Not getting enough sleep is a common affliction in the modern age. If you don’t always get as many hours of shut-eye as you’d like, perhaps you were concerned by news of a recent study that found people who sleep less than six hours a night are at higher risk of type 2 diabetes.

So what can we make of these findings? It turns out the relationship between sleep and diabetes is complex.

The study

Researchers analysed data from the UK Biobank, a large biomedical database which serves as a global resource for health and medical research. They looked at information from 247,867 adults, following their health outcomes for more than a decade.

The researchers wanted to understand the associations between sleep duration and type 2 diabetes, and whether a healthy diet reduced the effects of short sleep on diabetes risk.

As part of their involvement in the UK Biobank, participants had been asked roughly how much sleep they get in 24 hours. Seven to eight hours was the average and considered normal sleep. Short sleep duration was broken up into three categories: mild (six hours), moderate (five hours) and extreme (three to four hours). The researchers analysed sleep data alongside information about people’s diets.

Some 3.2% of participants were diagnosed with type 2 diabetes during the follow-up period. Although healthy eating habits were associated with a lower overall risk of diabetes, when people ate healthily but slept less than six hours a day, their risk of type 2 diabetes increased compared to people in the normal sleep category.

The researchers found sleep duration of five hours was linked with a 16% higher risk of developing type 2 diabetes, while the risk for people who slept three to four hours was 41% higher, compared to people who slept seven to eight hours.

One limitation is the study defined a healthy diet based on the number of servings of fruit, vegetables, red meat and fish a person consumed over a day or a week. In doing so, it didn’t consider how dietary patterns such as time-restricted eating or the Mediterranean diet may modify the risk of diabetes among those who slept less.

Also, information on participants’ sleep quantity and diet was only captured at recruitment and may have changed over the course of the study. The authors acknowledge these limitations.

Why might short sleep increase diabetes risk?

In people with type 2 diabetes, the body becomes resistant to the effects of a hormone called insulin, and slowly loses the capacity to produce enough of it in the pancreas. Insulin is important because it regulates glucose (sugar) in our blood that comes from the food we eat by helping move it to cells throughout the body.

We don’t know the precise reasons why people who sleep less may be at higher risk of type 2 diabetes. But previous research has shown sleep-deprived people often have increased inflammatory markers and free fatty acids in their blood, which impair insulin sensitivity, leading to insulin resistance. This means the body struggles to use insulin properly to regulate blood glucose levels, and therefore increases the risk of type 2 diabetes.

Further, people who don’t sleep enough, as well as people who sleep in irregular patterns (such as shift workers), experience disruptions to their body’s natural rhythm, known as the circadian rhythm.

This can interfere with the release of hormones like cortisol, glucagon and growth hormones. These hormones are released through the day to meet the body’s changing energy needs, and normally keep blood glucose levels nicely balanced. If they’re compromised, this may reduce the body’s ability to handle glucose as the day progresses.

These factors, and others, may contribute to the increased risk of type 2 diabetes seen among people sleeping less than six hours.

While this study primarily focused on people who sleep eight hours or less, it’s possible longer sleepers may also face an increased risk of type 2 diabetes.

Research has previously shown a U-shaped correlation between sleep duration and type 2 diabetes risk. A review of multiple studies found getting between seven to eight hours of sleep daily was associated with the lowest risk. When people got less than seven hours sleep, or more than eight hours, the risk began to increase.

The reason sleeping longer is associated with increased risk of type 2 diabetes may be linked to weight gain, which is also correlated with longer sleep. Likewise, people who don’t sleep enough are more likely to be overweight or obese.

Good sleep, healthy diet

Getting enough sleep is an important part of a healthy lifestyle and may reduce the risk of type 2 diabetes.

Based on this study and other evidence, it seems that when it comes to diabetes risk, seven to eight hours of sleep may be the sweet spot. However, other factors could influence the relationship between sleep duration and diabetes risk, such as individual differences in sleep quality and lifestyle.

While this study’s findings question whether a healthy diet can mitigate the effects of a lack of sleep on diabetes risk, a wide range of evidence points to the benefits of healthy eating for overall health.

The authors of the study acknowledge it’s not always possible to get enough sleep, and suggest doing high-intensity interval exercise during the day may offset some of the potential effects of short sleep on diabetes risk.

