This was the third week of the healthy lifestyle programme where the main focus was on sleep and stress and how theses factors link to diabetes.

Reflective Summary

The first discussion that the group had was based around sleep, specifically how diabetes can affect sleep. Both laboratory and epidemiologic evidence supports an association between short sleep duration, which is considered to be less than 7 hours per night and an increased risk of diabetes (Touma & Pannain, 2011). There is also a relationship between poor sleep quality and diabetes. Spiegal et al. (2004) researched partial sleep deprivation in healthy lean adults. They concluded that restricting sleep to 4 hours per night for 6 nights resulted in a 40% decrease in glucose tolerance. This change also resulted in an increase in in activity of the sympathetic nervous system where both of these effects are reversed with sleep recovery (Touma & Pannain, 2011). If anyone in the group struggles to sleep because of their diabetes, napping and segmented  sleep are associated with better glycemic control in type 2 diabetes therefore this could help to control there diabetes (Gozashti, Eslami, Radfar & Pakmanesh, 2016).

The final topic covered in the session was about different stresses that the group face, how it affects sleep and what can be done to overcome stress. Stress can be induced by many factors such as insecurities in personal, social and professional life, but also by factors such as impaired or in-sufficient sleep (Geiker et al., 2018). It is common that people who develop diabetes also experience weight gain. Several studies have confirmed a link between sleep and obesity. They found increased energy intake and weight gain after acute sleep deprivation (Geiker et al., 2018).

Areas for Improvement	Action Plan
Be aware that even older people can have problems with mental health	Consider the patient’s lifestyle such as work commitment, family etc during the subjective assessment – do they seem lonely, depressed or even suicidal?
Give advice on any abnormalities with lifestyle factors	Research modifications for different lifestyle factors to see which are effective

Closing the Loop

With any client I will consider what their lifestyle is like and how this could impact their pain. Furthermore, it may mean I need to refer them on for something that is not to do with the injury. As I see more clients I will be able to understand what modifications are effective and work for different people.

References

Geiker, N. R. W., Astrup, A., Hjorth, M. F., Sjödin, A., Pijls, L., & Markus, C. R. (2018). Does stress influence sleep patterns, food intake, weight gain, abdominal obesity and weight loss interventions and vice versa?. Obesity Reviews, 19(1), 81-97.

Gozashti, M. H., Eslami, N., Radfar, M. H., & Pakmanesh, H. (2016). Sleep pattern, duration and quality in relation with glycemic control in people with type 2 diabetes mellitus. Iranian journal of medical sciences, 41(6), 531.

Spiegel, K., Leproult, R., L’Hermite-Balériaux, M., Copinschi, G., Penev, P. D., & Van Cauter, E. (2004). Leptin levels are dependent on sleep duration: relationships with sympathovagal balance, carbohydrate regulation, cortisol, and thyrotropin. The Journal of clinical endocrinology & metabolism, 89(11), 5762-5771.

Touma, C., & Pannain, S. (2011). Does lack of sleep cause diabetes. Cleve Clin J Med, 78(8), 549-58.