Can Diabetic Retinopathy (Eye complications) Lead to Sleepless Nights?

Diabetic retinopathy (DR) is a common complication of diabetes, affecting the eyes and potentially leading to vision loss. But did you know it might also be linked to insomnia? A study published in Frontiers in Endocrinology explores this intriguing connection.

Korean researchers conducted a population-based study to investigate the association between diabetic retinopathy and the risk of developing insomnia. They found that people with diabetic retinopathy (DR) had a 13% higher risk of insomnia compared to those without DR, even after controlling for comorbidities (other health issues), diabetes-related variables, and lifestyle factors.

The researchers proposed several mechanisms for this association, including the impact of anxiety and depression as relating to impaired vision that may lead to insomnia. Another very intriguing hypothesis (in my opinion) is that the increased insomnia risk may be attributable to circadian (day/night) disruption induced by diabetic retinopathy, since the retina (back of the eye) detects light, which is critically important for the integrity of the body’s natural sleep/wake rhythm. This may be related to the presence of less light-sensitive, melanopsin-expressing retinal ganglion cells, which are critical for the regulation of melatonin and normal sleep-wake cycles.

We know that poor sleep is associated with many adverse health consequences. Health care professionals should always ask their patients about sleep duration and quality. For people with diabetes, it should be routine to ask about sleep. Some diabetes medications can cause low blood sugars (insulin, sulfonylureas, and meglitinides), and low blood sugars can certainly disrupt sleep (and are dangerous). Sleep apnea is also common in people with diabetes, with a low threshold to test for this condition. This study suggests that we should also be particularly attentive to assessment of sleep in our patients with diabetic retinopathy. Likewise, I encourage anyone struggling with sleep (diabetes or not) to discuss this concern with your doctor!

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