In fact, exercise at any intensity can improve blood glucose levels.

Giuliana Murfet, Casual Academic, Faculty of Health, University of Technology Sydney and ShanShan Lin, Senior Lecturer, School of Public Health, University of Technology Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

In the 2007 film The Bucket List Jack Nicholson and Morgan Freeman play two main characters who respond to their terminal cancer diagnoses by rejecting experimental treatment. Instead, they go on a range of energetic, overseas escapades.

Since then, the term “bucket list” – a list of experiences or achievements to complete before you “kick the bucket” or die – has become common.

You can read articles listing the seven cities you must visit before you die or the 100 Australian bucket-list travel experiences. https://www.youtube.com/embed/UvdTpywTmQg?wmode=transparent&start=0

But there is a more serious side to the idea behind bucket lists. One of the key forms of suffering at the end of life is regret for things left unsaid or undone. So bucket lists can serve as a form of insurance against this potential regret.

The bucket-list search for adventure, memories and meaning takes on a life of its own with a diagnosis of life-limiting illness.

In a study published this week, we spoke to 54 people living with cancer, and 28 of their friends and family. For many, a key bucket list item was travel.

Why is travel so important?

There are lots of reasons why travel plays such a central role in our ideas about a “life well-lived”. Travel is often linked to important life transitions: the youthful gap year, the journey to self-discovery in the 2010 film Eat Pray Love, or the popular figure of the “grey nomad”.

The significance of travel is not merely in the destination, nor even in the journey. For many people, planning the travel is just as important. A cancer diagnosis affects people’s sense of control over their future, throwing into question their ability to write their own life story or plan their travel dreams.

Mark, the recently retired husband of a woman with cancer, told us about their stalled travel plans:

We’re just in that part of our lives where we were going to jump in the caravan and do the big trip and all this sort of thing, and now [our plans are] on blocks in the shed.

For others, a cancer diagnosis brought an urgent need to “tick things off” their bucket list. Asha, a woman living with breast cancer, told us she’d always been driven to “get things done” but the cancer diagnosis made this worse:

So, I had to do all the travel, I had to empty my bucket list now, which has kind of driven my partner round the bend.

People’s travel dreams ranged from whale watching in Queensland to seeing polar bears in the Arctic, and from driving a caravan across the Nullarbor Plain to skiing in Switzerland.

Nadia, who was 38 years old when we spoke to her, said travelling with her family had made important memories and given her a sense of vitality, despite her health struggles. She told us how being diagnosed with cancer had given her the chance to live her life at a younger age, rather than waiting for retirement:

In the last three years, I think I’ve lived more than a lot of 80-year-olds.

But travel is expensive

Of course, travel is expensive. It’s not by chance Nicholson’s character in The Bucket List is a billionaire.

Some people we spoke to had emptied their savings, assuming they would no longer need to provide for aged care or retirement. Others had used insurance payouts or charity to make their bucket-list dreams come true.

But not everyone can do this. Jim, a 60-year-old whose wife had been diagnosed with cancer, told us:

We’ve actually bought a new car and [been] talking about getting a new caravan […] But I’ve got to work. It’d be nice if there was a little money tree out the back but never mind.

Not everyone’s bucket list items were expensive. Some chose to spend more time with loved ones, take up a new hobby or get a pet.

Our study showed making plans to tick items off a list can give people a sense of self-determination and hope for the future. It was a way of exerting control in the face of an illness that can leave people feeling powerless. Asha said:

This disease is not going to control me. I am not going to sit still and do nothing. I want to go travel.

Something we ‘ought’ to do?

Bucket lists are also a symptom of a broader culture that emphasises conspicuous consumption and productivity, even into the end of life.

Indeed, people told us travelling could be exhausting, expensive and stressful, especially when they’re also living with the symptoms and side effects of treatment. Nevertheless, they felt travel was something they “ought” to do.

Travel can be deeply meaningful, as our study found. But a life well-lived need not be extravagant or adventurous. Finding what is meaningful is a deeply personal journey.

Names of study participants mentioned in this article are pseudonyms.

Leah Williams Veazey, ARC DECRA Research Fellow, University of Sydney; Alex Broom, Professor of Sociology & Director, Sydney Centre for Healthy Societies, University of Sydney, and Katherine Kenny, ARC DECRA Senior Research Fellow, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.