Sleeplessness increases insulin resistance

man sleeping at keyboard
May 18, 2015
Leigh Erin Connealy, M.D.

Last week, when I wrote about the dangers of sleeping pills, I touched very briefly on some of the major health problems caused by sleep deprivation. Research has not only linked it with greater risk of cardiovascular disease, cancer, and obesity but also with blood sugar issues ranging from insulin resistance to diabetes.

Why does lack of sleep cause people to gain weight and develop blood sugar problems? Interesting research published last month has shed some light on the connection.

It turns out that not getting enough sleep raises the amount of free fatty acids (FFAs) in the body. FFAs are fats that have been broken down, taken out of your fat cells, bound to protein, and then transported through the bloodstream.

Abnormally high blood levels of FFAs can boost the chances of developing various other health concerns, including obesity, endothelial dysfunction (which ups the risk of cardiovascular disease), insulin resistance, and diabetes.

Certain hormones, such as epinephrine, glucagon, and norepinephrine, also release FFAs into the blood. If your body produces excessive levels of these hormones, elevated FFA levels often follow.

In this study, researchers wanted to learn out how sleep restriction affected hormones and FFAs. They followed 19 men, allowing them to sleep for either 8 ½ or 4 ½ hours for four consecutive nights.

Blood tests revealed that those who slept less experienced a surge in FFAs overnight and in the early morning hours. They believe this was the result of prolonged hormone secretion at night and higher norepinephrine levels in the morning.

The researchers also noted that the sleep-deprived men had lower insulin sensitivity. This means their bodies required more insulin to stabilize blood glucose.

Getting a Handle on Sleep

As this study shows, getting plenty of shuteye every night is one of your first lines of defense against obesity and diabetes. It’s so important that every time a patient comes into my practice complaining of weight gain, the first thing I ask them is how much uninterrupted sleep they get each evening.

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With the hustle and bustle of modern life, I can understand how and why sleep becomes less of a priority. But establishing a bedtime routine can go a long way in promoting good overall health and preventing countless diseases.

Here’s how you can create a regular nighttime schedule, encourage calm and relaxation in the evening hours, and maintain a comfortable sleep environment.

  • Maintain a consistent sleep/wake schedule, even on weekends. This helps regulate your body’s internal clock. Avoid afternoon naps unless absolutely necessary.
  • Limit your exposure to light (TV, lamps, computers, etc.) as you approach your bedtime. When you awaken, expose yourself to bright light as soon as possible. This also helps with setting your internal clock.
  • Cover or remove any electronics with bright lights, such as your alarm clock, cable box, nightlight, etc. Consider using blackout curtains or an eye mask as well.
  • Eliminate noise and other disturbances. You may want to use ear plugs, a white noise machine, or fan to drown out any outside commotion.
  • Several hours before you go to bed, avoid caffeine, alcohol, and tobacco, all of which interfere with sleep.
  • If you’re tired, go to bed, regardless of what time it is. Don’t fight to stay awake.
  • Exercise every day.

If these lifestyle changes don’t help enough, you may benefit from a natural sleep aid.

One of my top recommendations is melatonin—a hormone naturally produced by the brain that regulates your sleep/wake cycle. Start by taking 1 mg just before bedtime. If you need more, you can take up to 3 mg per day.

Another potent sleep enhancer is 5-hydroxytryptophan (5-HTP)—the precursor to the neurotransmitter serotonin. Serotonin has several important roles, including sleep and appetite control, memory, learning, and temperature regulation. Supplementing with 5-HTP can help reestablish healthy sleep patterns.

If you need additional support, valerian, lemon balm, and chamomile are known to promote a sense of calm. I usually encourage my patients to look for tea made with these herbs and sip them half an hour before retiring for the night.

In the few cases where these natural options do not help my patients get the restful sleep they need, I prescribe a drug called trazodone. It’s actually not a sleeping pill, but an antidepressant. In very low doses (50 mg), trazodone promotes relaxation and sleep without the side effects typically experienced with other antidepressants, such as weight gain or sexual dysfunction. In my 30 years practicing medicine, I have never witnessed any adverse effects with this drug—and it really works! In fact, one of my patients lost 17 lbs. after I prescribed it, simply because she was able to finally get a full night’s rest after years of insomnia and disturbed sleep.

You need a prescription for trazodone, but I wholeheartedly recommend it—as well as my other supplement and lifestyle suggestions—over pharmaceutical sleeping pills such as Ambien or Lunesta.

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