Sleeping like a log; it’s a wonderful way to sleep isn’t it? Unless, of course, that proverbial log is rolling about throughout the night, sweating, and being woken by a CGM alarm.
Wait, do logs sweat? Probably not, but without a proper night’s sleep it’s hard to tell.
Those with diabetes understand all too well what sleep deprivation feels like. If not being woken during the night by symptoms of hypo- or hyperglycemia, then those with diabetes can still wake in the morning feeling like they haven’t slept well.
Sleep is a precious resource; without sleep, people barely function. On the other hand, with sleep, people are like superheroes.
At Hedia, we like to bring out the superhero in you. We want you to catch as many of those Zs as possible. Have a read about why sleep is important and what you can do to get more of it!
Why Diabetes and Sleep don’t Always go well Together
If you have diabetes and you suffer from poor sleep, then you are not alone.
In a study by Dr Barnard, cited by T1D Exchange Glu, a third of adults with type 1 diabetes would wake once or more during the night. 82.5% of respondents felt that waking in the night had a negative impact on their daily functioning.
Often, people with diabetes wake because of symptoms of hypoglycemia (a hypo/going low) or hyperglycemia (going high).
Some of the common symptoms of a hypo that may wake a person with diabetes are sweating and feeling dizzy. Even without being woken during the night, they may wake in the morning with a headache, damp bed sheets from sweating, and feeling unrested.
Meanwhile, going high during the night may lead to waking feeling thirsty or needing to urinate.
Some with diabetes may even wake for no apparent reason. If so, it’s worth checking blood sugar levels to see what the body is up to.
Another culprit of the poor-sleep-club is the continuous glucose monitor (CGM). The alarm is there to help; if you are being woken by the CGM, then it is doing its job. It’s telling you that something needs to be done.
The problem is the delay in the glucose readings. Even if you’ve dealt with the issue, the alarm may continue to sound for a few minutes afterwards, keeping you awake.
If sleeping like a non-sweating log is your aim, and you want to avoid these situations, then something needs to be done before going to sleep.
Prepare for Sleep
In order to sleep well, ensure that you have a sleep routine – that accounts for about 8 hours sleep – in an environment that helps you relax.
This would be a dark, quiet, well-ventilated room. If you are a light sleeper, consider using a blindfold and earplugs.
According to the Sleep Foundation, you should avoid intense activity before bed because it is stimulating. For those with diabetes, exercise directly before bed could also impact blood sugar levels in the night. Read more with the blog post Does Exercise Lower Blood Sugar?. However, balanced exercise earlier in the day will bring on the tiredness.
Avoid other stimulation by limiting blue light from screens or coffee. Just try to generally relax. We already have some tips for this on our blog post about stress and diabetes.
Some studies suggest that those with diabetes are more likely to suffer from either sleep apnea (a condition where breathing stops a person from reaching deep sleep) or restless leg syndrome. If those conditions do affect your ability to sleep, then contact a doctor for advice.
In terms of your diabetes and sleep – you don’t need us to tell you that getting blood sugar under control is important. We know it’s the all too familiar daily mission of those with diabetes.
But, maybe, one of the following tips is something you hadn’t considered before:
Check your blood sugar levels an hour before going to sleep. If the blood sugar is not as expected, you will have time to remedy it before bed-time.
Keep a record of your blood sugar before bed; you can show your results to a doctor to figure out what your ideal blood sugar levels should be before bed. And, of course, you can easily keep track of those blood sugar levels with Hedia’s diabetes logbook. And no, that’s a different kind of log.
2) Eating before bed
For many people with diabetes, this would be a bad idea because it can lead to hyperglycemia in the night. So, some people should avoid this.
However, if you find that you go too low during the night, try eating a snack before bed to balance it out. It’s all about figuring out what works best for your diabetes. If you do eat before bed, avoid food that is particularly stimulating, like refined sugar.
3) Long-acting insulin
Consider what your long-acting insulin is up to. Its job is to work throughout the night. If you’re going too high or low at night, perhaps something needs to be adjusted with that insulin.
