Can Type 1 Diabetes Affect Sleep? Tips for Better Sleep

If you have type 1 diabetes, you know that it tends to impact almost every aspect of your life. One thing that it impacts deeply before and after the diagnosis is sleep.

Unfortunately, people who have type 1 diabetes have disturbed sleep due to various reasons, which we’ll discuss later. On top of that, the lack of sleep can then impact diabetic control, resulting in a vicious cycle. 

So, let’s discuss how diabetes affects sleep and how sleep deprivation can affect your glycemic control, and what you can do to sleep better.

Does Diabetes Affect Sleep?

Diabetes does have an impact on sleep, and sadly, it’s a negative impact.

One of the first things people experience with diabetes is excessive urination. This symptom is a consequence of raised blood sugar levels. People with high blood sugar often have to go to the bathroom multiple times during the day and night, which means their sleep is constantly disrupted.

If you have hyperglycemia or raised blood glucose levels, you may also feel hungry and thirsty, which, again, can disturb your sleep.

On the other hand, if your blood sugar levels drop during the night, you may wake up because of it. It could lead to symptoms like tremors, excessive sweating, confusion, nausea, dizziness, and irritation. Sometimes people who experience hypoglycemic episodes at night have difficulty going back to sleep even after they’ve corrected their blood sugar levels.

It’s also not uncommon for people with diabetes to experience restless leg syndrome.

Restless leg syndrome (RLS) is a condition in which you feel a constant discomfort in your legs, especially when you’re sleeping. The only way to feel better is to move your legs, which is why sleeping is difficult for people with RLS.

This condition can affect anyone, but it has been seen to occur more commonly in people with diabetes. This could be because longstanding high blood glucose levels can lead to damage to peripheral nerves or diabetic neuropathy.

Lastly, it is thought that there is a relationship between sleep quality and blood glucose regulation. Even in non-diabetics, sleep quality has been shown to be affected by blood glucose levels. In general, T1D’s with “poor” glucose management have worse sleep quality than those who have better glucose management. 

A Lack of Sleep Also Affects Diabetes

Not only can diabetes affect quality of sleep, but a lack of sleep can also, in turn, affect diabetes. 

Poor sleep quality can lead to various problems, such as daytime drowsiness, difficulty concentrating on work, increased risk of depression, poor memory, increased cravings for carbohydrates, weight gain, and even poor glycemic control.

Although there aren’t many studies about this, one study is often used as an example. Based on the HbA1C levels tested, people who slept for more than 6.5 hours each night had better diabetic control compared to those who slept less than 6.5 hours each night.

The reason for this is not exactly clear, but lack of sleep has been linked with decreased insulin sensitivity and increased insulin resistance.

Another study reported that children with type 1 diabetes who were having difficulty falling asleep, on average, had higher HbA1C levels than children with type 1 diabetes who didn’t have trouble falling asleep.

Tips for Better Sleep if You Have Type 1 Diabetes

With all this in mind, the next question that pops up is, how can you improve your sleep?

A chart generated by Gluroo to help users assess their glycemic control over night. The data shown are my own BGL traces for the past three nights.

These are some basic measures you can take to improve your sleep:

  1. You should create a proper sleep schedule where you go to bed at a certain time and wake up at roughly the same time each morning. Aim for about 8 hours of sleep in this schedule. Following this schedule will attune your body to sleeping at the same time.
  2. Avoid caffeine, smoking, or any stimulants that keep your body awake, especially near your bedtime. Don’t rely on them to stay up.
  3. Work out during the day and avoid long naps so that your body is tired by the time you have to go to bed.
  4. I know we all love scrolling mindlessly through our phones before going to bed but try to not use your electronic devices for at least an hour before going to bed. 
  5. Make sure the room is dark and at a temperature that is comfortable for you. You don’t want to wake up in the middle of the night sweating or freezing.
  6. If you have pets that might disturb you, put them to sleep before bed and keep them out of your room if they are too disruptive.

While these are some general steps you can take, some specific ones that can help people with type 1 diabetes are:

  1. Check your blood glucose levels before you go to sleep so that you can correct them beforehand rather than waking up in the middle of the night with symptoms and then having trouble sleeping again.
  2. Have a diet plan that maintains your blood glucose levels during the night. An easy way to do this is to eat your last meal of the day earlier, so that by the time you go to bed, your BGL is mostly stable. For example, imagine you go to bed at 11PM. If you eat dinner at 8PM, you’ll still have plenty of carbs and insulin left to act in your system by the time you go to bed. This can result in interruptions in your sleep, if you didn’t perfectly nail the insulin dose and timing (which, as we all know, is often impossible). If instead you eat dinner at 5PM, then by the time you go to bed at 11PM, your system is mostly stable and may only take a minor adjustment before you sleep. 
  3. Chart any episodes of hypoglycemia or hyperglycemia you have at night, and then discuss with your doctor how these can be reduced. Gluroo is a great tool for this because by connecting to your CGM, it registers these episodes for you. No need for paper or digital manual logs.
  4. Ensure your continuous glucose monitoring alarm is on to inform you if anything is wrong.
  5. Be mindful of things that can cause nighttime hypoglycemia, like excessive insulin use, alcohol use, or physical activity right before sleep.

Proper Sleep Is Essential For Diabetes Control

Type 1 diabetes requires a lot of patience and effort to deal with it, and takes an emotional and physical toll on you. It requires constant monitoring, regular insulin administration, and a lot of changes and precautions when it comes to diet.

A good night’s sleep is vital. Unfortunately, diabetes makes it harder for people to have a peaceful sleep at night. At the same time, poor sleep also worsens your glycemic control. Overall, it’s a vicious cycle that you must break to live a healthy life.

It’s understandable to have a hard time with your sleep if you suffer from T1D, but if you follow some of the advice we have given in the article, you’ll hopefully be able to break this cycle. 

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