This article was published in the Journal of Clinical Diabetology, An Official Publication of Association of Clinical Diabetology
(A National Conclave of Diabetologists), JCD – Vol 5 – Issue 3, (Gunjan Trivedi, Dr Banshi Saboo, Dr Dhruvi Hasnani, Dia Care, Ahmedabad)

What’s the message in this review ? 

Quality of sleep is very important parameter and risk factor for good health and wellbeing.  Poor sleep results in more complications if you already have a chronic disease (non-communicable disease) and if you have chronic disease, it is highly likely that your sleep is disrupted.  Hence, this is a vicious cycle.  The sleep quality is often not called out as a problem due to insufficient attention given for its detection. Moreover, the work is often done at the symptom level or disease level (tip of the iceberg….i.e. at the point of “challenges” in below figure. However, the real effort is needed to identify the lifestyle choices resulting in sleep disruption. Once the sleep is disrupted it impacts the nervous system, endocrine system (hormones and hence the metabolism) and eventually causing the impact on immune system and increasing the cellular level glucose imbalance and inflammation.  This multi-pronged impact causes increase of blood pressure, the drive to eat more, disrupts the insulin levels and causes metabolic disorders (all – very high risk factors which eventually lead to diseases such as diabetes, hypertension, heart disease and so on).  Moreover, as discussed earlier, the sleep disruption and chronic diseases go hand in hand and the vicious cycle causes more disruption – eventually impacting wellbeing (physical, emotional social and cognitive !).

Read on for more details—

Abstract:

Sleep is an important recovery function for human body, energy and the mind.  Sleep disorders are associated with many adverse health outcomes.  Modern lifestyle choices (24-hour operations, poor diet, physical inactivity, increased stress and tobacco/alcohol consumption) are known to affect sleep and at the same time insufficient sleep (& recovery) creates adverse effects on the autonomic nervous system, metabolism and immune system.

This review examines the evidence of sleep disorders on health – especially on two specific markers of chronic disease (chronic inflammation and metabolic syndrome) and documents the complex relationship between sleep disorders, chronic disease risk factors, pathophysiology and development of chronic disease.  The review develops a case for evaluating the presence of sleep disorders for physicians regardless of the presence of chronic disease. Finally, the review identifies and documents commonly used tools for screening for physicians to get insights for the treatment plan.

Key words: Sleep disorders, screening for insomnia, metabolic syndrome, chronic disease, chronic inflammation

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