“A good laugh and a long sleep are the best cures in the doctor’s book” is an Irish proverb. But restful sleep may be difficult when you have diabetes, which can cause poor sleep quality. It’s a vicious cycle in which diabetes complications can cause poor sleep quality, while poor sleep quality can make diabetes worse. Let’s explore the connection between diabetes and sleep disorders.
Diabetes and Sleep Disorders
Clinical research shows up to one-third of patients with diabetes suffer from sleep disorders. Another study from the University of Pittsburgh revealed that half of the patients with type 2 diabetes described themselves as poor sleepers. As a result, those with poor sleep had difficulty with diabetes control (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4478581/).
Nearly 25% of Type 2 diabetics have sleep disorders and over 75% had at least one sleep symptom regularly. Sleep disorders include insomnia and breathing disorder. Sleep symptoms include difficulty falling asleep, sleep apnea, and daytime sleepiness (Predictors of sleep disorders among patients with type 2 diabetes mellitus – ScienceDirect).
Blood Glucose Levels & Poor Sleep Quality
Diabetes often leads to interrupted sleep because of high or low blood sugar levels. When blood sugar is high, your kidneys compensate by making you urinate more frequently. This leads to interrupted sleep because you wake up constantly due to frequent trips to the bathroom and increased thirst.
In contrast, low blood sugar can disrupt sleep with nightmares, sweating, shakiness, hunger, and irritability.
Falling asleep can also be challenging because of the fear of dropping low. Thus, it’s critical to manage blood sugar levels to prevent nighttime lows. One way to do this is to use cornstarch as a bedtime snack to prevent lows (https://backtonaturediabetic.com/cornstarch-may-prevent-low-blood-sugar/).
High or low blood sugar may mean adjusting medication, basal insulin, meal times, the amount of carbs, and exercise time. Talk to your doctor if your sugar levels are preventing restful sleep.
The Importance of 7+ Hours of Sleep
Sleeping less than six hours can lead to elevated blood sugar.
Josie Bidwell, an associate professor at the University of Mississippi, states “in general, poor sleep plays a role in insulin resistance, which occurs when your body has difficulty using insulin to move glucose from your blood into cells. This can result in high blood sugar. If you are struggling to gain control of your blood glucose, looking at your sleep and doing what you can to get the recommended 7 plus hours can be a game changer.”
Research from the Sleep Foundation Organization
The Sleep Foundation Organization’s research demonstrates poor sleep’s effect on diabetes control:
- Lack of sleep increases cortisol
- Sleep deprivation reduces insulin sensitivity
- Type 2 diabetics with high blood sugar experience poor sleep
- High blood sugar is linked to severe sleep-breathing issues
- High and low blood sugar during the night can lead to insomnia and next-day fatigue
Sleep Apnea
There is a strong correlation between obstructive sleep apnea (OSA) and diabetes. OSA is when breathing starts and stops while asleep. The tissue at the back of the throat collapses and blocks the airway, restricting breathing. OSA is associated with obesity and having a thick neck circumference, which can narrow the airway when you lie down. As a result, OSA deprives the body of oxygen, which impairs glucose metabolism and promotes insulin resistance.
Symptoms of OSA include snoring, sleepiness during the day, gasping for air, falling asleep during the day, and morning headaches.
Up to 30% of OSA patients have type 2 diabetes, while 86% of obese diabetic patients have OSA (https://www.bergerhenryent.com/the-relationship-sleep-apnea-has-with-obesity-and-diabetes/).
Treatments for reducing OSA include:
- Losing weight
- Exercising
- Drinking alcohol moderately, but not before bedtime
- Quitting smoking
- Sleeping on your side– you can place a pillow or tennis ball next to you to prevent turning on your back
- Using a nasal decongestant
- Talking to your doctor about a CPAP (continuous positive airway pressure) machine
Diabetic Neuropathy
Diabetic neuropathy is nerve damage caused by diabetes. It can keep you up at night because of the pain, including tingling, aching, and a burning feeling. Tips you can try for sleeping better include:
- Sleeping in a recliner
- Sleeping on the back with a pillow underneath the legs
- Sleeping on one side of the body with a pillow between the thighs
Restless Leg Syndrome (RLS)
Restless Leg Syndrome is the uncontrollable urge to move your legs. While it is like neuropathy, it usually occurs at night.
Diabetics with RLS have poorer sleep quality, longer time to fall asleep, lower sleep efficiency, and more daytime dysfunction (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4478581/). In addition, smoking aggravates RLS, so it’s another significant reason to stop.
Menopause can also increase the occurrence of RLS. Sleep disturbances such as insomnia are also likely.
Tips for Better Sleep
- Manage blood sugar levels
- Keep a regular bedtime schedule
- Shut off blue light exposure (phone, tv, and computer) 30 minutes before sleep because blue light increases insulin resistance. You can also wear blue light-blocking glasses during the day.
- Don’t drink alcohol or caffeine before bedtime
- Exercise during the day, which may help you fall asleep easier at night
- Keep the bedroom cool, dark, and quiet
- Use a white noise machine
- Engage in relaxing activities before bedtime, e.g. take a warm shower, listen to relaxing music, read a book, etc.
Conclusion
Sleep is important for your mind and body. Whether diabetes causes poor sleep quality or poor sleep worsens diabetes, there are actions you can take to improve both. Controlling your blood sugar will always be the top priority. You can also get tested for sleep apnea and improve ways to get a good night’s rest.
Quote
“Happiness is waking up, looking at the clock, and finding that you still have two hours left to sleep” -Charles M. Schulz