If you (or someone in your family) has diabetes and you do your best to manage your blood sugar levels throughout the day, yet your levels often are still curiously high, a recent study has shed light on why that might be the case.

Getting poor-quality sleep at night may be secretly sabotaging your blood sugar-even when you're doing everything right!

And this is a recipe for diaster. Study author Michelle Perfect, PhD, an assistant professor of psychology, disability and psychoeducational studies at The University of Arizona in Tucson explains...

A Chicken-and-egg Conundrum

This study was done on kids with type 1 diabetes, but as you'll see later, this news about sleeping applies to all types of diabetics of all ages.

The study: Fifty children ages 10 to 16 with type 1 diabetes were compared with a matching number of similarly aged kids without the condition. Participants underwent a home-based sleep study for five nights, wearing equipment that measured their blood sugar, sleep stage (one of four stages ranging from light to heavy), speed of breathing and heart rate. Parents and children also answered questions about topics such as mood level and amount of daytime sleepiness. School records were obtained to analyze grades. And the kids and their parents were told to administer insulin as they normally would.

The findings, which appeared in the January 2012 issue of Sleep, were intriguing. Children in the control group (no diabetes) spent 19% of their sleep time in deep sleep, while children with diabetes spent only 15% of their sleep time in deep sleep. Sleep apnea-a serious condition that causes dangerous pauses in breathing during sleep and awakenings during the night and that heightens risk for heart attack and stroke-was experienced by about one-third of the children with diabetes. Compared with the control group, the diabetics were more likely to have high blood sugar, which was expected, said Dr. Perfect, since very few kids achieve perfect glucose control. But interestingly, the diabetic kids with sleep apnea had much higher blood sugar levels compared with diabetic kids who did not have sleep apnea.

So that raises the question-does poor-quality sleep cause blood sugar irregularities, or do these sugar fluctuations lead to troubled sleep? It could be either or both, said Dr. Perfect, who didn't set out to answer that question and said that more research needs to be done to figure out the answer. There are theories supporting both angles. For example, prior studies from other research teams established that not getting enough deep sleep causes the brain to release less of a chemical that helps stabilize blood glucose levels. But on the other hand, Dr. Perfect said that if you have diabetes, you may sometimes need to get up in the middle of the night to check your blood sugar, so having diabetes may also cause more sleep disturbances, though that wasn't specifically analyzed in this study. It's also possible that poor blood glucose control-such as not administering enough insulin at the proper times-could lead to sleep problems.

Tips for Solid Shut-Eye

Dr. Perfect said that her findings support what other studies on type 2 diabetics and sleep have found-the better your sleep, the better your blood sugar control. So people of any age with diabetes should pay close attention to how well they're sleeping and should ask their family members to keep an ear out for lots of snoring or gasping while sleeping a sign of sleep apnea, which is dangerous and would require immediate attention from a doctor.

Dr. Perfect advises diabetics of all ages to ask themselves the following questions...

Most of the time, do I feel refreshed when I wakeup?

Am I easily awoken during the night?

If the answer to these questions is "no" and then "yes,'' then Dr. Perfect advises that you talk to your doctor, because it may mean that you're not getting enough deep sleep. There isn't any quick trick that can make you sleep deeply throughout the night, but you can be more diligent about ensuring good sleep habits-including minimizing light and noise in the bedroom... abstaining from caffeine and stimulating activities such as exercising or web surfing near bedtime... and keeping your bedroom a little cooler than the rest of the house. Quality sleep is important for everyone-and, it seems, even more so if you have diabetes.

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