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How to better manage diabetes and sleep
If you're living with diabetes, it's important to understand the relationship between diabetes and sleep. This is because maintaining a healthy sleep schedule while living with type 1 diabetes (t1d) can be challenging for a few reasons.
A study published in Diabetes Spectrum showed that both children and adults living with t1d reported poorer sleep patterns than those without diabetes. Additionally, those with t1d may experience a lighter sleep cycle due to stress and interruptions. Daily management choices and blood sugar fluctuations can cause stress hormones to be released throughout the day and even into the night. This can then turn into a vicious cycle because these hormones can make blood sugar levels more difficult to manage.
Here's a look at some specific causes for interrupted or deprived sleep within the t1d community — and how you can work to prevent them.
Preventing hypoglycemia
Hypoglycemia, or low blood sugar, can occur while sleeping if you have too much insulin in your system. The side effects of low blood sugar include:
- Shaking
- Sweating
- Dizziness
- Hunger
- Pounding heartbeat
Some ways to prevent hypoglycemia while you're sleeping include:
- Make sure you don't have too much insulin on board (IOB) before going to sleep. If you wear an insulin pump or use a smart pen, you'll be able to see how much IOB you have left in your system. Before going to bed, be sure to eat enough food to cover for the insulin in your system.
- Have some protein before bed. Protein can help stabilize blood sugar levels by softening the absorption of carbohydrates.
Preventing hyperglycemia
A blood sugar spike, or hyperglycemia, in the middle of the night isn't quite as urgent as a low blood sugar situation, but it can still make you feel awful. Some side effects of high blood sugar include:
- Headache
- Nausea
- Extreme thirst
- Frequent urination
- Confusion
- Shortness of breath
- Vomiting
Frequent urination and extreme thirst are likely the most common culprits for interrupted sleep when your blood sugar is high throughout the night. Some ways to combat hyperglycemia overnight can include:
- Increasing your overnight basal rate or long-acting insulin dosage. Be sure to speak with your doctor first, but this can help lessen any overnight blood glucose spikes.
- Limit snacking right before bed. Even if you take the appropriate amount of insulin, late-night snacking can cause overnight high blood sugar levels. Laying down or staying sedentary decreases the likelihood of insulin absorption, as opposed to moving around right after you've eaten. If you do need a snack, perhaps take a walk right after eating and before going to sleep.
Using CGM alerts to help manage diabetes and sleep
If something is off with your blood sugar and you wear a continuous glucose monitor (CGM), you'll likely get an alert in the middle of the night. CGM alerts will sound if your blood sugar is too low, too high, rapidly dropping, or rapidly rising. The alert will also sound if the signal is lost or if your sensor or transmitter needs to be changed.
Fortunately, these alerts can be customized to your liking, so you can opt to only receive certain notifications overnight. For instance, you might like to be alerted frequently during the day when your blood sugar reaches a certain number as your "high alert" to keep tighter control. But you can program that alert to be a bit higher on the graph overnight so you aren't hearing those alarms as often. It's also important to make sure the more urgent alerts — such as when your blood sugar is falling or rising rapidly — are audible.
More tips to promote a restful sleep
You can take further steps to make sure you're setting yourself up for a restful night's sleep. Here are five strategies to consider:
- Keep some glucose or quick sugar on your nightstand. This easy access can come in handy if you experience low blood sugar in the middle of the night.
- Silence text message or phone call ringtones. You don't need to be awoken by your friends' late-night antics or group chats, but make sure your CGM alerts are easy to hear.
- Limit screen time. Don't scroll through social media or look at your phone after you've gotten into bed, as the exposure to blue light can keep you up.
- Meditate before bed. Meditation can help silence the mind and create a peaceful state that's suitable for deep relaxation.
- Turn on some ambient music or white noise. Some people respond well to having some soothing sounds to lull them to sleep, as this can help to "turn off the brain" and limit unhelpful thoughts that can keep you awake.
Achieving a restful sleep schedule is possible while living with type 1 diabetes! Interested to learn other tips and tricks that can assist with your daily management? Explore the library of articles on the Edgepark Health Insights blog.
