Diabetes and Sleep

Sleep in people with type 1 diabetes (T1D) and their caregivers has been a hot topic recently. The quality and quantity of sleep (or the lack thereof) has been talked about by people living with T1D for years; however, with the new devices and alarms now on the market, it has gained the attention of researchers and clinicians.

People with diabetes have interrupted sleep on a regular basis – from need to urinate during the night because of high blood sugars and then correcting (and then often waking to check their blood sugar to make sure it went down but not too much); waking to treat a low blood sugar and then having difficulty falling back to sleep; setting alarm clocks to check blood sugars; high and low CGM alarms and needing to treat those high or low blood sugars; pump alarms for occlusions, batteries, etc.; or even worries about diabetes that keep you up at night. Because parents of children with T1D manage their child’s blood sugar (and worry a lot more about diabetes than their children), they experience this same disrupted sleep.

Recent research has documented sleep loss because of diabetes disruptions, both anticipated (e.g., setting the alarm clock to check blood sugar) and unanticipated (e.g., pump occlusion alarms), of up to 10 hours a week. This is important because sleep is important to good cardiovascular and metabolic health. In addition, children, adolescents, and adults who reported less sleep also have higher HbA1cs. And, people with T1D who have sleep disruptions/lack of sleep are less insulin sensitive and require more insulin the following day after not sleeping well

Tips for Better Sleep

There is no magic bullet to help people with T1D or their caregivers get better sleep. As parents you will always worry about your child’s blood sugar throughout the night, and as individuals with T1D you will always want to make sure you are safe throughout the night. But you can use some tips to get a better night (and more) sleep.

  •  You should first make sure that you (or your child with T1D) do not have any medical issues contributing to your sleep issues. Obstructive sleep apnea (OSA) had been highly linked with type 2 diabetes, but some newer research has shown that OSA is more common among people with type 1 diabetes than those without diabetes. People with OSA stop breathing repeatedly and then start again throughout the night. Make sure to talk to your doctor to rule out if you have a treatable sleep disorder.

  • Talk to your healthcare provider about setting CGM alarms to a different setting at night for high and low blood sugars to reduce alarms.

  • If your diabetes worries are preventing you from sleeping, talk to your doctor or your child’s healthcare provider. They can give you tips for managing blood sugars throughout the night and can assess if your fear of hypoglycemia could be a barrier to good rest.

  • Get into a routine – try to go to bed at the same time and get up at the same time every day (including weekends).

  • Get regular physical activity – being active during the day can help you fall asleep as well as improve your emotional well-being.

  • Avoid caffeine, alcohol, or eating a lot right before you go to bed.

  • Create a relaxing sleeping environment – make sure your bedroom is quiet, the blinds are shut (keeping the light out), and at a comfortable temperature.

  • Keep electronics out of your bedroom, including computers, TVs and smart phones.

Getting a good night’s rest is important for everyone’s health and well-being. Although type 1 diabetes will interrupt your sleep at times, getting regular sleep is important for your long term health!