Why might afternoon nappers be at greater risk of diabetes?

I noticed a few reports last week (an example here) regarding a study that was presented at a diabetes conference. Apparently, the research shows that individuals taking naps in the afternoon is associated with a significantly enhanced risk of developing diabetes. When such studies are reported there’s a tendency for journalists (and sometimes the originators of the study) to suggest that because two things are associated, one is causing the other. For example, the headline of the BBC report I linked to above reads: Napping ‘increases diabetes risk’.

However, just because two things are associated most certainly does not mean that one is causing the other. It might be that before individuals develop full-blown diabetes they are prone to fatigue and sleepiness as a result of a pre-diabetic state. In this way, it might be the pre-diabetic state, not the napping, that leads onto actual diabetes.

While there is no relevant science in this area that I am aware of, there is I think a quite precise mechanism that might explain the link between afternoon napping and increased risk of diabetes. It concerns fluctuations in the level of sugar in the bloodstream.

After eating, blood sugar levels usually rise, which in health causes the body to secrete a hormone call insulin, one of the chief effects of which is to reduce blood sugar levels. However, if for any reason the rise is blood sugar level is substantial, insulin secretion can follow suit, and this can lead to low blood sugar (hypoglycaemia) some time later.

Hypoglycaemia will generally cause physical and mental energies to stall, and may induce sleepiness to the extent that someone actually feels compelled to sleep. One of the other symptoms that this can give rise to is the feeling of peckishness (particularly for something sweet) on awakening.

The most common time in the day for this effect to occur is the mid-late afternoon (about 3 hours after lunch). I reckon the mid-late afternoon lull that some of us suffer from is quite often related to this specific imbalance. For a lot of us, it reflects the body’s reaction to what a lot of us choose to eat a lunch (something bread-based).

Now, if an individual habitually has this imbalance, the likelihood is that they’re going to be secreting relatively high levels of insulin too. As a result, one or both of two things can happen in time:

1. the body may become somewhat ‘numb’ to the effects of insulin

2. the pancreas which secretes insulin can exhaust, leading to inadequate amounts of insulin

Either of these states can lead an individual down a path to type 2 diabetes. And these mechanisms may possibly explain why individuals taking afternoon naps are more prone to developing diabetes in time.

It has also been suggested that the need to nap during the afternoon is a sign of some form of sleep disturbance that could be increasing diabetes risk. Here again, though, blood sugar imbalance may be playing a part.

The reason is that just like blood sugar levels can fall in the mid-late afternoon, they can fall in the middle of the night too (often at 3.00-4.00 am). In response to this, the body is likely to secrete certain hormones that will liberate sugar from stores fuels such as glycogen in the liver. This will certainly get the body out of a hole, but the problem is the hormones that the body secretes in response to low blood sugar include adrenaline and cortisol: the two major ‘stress hormones’. Their presence in the system will do nothing to promote deep sleep, and may trip individuals into wakefulness. Individuals may find it difficult to drop off again, which could mean that they really don’t get enough sleep. The ‘sleep debt’ so incurred could easily manifest in the form of afternoon fatigue. Cortisol, as it happens, also antagonises the effects of insulin, which is another mechanism by which blood sugar imbalance may increase diabetes risk.

We don’t know if these theories are relevant or not. But one thing I do know for sure is this: when individual take steps to stabilise their blood sugar levels, they usually are much more alert and productive in the afternoons, and much less likely to wake up at night. For most individuals, blood sugar stability can be achieved by eating a diet based on natural unprocessed ‘primal’ foods (such as meat, fish, eggs, nuts, seeds, fruits and vegetables other than the potato), and by eating such foods regularly.

7 Responses to Why might afternoon nappers be at greater risk of diabetes?

  1. Ieneke van Houten 11 March 2009 at 7:36 pm #

    Balancing blood sugar levels through healthy eating habits is one great place to start building health in general.

    Great blog, I just discovered it through HSI and love the balanced tone.


  2. Chris 12 March 2009 at 2:39 pm #

    Great cartoon noting that correlatin does not equal causation:


  3. Hilda Glickman 13 March 2009 at 7:43 pm #

    How daft can people get? Napping causes diabetes? Just like people who live in a country with more TVs get more cancer. It’s true but not causal. Sleeing more is related to low thyroid.

  4. Susan 14 March 2009 at 1:19 am #

    This may be so, however the horizon TV programme on ‘the body clock’ had an expert who said it was normal for the human to have a nap in the afternoon, though he said about 2 pm. My father always had a 20 min nap after lunch long before he became old. He lived to 90 and did not develop diabetes. Also age alters sleep patterns?

    I find if I often get sleepy immediately after a meal, & once practically conked out after foolishly gorging on half a loaf of ciabatta, which I avoid now!

  5. diamond 17 March 2009 at 4:52 am #

    I think in my case, sleeping in the afternoon is associated with having a teething toddler up at night! 🙂

  6. Trinkwasser 22 March 2009 at 5:03 am #

    My insulin resistance is hugely improved over what it was but my carb intolerance in the morning is still about twice what it is in the evening. Many diabetics have an even greater slope.

    One thing I’ve noticed is that if I have a postprandial nap/siesta it appears to reset my carb intolerance back to breakfast levels.

    I can stay normoglycemic with a maximum of 15g carbs at breakfast, rising to 30 – 50g in the evening. If I then have a nap for a couple of hours and get up I am restricted back to 15g carbs again.

    OTOH when my BG was uncontrolled I used to find it impossible to keep my eyes open a couple of hours after eating: a brief nap and I would jerk awake again. Analysis showed that my BG would spike after eating then drop rapidly (Reactive Hypoglycemia) and the rapid drop would cause a dump of cortisol and adrenalin followed by a mass of glucose from the liver.

    Many diabetics get “Dawn Phenomenon” where the liver releases a load of glucose on wakening (normal people do this too but the glucose is covered by insulin which is lacking in diabetes). I never used to do this *until* I overexerted myself in the morning which could double my BG quite rapidly without any food being involved.

    So IMO it’s a circular process, the sleep/wake cycle feeds insulin resistance and insulin and BG levels feed back to the wakefulness

    Now my body is trained to run on ketones rather than glucose where possible, these variations are greatly improved

  7. C Miller 28 January 2011 at 10:13 pm #

    I’m not surprised at all… I took a nap every day after work from about the age of 30 until just last year at the age of 40.

    After just a month or two on a low-carb diet my need to nap in the afternoons completely vanished.

    It is just one of the many “unrelated” issues that have cleared up for me now that I’ve removed sugar and grains from my diet.

    It’s been nearly a year now following this new lifestyle choice, and my pre-diabetes has completely resolved, my blood pressure has dropped, LDL has dropped, Triglycerides have plummeted, and my HDL has increased.

    I will never go back to the SAD diet. It’s simply not worth it.

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