Insomnia and diabetes up risk of early death: study

Sleep problems should be taken just as seriously as other health risk factors, say researchers.

Dave Yasvinski 4 minute read June 9, 2021
insomnia diabetes

Poor sleep is known to be unhealthy, but diabetes adds an additional risk. Getty

People who struggle to get a good night’s sleep are more likely to suffer an early death, particularly if they have diabetes, according to a new study.

The research, which appears in the Journal of Sleep Research, found that people with diabetes who have trouble falling or staying asleep were 87 per cent more likely to die of any cause during the course of the study’s nine-year follow-up period. This group was 12 per cent more likely to die over the same period than those with diabetes but no difficulty sleeping.

“If you don’t have diabetes, your sleep disturbances are still associated with an increased risk of dying, but it’s higher for those with diabetes,” said Kristen Knutson, corresponding study author and an associate professor of neurology (sleep medicine) and preventive medicine (epidemiology) at Northwestern University Feinberg School of Medicine.

The road to rectifying the situation, Knutson said, begins by answering one simple question: “Do you have trouble falling asleep at night or do you wake up in the middle of the night?

“This simple question is a pretty easy one for a clinician to ask,” she said. “You can even ask yourself. But it’s a very broad question and there are a lot of reasons you might not be sleeping well. So, it’s important to bring it up with your doctor so they can dive deeper. Is it just noise or light or something bigger, like insomnia or sleep apnea?

“Those are the more vulnerable patients in need of support, therapy and investigation into their disease.”

Researchers analyzed the data of close to 500,000 middle-aged people included in the UK Biobank — a large-scale health database containing in-depth genetic and medical information — to produce what they believe is the first study to explore the combined effect of insomnia and diabetes on mortality risk.

“Although we already knew that there is a strong link between poor sleep and poor health, this illustrates the problem starkly,” said Malcolm von Schantz, the study’s first study author and a professor of chronobiology at the University of Surrey.

“The question asked when the participants enrolled does not necessarily distinguish between insomnia and other sleep disorders, such as sleep apnea. Still, from a practical point of view it doesn’t matter. Doctors should take sleep problems as seriously as other risk factors and work with their patients on reducing and mitigating their overall risk.”

A good night’s sleep was one of the first casualties of the coronavirus for millions of people around the world as the unending stress and anxiety of the pandemic produced countless restless nights (and even inspired the creation of the term coronasomnia). COVID-19 may have dragged the problem into the light of day but lack of sleep was an issue long before the virus reared its head.

According to a survey of the sleep habits over 13,000 people in 13 countries by Philips, just 55 per cent of respondents were satisfied with their current quality of sleep. It found people were hitting the hay for an average of just 6.9 hours per weeknight and 7.7 hours on Saturday and Sunday.

“As our society has changed and become more ‘always on,’ that chronic stress really impacts your ability to get that recommended seven to nine hours of good sleep each night,” Jillian Mariani, the general manager and founder of Niyama Wellness, told “The pandemic has really increased that stress load most people are bearing. It’s just been a pretty awful year overall.”

It has gotten even worse for people with diabetes, particularly Type 2 — the version of the metabolic disease where a person’s body does not produce enough insulin or doesn’t properly use the insulin it does make — although some study participants had Type 1. Researchers hope the findings will be applied in clinical settings to help put affected patients on the road to better health or at least open up appropriate avenues of treatment.

“Because a large proportion of the sample reported frequent sleep disturbances (28 per cent), these findings have important public health implications,” they concluded. “The results are also relevant to clinical practice and frequent sleep disturbances may be an important health indicator for clinicians to consider, particularly for diabetes patients. We found that a single question was sufficient to detect mortality risk and clinicians could use a similar brief question to identify patients who may need additional therapy or support.”

For more information on diabetes, support or to connect with other patients, visit Diabetes Canada.

Dave Yasvinski is a writer


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