Blood Sugar Control, Nutritional Therapy, Sleep Hygiene, Supplements
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9 Reasons Disturbed Sleep Could Be Undermining Your Blood Sugar Control

Nothing makes you feel worse than a bad night sleep, waking up feeling like you’ve had a ‘night on the tiles’ when you’ve been tucked up in bed, affects your whole performance the next day. If this occurs regularly then it can severely affect your ability to manage your blood sugar levels. Let’s take a look at the impact of sleep deprivation, possible underlying factors and an action plan for a better snooze.

Sleep Stages

There are four stages to non-rapid eye movement sleep (NREM):

Stage 1 is transitional sleep
Stage 2 is light sleep
Stages 3 and 4 are the deep stages of sleep during which the body repairs and builds tissues. These stages have the biggest and slowest brain waves ‘delta waves’. Stage 4 is always more intense and each stage can last from 5-15 minutes, during a sleep cycle people progress through all stages then the cycle starts again.

There are also two different sleep states: NREM and rapid eye movement (REM) sleep, sometimes called dreaming sleep. In REM sleep we are almost paralysed, with large muscles unable to move – only the heart, diaphragm, eye muscles and the smooth muscles (such as the muscles of the intestines and blood vessels) are able to move.

Sleep Issues

Why we sleep is not yet fully understood, but is thought to include memory consolidation, immune function and maintenance of mood. It is estimated the at some point in our lives 40% of individuals can be affected by a primary sleep disorder such as sleep apnoea, insomnia, restless leg syndrome, snoring, feeling unrested during the day and not getting enough sleep. The main sleep-related difficulties are difficulty concentrating and remembering things.

Evidence is emerging the disturbances in sleep and sleep disorders play a role in the development of chronic conditions, however the relationship is often unclear. Numerous medical conditions can affect sleep such as diabetes or other inflammatory conditions such as arthritis which can lead to poor sleep quality and induce symptoms of excessive daytime sleepiness and fatigue.

It has been suggested that poor sleep can lead to the development of cardiovascular disease, where an underlying inflammatory component has been proposed.

Sleep deficit in type 2 diabetes leads to an increased sympathetic nervous system output which in turn increases cortisol, causing increased insulin resistance leading to weight management issues and/or high morning sugar readings for some individuals. This is due to cortisol’s action on the liver to release glucose.

What is Insomnia?

Insomnia can be described as difficulty falling asleep, waking up often during the night and having trouble falling back asleep, waking up too early in the morning or feeling tired upon waking. There are two types of insomnia:

Primary – a sleep problem which is not associated with any other health condition.
Secondary – a sleep problem caused by something else, such as asthma, depression, arthritis, heartburn, pain, medication or alcohol.

Acute insomnia can last from one night to a few weeks, where chronic insomnia affects an individual for a prolonged period of time, generally at least 3 nights a week for a month.

The 9 Main Underlying Factors

1. Altered levels of various hormones and neurotransmitters, affect blood sugar control.
2. A disturbance related to adrenal issues from stress or trauma (cortisol). Cortisol works with insulin in regulating glucose levels.
3. Melatonin imbalance which is closely associated with the light/dark cycle, the night time rise and the opening of the sleep gate at night.  It’s disruption affects hormones related to glucose regulation.
4. The hormone Ghrelin (along with Leptin) regulates your energy balance and regulates your appetite and body weight. Studies show a dysregulation in energy balance and lowered ghrelin levels in insomnia patients, which is intricately linked with glucose metabolism.
5. The GABA neurotransmitter plays a complex role in the feedback mechanism to the brain in controlling cortisol levels.
6. Blood sugar imbalance in itself, especially low blood sugar levels (hypoglycaemia)
7. Micronutrient imbalances affect the body’s metabolism and regulation of glucose systems.
8. Magnesium – deficiencies are common and magnesium is known to cause neurological issues related to sleep including depression. It is also important for regulating cortisol and the complex feedback system to the brain.
9. Overuse of stimulants.

Actions for Managing Disturbed Sleep and Adrenal Issues

Sleep hygiene – regular routines, exercise and daylight. Bedroom temperature not too hot.
Avoid stimulants an hour before bed – tea, coffee, sugar, TV, computers, laptops and phones.
Manage stress
Avoid poor food choices including poor nutrient reserves, food additives and food reactions/sensitivities which add stress to the body.
Ensure adequate sodium intake, especially if adrenal glands are exhausted through physical (food, infection and trauma) or emotional stress. Exhaustion leads to a reduction in the hormone aldosterone, which stimulates sodium excretion via frequent urination.
Consider supplementing with Magnesium, Vitamin C and Vitamin B5 are key nutrients involved in the biochemical processes associated with cortisol production and regulation.
Deficiency in vitamin B6 (niacin) can lead to sleep problems. Niacin helps to ease anxiety related sleep issues, take with the full complex of B vitamins.
Consider supplementing with 5-HTP (5 Hydroxytryptophan) which is a precursor to serotonin or tryptophan rich foods such as yogurt, cheese, red meat, eggs, fish, poultry (especially turkey), sesame seeds, almonds, sunflower seeds, pumpkin seeds, spirulina and peanuts. 5-HTP works in the brain and central nervous system by increasing the production of the chemical serotonin. Serotonin can affect sleep, appetite, temperature, sexual behaviour, and pain sensation. Since 5-HTP increases the synthesis of serotonin, it is used for several conditions where serotonin is believed to play an important role including depression, insomnia and obesity.
Consider herbal extracts such as Valerian, one of the most researched herbal supplements which promotes relaxation and reduces stress.
Other popular plant extracts include: Californian poppy, hops, lemon balm, lime flowers, vervain and wild lettuce, use as a dry herb mixture infused in hot water then strained. St John’s Wort tablets may also be helpful to some individuals.

Please consult with your pharmacist and doctor for interactions with certain medications and medical conditions. Consult with your doctor before taking any type of supplement, to ensure it is safe and suitable for you.

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Hi I’m Beth, a nutritional therapist and coach (BSc N. Med mFNTP CNHC) at Clinicanutrition, I’m the creator of The Sugar Hunter Program, an online self-management toolkit and group coaching support program for blood sugar control.