The so-called dawn phenomenon is where the body releases hormones in the early hours of the morning to prepare the body for waking up. This may cause blood sugar to rise, and some people experience high blood sugar in the morning because of this.
Considering the impact of the long-acting insulin could be a way to address this. Your doctor will help you figure it out.
4) Drink water in the evening
But not directly before bed. Try to make sure you drink enough water to help the body with its metabolism. Just don’t do it close to bedtime to avoid waking in the night to use the bathroom!
5) Prepare to be woken
Yes, you’re trying to avoid this but knowing that you’re ready for it might help you relax.
Try setting an alarm for the night to test your blood sugar levels. That way, you won’t have to spend the night worrying about your diabetes. Instead, test your blood sugar during the night, and then go back to sleep safe in the knowledge that you have managed your diabetes well.
If you’re worried about hypos in the night, prepare by having something to eat by your bed.
Diabetes and Sleep: what Happens Without that Sleep
By ensuring that you get to sleep, you are actually helping your diabetes management a great deal.
The main issue with diabetes and sleep is metabolism. Metabolism is important because that’s when the body deals partly with glucose and insulin.
Those with diabetes don’t always have enough natural insulin, but the body goes through the same process of metabolism. Without sleep, the body is less efficient at focusing on metabolism because of the hormones that are released during sleep (more on that in a minute).
The Sleep Foundation refers to a study where subjects (not necessarily with diabetes) were deprived of proper sleep for six nights. Their ability to break down glucose was subsequently 40 percent lower on average.
Similarly, in another study, subjects were deprived of deep sleep, after which their glucose tolerance and insulin sensitivity decreased by 25 percent.
If this is what happens to people without diabetes, imagine what sleep deprivation does to those with diabetes – who already need to think about their insulin sensitivity and how their body breaks down glucose.
Additionally, without sleep, ghrelin levels go up and leptin levels go down. Basically, you have more of that hormone that makes you feel hungry.
It is not surprising, then, that a person with diabetes may find that their blood sugar levels are more difficult to manage after a bad night’s sleep. It’s also not surprising that a lack of sleep could lead to higher HbA1c levels, according to a study in the Diabetes Spectrum journal.
On top of this, it’s well-known that concentration and problem-solving is difficult after poor sleep. (Still not sure if logs sweat.) Mistakes or poor choices when managing diabetes are likelier without getting enough shut-eye.
Writing for diaTribe, Adam Brown even did his own experiment on himself, where he found that the state of his diabetes was worse after nights of less than seven hours of sleep. This included the result that his blood sugar was 21% more variable after less sleep.
Why Sleep is Important for People with Diabetes
Our bodies go through a lot during the day when we’re awake. We use our muscles, we overthink things, and in the background, our various hormones are busy regulating the body.
Sleep gives time for the body to focus on what it can’t focus on during the day. Here is just some of what the deep sleeping body does:
- More human growth hormone (HGH) is released. This leads to growth of muscle mass, and reparation of cells and tissues. Amongst other additional functions, HGH regulates sugar and fat metabolism. This would partly explain why studies show that people with less HGH are more likely to have belly fat.
- Cortisol, the so-called stress hormone, is lowered. This is particularly important for those with diabetes because stress makes the body less receptive to insulin. Read more on our blog post about stress and diabetes.
- The hormone that makes you feel hungry (ghrelin) and the hormone that makes you feel full (leptin) are balanced. If you have those hormones in the right balance, then you’re less likely to overeat.
- Pulse and blood pressure is lowered, giving the blood vessels a rest.
- The brain sorts out the information you don’t need. You’re able to deal with mental problems better because of this.
Clearly, sleep is a good thing. If sleep generally benefits your body, it will also benefit your diabetes. It really does give you superpowers!
Diabetes and sleep may not always be the greatest bedfellows. However, once you get on the good side of sleep, it can truly help your diabetes and your general sense of well-being.
Go to bed tonight dreaming of what superpowers you will gain after hitting the hay. You are super for managing your diabetes, and maybe, one day, you will have the power to figure out whether a log does indeed sweat.