Lombrozo was never a good sleeper. "Then I started my own
company, and it got worse," said the Marietta, Ga., owner
of an information-technology management company. "I got
to bed later, got up earlier, wasn’t eating well. I gained
15 pounds, which made me snore and woke me up even more."
result, Type 2 diabetes, which had been lurking in his family
genes, caught up with him. Now Lombrozo must give himself a
daily insulin injection and test his blood-sugar levels
several times a day to keep the disease in check.
27 million other Americans afflicted with Type 2 diabetes,
Lombrozo learned that sleep deprivation and diabetes feed on
each other: Diabetes symptoms disturb sleep, while sleep loss
contributes to diabetes. Add obesity and stress, and you have
a vicious circle.
known as adult-onset diabetes, Type 2 means having too little
insulin (a hormone that helps the body use sugar) and too much
glucose (sugar). As Americans’ average number of sleep hours
has decreased, Type 2 diabetes has become more common.
nine hours of sleep per night is ideal, according to the
American Diabetes Association, but 35 percent of us get less.
to diabetes complications such as restless-leg syndrome and
neuropathy (nerve pain or numbness), many diabetics cannot
sleep well, causing their condition to worsen. But the road to
diabetes can start from the other direction, too, meaning
1 sleep enemy is apnea, a breathing interruption caused by
apnea and diabetes go hand in hand," said Dr. Florence
Comite, a New York City endocrinologist. About 36 percent of
Type 2 diabetics have sleep apnea, according to the diabetes
helps our bodies restore themselves," Comite explained.
"Without enough sleep, we can actually bring on
diabetes." It’s all about hormones, she explained,
starting with insulin, the hormone that’s in short supply
sleep allows HGH (human-growth hormone) and IGF-1
(insulin-like growth factor 1) to grow cells and repair
enough sleep, the body produces leptin, the hormone that
depresses the appetite. Without enough sleep, it produces more
ghrelin, which stimulates the appetite.
deprivation increases cortisol, the "stress hormone"
that prevents insulin from getting into the cells
addition to preventing sleep, apneas reduce the amount of
oxygen going to the brain and heart. "The pressure from
trying to breathe stretches the heart, which puts out a
diuretic," explained Robert Rosenberg, DO, a Prescott
Valley, Ariz., sleep specialist . "Men blame their
prostates, and women blame menopause, but really it’s their
sleep apnea that’s causing them to have to go to the
bathroom at night."
apnea is more common among people who are male, older, have
thick necks or sunken chins, and among those who carry their
excess weight at their waists.
being overweight elevates sleep apnea risk, even diabetics who
are not obese are at risk.
doctor diagnoses apnea with a home monitor or by sending you
to a sleep center for the night.
(obstructive sleep apnea) is the most common form of apnea and
causes breathing to stop briefly. With the less common but
more dangerous type, CSA (central sleep apnea), breathing
stops completely for longer periods. This can be fatal.
first line of sleep apnea treatment is weight loss. If that
doesn’t help, the doctor prescribes a mask or nose plugs
that feed pressurized air into the airways. If this fails,
surgery to unblock obstructions might be an option.
obesity is not part of the diabetes-sleep equation to start,
it often becomes one. A hormone imbalance causes the diabetic
to eat the wrong foods and be too tired to exercise. The
threat of heart disease causes worry, which makes comfort
foods like cookies more enticing.
wonder people just give up," said Dr. Charlie Seltzer, a
Philadelphia obesity medicine physician who lost 75 pounds by
following his own advice: "Figure out how many calories
you take in, and eat less."
Seltzer, having diabetes in his family scared him into a
healthier lifestyle, he said. Others can prevent Type 2
diabetes with his multipart prescription of more sleep, more
hours at the gym, and healthy foods instead of sugary and
restaurant meals encourage overeating, Seltzer offers this
tip: "Before you go to the restaurant in the evening,
look at the menu and calorie count online. Choose your entree
before you go so you won’t order on impulse. Then you work
backward to wear off the calories by evening."
can shrug off stress, which affects sleep and diabetes
prevention, even if he gets a late-night call from a client.
"I’m one of those people who can turn it off," he
said. But others must consciously de-stress to keep their
cortisol levels down.
are ways to fight the battle:
in the morning so your body can wind down before bedtime,
advised the doctors. Avoid drinking alcohol, caffeine and big
meals in the evening. Go to bed at the same time, even on
weekends, but sleep late on weekends if you need to catch up.
your bedroom relaxing, dark and free of electronic devices,
including computers, TVs, tablets and cellphones. "They
emit blue light, which destroys melatonin production,"
partner must have a bedroom TV, use an eye mask and earplugs
to block light and noise. "Or get a separate room,"
know what helps their kids sleep but seldom indulge themselves
in the routine, Comite said. "Take a warm bath and talk
quietly," she said. "Then wear out a melodic book
like ‘Goodnight Moon.’"
following are resources for more information about the
Academy of Sleep Medicine, aasmnet.org
Diabetes Association, diabetes.org
Rosenberg’s anwersforsleep.com where he pledges to answer
questions within 72 hours.
Soundly Every Night," a book by Rosenberg
for Dummies," a book by Dr. Alan L. Rubin