Is sleep management important for the treatment of type 2 diabetes?

This study reviewed data from studies investigating the effects of sleep disorders on type 2 diabetes symptoms.

Sleep disturbances are a common condition experienced by patients with type 2 diabetes (T2D). Some of these conditions include insomnia (inability to sleep) and obstructive sleep apnea (OSA; shallow or absent breathing during sleep).

Both insomnia and OSA are associated with hypertension (increased blood pressure) and insulin resistance. This can be detrimental to T2D management. It is possible that improving sleep quality could benefit patients with T2D.

This study reviewed data on strategies to improve sleep in T2D patients.

Medications maybe be used to help with sleep management. Benzodiazapines, such as flurazepam (Dalmane) or temazepam (Restoril), and Z drugs, such as eszopiclone (Lunesta) and zaleplon (Sonata), may improve insomnia symptoms. However, these treatments are associated with a number of side effects, included daytime sleepiness, dizziness, and cognitive impairment. They may also have an effect on how the body breaks down glucose.

Melatonin is a sleep-promoting hormone. One analysis, including 1683 patients with sleep disorders, found that melatonin shortened the time until sleep compared to a placebo (substance with no active effect). However, the exposure to natural light and timing of melatonin treatment varied in these studies. It is not clear whether melatonin supplementation has any significant effect on sleep.

Cognitive behavioral therapy (CBT) aims to change the behavior around sleep, including relaxation, habits, and associations between bed and sleep. In one study, a 6-week CBT course reduced the time to falling asleep by 19.9 minutes. Other studies have noted similar improvements. 

Continuous positive airway pressure therapy (CPAP) is an effective treatment option for OSA. This machine maintains breathing overnight. In a study of T2D patients with OSA, CPAP reduced HbA1c (average blood glucose over 3 months) by 0.4%. However, further studies are needed on the effect of CPAP on HbA1c.

Lifestyle interventions, such as improved diet and exercise, have also been shown to improve sleep quality.

This review discussed the management of sleep disorders in the treatment of type 2 diabetes. 

There is conflicting evidence on whether sleep disorders are secondary to the development of diabetes or whether sleep disorders increase the risk of developing type 2 diabetes. 

If you have any issues with sleep then please discuss this with your physician.