Nocturia and Diabetes

The effect of sleep duration and quality on patients with type 2 diabetes mellitus
Sleep Duration
Sleep plays a very interesting role for individuals diagnosed with type 2 diabetes mellitus. Slow wave sleep (SWS) or deep sleep (stages 3 and 4 or stage N3) is characterized by slow, high amplitude delta waves and non-rapid eye movements (NREM). SWS is thought to be the most physically restorative of the sleep stages. One study found that the quantity of SWS was significantly lower in individuals diagnosed with type 2 diabetes mellitus.¹¹ This decreased SWS combined with the tendency of individuals with type 2 diabetes mellitus to experience nocturia coupled with hyperglycemia means that sleep architecture can be severely compromised.

A second study examined the association of nocturia and type 2 diabetes mellitus. It found that nocturia, when nighttime waking to void was ≤2 times, affected next day physical activity. Subjects from the study reported diminished levels of physical activity during daytime hours following a night of sleep interrupted by nocturia episodes.¹² This finding is concerning, given how useful exercise is in controlling weight, BMI, and glucose values.

Sleep Quality
A third study observed that SWS is associated with hormonal changes that affect glucose regulation. When researchers supressed SWS in young, healthy, adult study participants where total sleep time remained the same, they found there was a significant decrease in insulin sensitivity. However, the participants did not display adequate compensatory insulin release. As a result, reduced SWS is associated with decreased insulin sensitivity. This observation could indicate an association between impaired SWS and an increased risk of developing type 2 diabetes, although more research is needed.¹³

Treatment of Nocturia in Type 2 Diabetes Mellitus Patients
Sleep duration and quality potentially play an important role in type 2 diabetes mellitus prevention and management. As such, any reduction in sleep hygiene in the general population should be identified as soon as possible and treated with efficacy. In patients already diagnosed with type 2 diabetes mellitus, the benefit of treating nocturia to restore proper sleep patterns becomes even more valuable.