CHAPTER 8 — SLEEP AND STRESS IN TYPE 2 DIABETES Sleep and stress are often overlooked in Type 2 Diabetes, yet they strongly influence blood sugar, appetite, weight, and energy. Improving these two areas can make nutrition and movement work much better, while ignoring them can block progress even when food is carefully controlled. HOW SLEEP AFFECTS BLOOD SUGAR During deep sleep, hormones support repair, learning, and metabolic balance. When sleep is short, broken, or poor quality, several changes occur:
- Insulin sensitivity is reduced the next day.
- Hunger hormones increase and satiety hormones decrease.
- Cravings for sugary and starchy foods become stronger.
- Stress hormones such as cortisol remain higher.
- Inflammation tends to rise.
Even a few nights of poor sleep can cause temporary insulin resistance in healthy people. For someone with Type 2 Diabetes this effect is often stronger. COMMON SLEEP PROBLEMS IN TYPE 2 DIABETES People with insulin resistance and diabetes often report:
- Difficulty falling asleep.
- Waking several times during the night.
- Needing to pass urine at night.
- Restless legs or night time cramps.
- Waking too early.
- Feeling unrefreshed in the morning.
Night time glucose swings, sleep apnoea, pain, and worry can all contribute. Each factor needs attention. BASIC SLEEP ROUTINE A regular routine prepares the body for rest. Useful foundations include:
- Keeping a fairly consistent bedtime and wake time, even on non work days.
- Reducing bright screens in the hour before bed where possible.
- Having a light evening meal and avoiding very heavy or late eating.
- Limiting caffeine from the afternoon onwards.
- Creating a dark, quiet, and cool sleeping environment.
Many people find that even a small improvement in sleep routine reduces fatigue and improves glucose readings. NIGHT TIME GLUCOSE AND SLEEP High or low glucose during the night can disrupt sleep. High night time glucose may cause:
- Thirst.
- Frequent urination.
- Hot or uncomfortable feelings.
Low night time glucose may cause:
- Sweating.
- Shaking.
- Vivid dreams.
- Sudden waking.
Tracking patterns with a glucose meter or continuous monitor, under professional guidance, can help adjust evening meals, medication timing, and activity. STRESS, CORTISOL, AND DIABETES Stress is not only an emotion; it is a physical state. When the brain senses threat or overload, the stress system activates and releases hormones such as adrenaline and cortisol. In the short term this can:
- Increase heart rate and blood pressure.
- Release stored glucose from the liver into the bloodstream.
- Reduce digestion and reproductive functions.
In the long term, frequent or continuous stress can:
- Increase insulin resistance.
- Encourage abdominal fat storage.
- Disturb sleep.
- Increase emotional eating and cravings.
Daily modern life often keeps the stress system half activated, leading to constant background tension. SOURCES OF STRESS Stress can arise from many areas:
- Work deadlines and financial pressure.
- Relationship difficulties.
- Caring responsibilities for family members.
- Health worries and fear of complications.
- Feelings of guilt or shame about weight or habits.
- Hidden sources such as noise, clutter, and constant digital alerts.
Not all stress can be removed, but the body can be trained to switch more easily between stress mode and recovery mode. SIMPLE STRESS REDUCTION TOOLS Several practical tools can help calm the stress system: 1. Breathing exercises Slow breathing can directly signal safety to the nervous system. Example:
- Breathe in through the nose for a slow count of four.
- Hold gently for a count of two.
- Breathe out through the mouth for a slow count of six.
- Repeat for three to five minutes.
2. Gentle movement Walking, stretching, and simple mobility work can:
- Release physical tension.
- Improve mood.
- Lower stress hormones over time.
3. Relaxation practices Options include:
- Progressive muscle relaxation, in which each muscle group is tensed and then released.
- Mindfulness, focusing attention on the breath or body sensations.
- Calming music or nature sounds.
4. Boundaries with news and digital input Limiting exposure to distressing news or constant notifications, especially in the evening, can make sleep easier and reduce feelings of overwhelm. EMOTIONAL EATING AND STRESS Stress and tiredness often increase emotional eating, especially of sugary or high carbohydrate foods. These provide brief comfort but can create large glucose spikes and later energy crashes. Helpful approaches include:
- Pausing before eating and asking whether the body is truly hungry or mainly stressed, tired, or bored.
- Preparing non food strategies for comfort, such as a walk, call to a friend, warm bath, or short rest.
- Keeping highly tempting foods out of easy reach and stocking supportive options.
BUILDING A CALMING EVENING ROUTINE A simple evening wind down period of 30 to 60 minutes can support both stress reduction and sleep. Examples:
- Light stretching or a slow walk.
- Warm shower or bath.
- Low light in the living space.
- Reading, relaxing audio, or gentle conversation instead of intense work or arguments.
The goal is to signal to the body that the active part of the day is ending. KEY POINTS SUMMARISED
- Poor sleep and chronic stress significantly worsen insulin resistance and blood sugar control.
- Improving sleep routine can reduce cravings, stabilise energy, and support better glucose readings.
- Chronic stress keeps cortisol high, encourages abdominal fat, and drives emotional eating.
- Simple daily tools such as breathing exercises, gentle movement, digital boundaries, and calming evening routines can reduce stress.
- Sleep, stress management, nutrition, and movement work together; progress often improves when all are addressed.
Later chapters will bring these elements together into daily and weekly plans that show how to combine food, movement, supplements, sleep, and stress management into a practical routine for Type 2 Diabetes.