Dr. Nishi Bhopal interviews triple board certified endocrinologist and lifestyle medicine specialist Dr. Chhaya Makhija about how sleep quality and circadian rhythm disruption contribute to insulin resistance, prediabetes, and diabetes via cortisol, adrenaline, growth hormone, and downstream effects on glucose regulation. They outline practical, time-efficient sleep questions clinicians can add to intake (sleep onset/maintenance, regular wake time, daytime sleepiness, snoring/gasping, bedtime routine, supplements, and late eating), discuss why routine cortisol/adrenaline testing is often unhelpful outside conditions like Cushing syndrome, and highlight tools such as HOMA-IR and continuous glucose monitors (Libre and Dexcom) for pattern-based lifestyle coaching. Dr. Makhija shares actionable interventions—post-meal movement, breathwork on waking and at bedtime, and finishing the last meal 3–4 hours before sleep—to reduce glucose excursions and dawn phenomenon, and connects untreated sleep disorders and metabolic dysfunction to erectile dysfunction and secondary hypogonadism, including a basic lab workup for low testosterone.
Have a patient who needs more than education? My clinical practice, Pacific Integrative Psychiatry, accepts referrals for insomnia and mental health care in California.
Referring a patient for the sleep programme? Effortless Sleep for clinicians has the referral details.
Not a clinician? The Effortless Sleep Program™ is the patient version of this work, available online, nationwide.
