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Wed, Jan. 22

Lack of sleep linked to diabetes

Dear Dr. Rosenberg: Can lack of sleep cause diabetes?

A: Yes, it can be a major contributing factor. We know that sleep-deprived individuals develop insulin resistance and a decrease in production of insulin during the night. In addition, they produce higher levels of cortisol and growth hormone, both of which elevate blood sugar levels. Several recent studies have shown that as little as one week of partial sleep deprivation (about four hours) results in abnormal glucose metabolism.

Dear Dr. Rosenberg: I am a cardiac patient. I had a heart attack several years ago and my heart is now weaker than normal. Recently, I had a sleep study and was told I had a type of sleep apnea called Cheyne Stokes central sleep apnea. How does that differ from obstructive sleep apnea, and how is it treated?

A: Cheyne Stokes is a central form of sleep apnea. It means that the ventilatory control center in your brain intermittently fails to signal your respiratory center to breathe. It is particularly common in patients with weak hearts. It is not treated with standard CPAP because there is no anatomical obstruction in this form of sleep apnea. There are several new machines on the market called ASV that will automatically breathe for you when they sense no respiratory effort is being made. These machines are very effective and will probably be what you need.

Dear Dr. Rosenberg: When my husband and his friends go to Las Vegas, they stay up all night and gamble. He loses a lot of money. I am wondering if this lack of sleep could be a contributing factor.

A: Yes, it is, and the casinos know it! People who are sleep-deprived tend to make riskier financial decisions. In fact, to quote a recent study published in a leading journal, "Late-night gamblers are fighting more than just the unfavorable odds of gambling machines; they are fighting a sleep-deprived brain's tendency to implicitly seek gains while discounting the impact of potential losses." So I would advise that you point this out to your husband before he bets the farm.

Dear Dr. Rosenberg: I get up three to four times per night to urinate. I have been to a urologist. He told me that he could find no reason for my frequent urination. When I told him it occurs at night only, he suggested I get a sleep study. My wife says I snore on occasion, but that is all. What is the purpose of the sleep test?

A: Your urologist is looking to see if you stop breathing in your sleep. Sleep apnea causes the lining of the heart to secrete a hormone that causes urination. Since you have this problem only when asleep, I think a sleep study is a good idea. It is amazing how many people, both men and women, suffer from frequent urination at night due to undiagnosed sleep apnea.

Dr. Robert Rosenberg, board-certified sleep medicine specialist, will answer readers' questions by incorporating them in future columns. Contact him at or via mail at the Sleep Disorders Center of Prescott Valley, 3259 N. Windsong Dr., Prescott Valley, AZ 86314.

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