groups, and access to resources for improving sleep hygiene can empower individuals to prioritize sleep as a key aspect of overall health [10].

Conclusion

The association between too little sleep and the heightened risk of type 2 diabetes underscores the importance of sleep as a modifiable risk factor for chronic disease. By addressing sleep disturbances and promoting healthy sleep habits, individuals can reduce their risk of developing type 2 diabetes and improve overall health outcomes. Public health efforts aimed at raising awareness, implementing preventive strategies, and integrating sleep interventions into diabetes management programs are essential for mitigating the growing burden of diabetes worldwide. Embracing the significance of sleep in diabetes prevention and adopting comprehensive approaches to sleep health promotion are critical steps toward a healthier future for all.

References

1. Naiman R. Dreamless: The silent epidemic of REM sleep loss. Ann N Y Acad Sci. 2017;1406(1):77-85.

   [Crossref] [GoogleScholar] [PubMed]

2. Burke MJ. It’s all in your head”—medicine’s silent epidemic. JAMA Neurol. 2019;76(12):1417-1418.

   [Crossref] [GoogleScholar] [PubMed]

3. Ng CH, Lim WH, Chin YH, Yong JN, Zeng RW, Chan KE, et al. Living in the non�alcoholic fatty liver disease silent epidemic: A qualitative systematic review of patients' perspectives. Aliment Pharmacol Ther. 2022;56(4):570-579.

   [Crossref] [GoogleScholar] [PubMed]

4. Abdoli S. Diabetes: "Defect point” or “positive opportunity". Middle East Journal. 2009;2. [GoogleScholar] 
5. Ramalho A, Petrica J. The quiet epidemic: An overview of emerging qualitative research trends on sedentary behavior in aging populations. Healthcare. 2023;11(15):2215.

   [Crossref] [GoogleScholar] [PubMed]

6. Khandoker AH, Jelinek HF, Palaniswami M. Identifying diabetic patients with cardiac autonomic neuropathy by heart rate complexity analysis. Biomed Eng Online. 2009;8:1-2.

   [Crossref] [GoogleScholar] [PubMed]

7. Khan RM, Chua ZJ, Tan JC, Yang Y, Liao Z, Zhao Y. From pre-diabetes to diabetes: Diagnosis, treatments and translational research. Medicina. 2019;55(9):546.

   [Crossref] [GoogleScholar] [PubMed]

8. Farran N. Mental health in Lebanon: Tomorrow's silent epidemic. Ment Health Prev. 2021;24:200218.

   [Crossref] [GoogleScholar] [PubMed]

9. Hong JH, Nakamura JS, Sahakari SS, Chopik WJ, Shiba K, VanderWeele TJ, et al. The silent epidemic of loneliness: Identifying the antecedents of loneliness using a lagged exposure-wide approach. Psychol Med. 2024:1-4.

   [Crossref] [GoogleScholar] [PubMed]

10. Leger D, Beck F, Richard JB, Godeau E. Total sleep time severely drops during adolescence.PLoS One. 2012;7(10):e45204  

    [Crossref] [GoogleScholar] [PubMed]