We spend a lot of time talking about what we eat and how much we exercise when it comes to our health.
But there is another piece of the puzzle that I don't think we talk about nearly enough:
Sleep.
You can eat a healthy diet. You can exercise regularly. You can watch your sugar intake. But if you consistently aren't getting enough quality sleep, your body may have a much harder time regulating blood sugar, appetite, stress hormones, blood pressure, and even your weight.
Sleep isn't simply downtime.
It is part of your body's daily repair and reset system.
And if you are working on improving your metabolic health, sleep deserves a place right alongside nutrition and exercise.
What Happens While We Sleep?
It may look like we're doing absolutely nothing while we're sleeping, but our bodies are incredibly busy.
During sleep, the body is repairing tissues, regulating hormones, supporting immune function, consolidating memories, and preparing the brain and body for another day.
Sleep is considered so important to cardiovascular health that the American Heart Association includes it in Life's Essential 8, alongside nutrition, physical activity, avoiding nicotine, weight, cholesterol, blood sugar, and blood pressure.
For most adults, the recommendation is approximately 7–9 hours of sleep each night.
But sleep isn't only about the number of hours.
Quality, consistency, timing, and whether you actually feel rested matter too.
What Does Sleep Have to Do With Blood Sugar?
Quite a bit.
When we eat carbohydrates, they are broken down into glucose, which enters our bloodstream. The pancreas responds by releasing insulin, which helps move glucose from the bloodstream into our cells, where it can be used for energy or stored.
When we consistently don't get enough sleep, this system can become less efficient.
Research has linked insufficient and poor-quality sleep with impaired glucose regulation and insulin sensitivity. In other words, the body may have a harder time responding appropriately to insulin.
Think about insulin as the key that helps unlock the door of the cell so glucose can enter.
When insulin sensitivity decreases, that key doesn't work as efficiently. The body may need to produce more insulin to accomplish the same job.
Over time, chronically impaired insulin sensitivity can contribute to insulin resistance, prediabetes, and eventually type 2 diabetes in susceptible individuals.
This is why I don't believe we should look at an elevated fasting glucose or A1C and immediately focus only on food.
We should also ask:
How are you sleeping?
One Bad Night Isn't the Problem
We've all had nights when we didn't sleep well.
Maybe you were traveling. Maybe you were worried about something. Maybe the dog woke you up at 3:00 AM.
One difficult night isn't going to suddenly give you diabetes.
The bigger concern is chronic sleep deprivation.
Research consistently finds associations between habitual short sleep and an increased risk of type 2 diabetes. A recent systematic review and meta-analysis found that sleeping fewer than seven hours per night was associated with greater odds of type 2 diabetes. Poor sleep quality was also associated with increased risk.
That doesn't mean lack of sleep alone causes diabetes. Genetics, nutrition, physical activity, body composition, medications, age and other factors can all contribute.
But sleep is one of those pieces we can sometimes overlook.
Sleep Affects More Than Blood Sugar
Sleep influences nearly every system in the body.
Consistently poor sleep has been associated with increased risk of:
• High blood pressure
• Cardiovascular disease
• Obesity
• Type 2 diabetes
• Impaired immune function
• Mood and cognitive problems
• Poorer appetite regulation
• Metabolic dysfunction
Poor sleep can also affect the choices we make the following day.
Think about how you feel after a terrible night's sleep.
Are you excited to exercise?
Are you reaching for a big salad and a bowl of lentils?
Or are you tired, hungry, craving sugar, looking for caffeine, and searching for something that will give you quick energy?
Our lifestyle choices don't exist independently of one another.
Sleep affects nutrition. Nutrition affects energy. Energy affects movement. Movement affects sleep.
Everything is connected.
What About Cortisol?
Sleep and our stress response are also closely connected.
Cortisol is an important hormone—not a "bad" hormone. We need it. It helps regulate our stress response, metabolism, immune function, and normal daily rhythm.
But chronic stress and disrupted sleep can interfere with healthy cortisol patterns.
Cortisol also helps make glucose available when the body needs energy.
This is one reason blood sugar isn't determined solely by what you ate.
Your hormones matter too.
If you have ever checked your fasting glucose in the morning and wondered, "How can my glucose be elevated? I haven't eaten anything," remember that your liver can release stored glucose into your bloodstream as part of normal hormonal regulation.
Your body is always working to maintain balance—even while you're sleeping.
Your A1C May Be Telling a Bigger Story
This is why I like looking at several markers together rather than focusing on one laboratory number.
Fasting glucose gives us a snapshot of your blood sugar at that particular moment.
A1C gives us an estimate of average glucose exposure over the previous several months.
But neither tells us why the number is elevated.
That's where we start asking questions.
What does your diet look like?
Are you exercising?
How much muscle do you have?
Are you under significant stress?
Are you taking medications that affect glucose?
How are you sleeping?
Health rarely comes down to one number or one behavior.
Don't Forget About Sleep Apnea
There is another important consideration when discussing sleep and metabolic health: sleep apnea.
Someone may spend eight hours in bed and still not be getting restorative sleep.
Obstructive sleep apnea repeatedly interrupts breathing during the night and can cause drops in oxygen and repeated awakenings that a person may not even remember.
If you snore heavily, wake up gasping, experience morning headaches, or regularly wake up exhausted despite spending enough time in bed, talk with your healthcare provider about whether you should be evaluated for a sleep disorder.
Sometimes improving health isn't about getting more sleep.
It's about figuring out why the sleep you're getting isn't restorative.
Simple Ways to Improve Your Sleep
You don't need an elaborate nighttime routine.
Start with the basics.
Keep a consistent schedule.
Try going to bed and waking up at approximately the same time each day.
Give yourself enough time to sleep.
If you need seven or eight hours but only allow yourself six, no supplement or sleep hack can replace that missing time.
Put the phone away.
Give your brain an opportunity to wind down instead of scrolling until the moment you close your eyes.
Create a dark, quiet, comfortable environment.
Watch your caffeine.
If you are having trouble sleeping, consider how much caffeine you consume and how late in the day you're consuming it.
Move during the day.
Regular physical activity can support better sleep as well as better blood-sugar regulation.
Create a nighttime ritual.
Read. Stretch. Meditate. Take a warm shower. Practice gratitude. Give your body a signal that the day is ending.
And perhaps most importantly:
Stop treating sleep as something you will get to after everything else is finished.
There will always be something else to do.
Sleep Is Part of Your Health Stack
We talk so much about eating better and exercising more—and those things absolutely matter.
But health isn't built from one habit.
Nutrition matters.
Movement matters.
Strength matters.
Stress management matters.
And sleep matters.
If you're working hard to improve your glucose, A1C, weight, cholesterol, blood pressure, or overall health, don't overlook what happens during those seven to nine hours each night.
Your body needs time to recover, repair and reset.
Sometimes the next step toward better health isn't doing more.
Sometimes it's simply getting more sleep.
To Health & Longevity, 🌿
Innovative Wellness
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References
American Heart Association. Life's Essential 8: How to Get Healthy Sleep. American Heart Association. Adults are encouraged to average 7–9 hours of sleep, and healthy sleep is included among the organization's key measures of cardiovascular health.
American Heart Association. Multidimensional Sleep Health: Definitions and Implications for Cardiometabolic Health. Circulation: Cardiovascular Quality and Outcomes/American Heart Association, 2025.
Sleep Features and the Risk of Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. 2025. The analysis examined sleep duration, sleep quality, chronotype and other sleep characteristics in relation to type 2 diabetes risk.