Getting a Better Night's Sleep with Diabetes or Pre-Diabetes

INTRODUCTION: If You Are Diabetic (Type 1 or 2) or Pre-Diabetic and Having Sleep Issues--You are Not Alone

Blood Sugar health and sleep are intricately connected, and many people with diabetes or pre-diabetes experience issues with getting a good night’s sleep. Both High blood sugar (hyperglycemia) and low blood sugar (hypoglycemia) during the night can effect sleep in several ways including the inability to fall asleep (insomnia); restless sleep and interrupted sleep --- all can also lead to next day fatigue and

other related problems. If you find yourself waking to use the bathroom, it could be that you drank too much liquid too close to bedtime or when blood sugar levels are high the kidneys overcompensate by causing you to urinate more often. During the night, these frequent trips to the bathroom lead to disrupted sleep.

In addition to the immediate frustration of sleepless nights, lack of good sleep can cause you problems the next day. Sleep deprivation raises levels of ghrelin, the hunger hormone, and decreases levels of leptin, the hormone that makes us feel full. To compensate for lower energy levels, people who sleep poorly may be more likely to seek relief in foods that raise blood sugar and put them at risk of chronic high blood sugars or obesity both of which are risk factor for diabetes. People who experience disturbed sleep or frequent nighttime awakenings may also be less likely to stick with their diabetes self-care routines, including eating foods that support blood sugar control, getting enough exercise and closely monitoring blood glucose levels.

And even if you are not diabetic or pre-diabetic, sleep deprivation also raises the risk of developing insulin resistance in the first place.

TIPS for Getting A Better Night’s Sleep

The good news is that careful attention to diet, exercise, and blood sugar levels can make a world of difference to sleep quality and, in turn, to overall health -- and when you are getting enough sleep, you may find that you have an easier time controlling your blood sugar. You’ll be more alert during the day, have more energy, less stress, and an overall better mindset for monitoring and managing your health and blood sugar levels. Here are some tips for getting a better night’s sleep.

1. Focus on controlling your blood sugar levels during the day.

Managing your blood sugar effectively throughout the day is your first line of defense against a restless night (includes adhering to a quality carbohydrate diet plan that does not include blood sugar spiking foods and incorporates lots of vegetables, healthy protein and good for you fats.) When your blood sugar is too high or too low, it can wake you up at night, so one of the best things for better sleep with diabetes is to keep your blood sugar levels within your target range so you’re not having highs or lows that prevent you from sleeping well. If you want to see if your blood sugar is spiking or going to low in the middle of the night, try checking it around 2 or 3 o’clock to see if you are actually having an issue. If you are on insulin, you can talk to your doctor about possible causes and what to do.

2. Don’t eat a heavy meal right before bedtime, and don’t drink alcohol or caffeine late at night.

Nighttime eating is a common issue for many people. In general it is a good idea to avoid eating food close to bedtime. If you want to have a light snack it should include a combo of protein and quality carbohydrate that does not spike blood sugar levels. Although it might seem comforting to have a piece of chocolate before bed, avoid this. Chocolate has caffeine, and caffeine can keep you awake. (a small amount of healthy chocolate is OK, just have it earlier in the day)

Regarding liquids: Black tea, coffee, caffeinated sodas, and drinks like hot chocolate interfere with your ability to fall asleep. For a better night’s sleep, limit the amount of caffeine you consume throughout the day with a goal of eliminating it several hours before bed. In general, don’t drink liquids close to bedtime. (limit all fluids at least an hour before bedtime to avoid waking up in the middle of the night to go to the bathroom and use the bathroom right before you go to bed). Although you might like to drink a glass of wine to relax, it is a good idea to stop alcohol consumption four hours before bedtime.

3. Exercise regularly.

Physical activity contributes to overall improved blood sugar control and getting enough exercise can help improve the quality of your sleep. Among its many benefits exercise can improve mood, which helps to lower stress and leads to better sleep. Aim to get at least 30 minutes of exercise five days per week, and also try to exercise about five or six hours before bedtime. You’ll sleep better at night if you exercise earlier in the day.

4. Aim for a healthy weight.

If you’re overweight set goals for weight loss and management. Losing 10 percent of your body weight can lead to better blood sugar control and decrease the risk of depression and sleep apnea, both of which can affect your nightly sleep.

5. Create a peaceful sleep environment.

The environment in your bedroom makes a significant difference when it comes to quality sleep. Ever wonder why you sleep so well in a comfy hotel room? It is largely because good hotels focus on creating a relaxing environment. Start by taking a look around your bedroom. Is it cluttered, full of electronic equipment or other distractions? Keeping your own bedroom uncluttered, a comfortable temperature, dark at night, and quiet while you sleep can greatly improve your sleep. Television, smartphones, tablets, and even clock radios that are too bright can interfere with your ability to fall and stay asleep. Also, make sure you have a supportive pillow and mattress.

If you currently use your bedroom as an office, rethink this arrangement, and try to make your bedroom a place to rest, not get distracted or reminded of stressful situations. I originally had my office in my bedroom, and realized that it was causing underlying anxiety, so I moved it to a corner of my dining room instead.

I am personally not against having TV’s, laptops or tablets for reading in the bedroom, as long as they are turned off at least ½ hour before you fall to sleep. If you need to have your cell phone by your bed, change the settings to only receive messages that are an emergency. If you currently use the TV as a way to fall asleep, try listening to calming music or some of the newer “nighttime stories” instead.

6. Sleep in your bedroom, not on the sofa.

Another very common issue for many is falling asleep on the sofa and then going up to bed, which totally interrupts healthy sleep. Try creating a bedroom oasis and go up to your bedroom before falling asleep. And partake in some of the relaxation tips below before you actually fall asleep.

7. Create a bedtime ritual that includes relaxing activities.

Relax before bedtime. Exercise, chores, errands…have it all finished at least an hour before you go to bed. Then, winding down and relaxing one to two hours before bed can help your body get ready for sleep. Consider a gentle yoga routine, breathing exercises, reading, listening to calm music, writing in a journal or a warm bath.

Keep in mind that everyone deals with some stress, but people with diabetes are often under even more pressure due to managing a chronic condition on top of everyday stresses. When that stress becomes too much, it can lead to “diabetes burnout” — and it can affect your sleep. Stress causes the body’s nervous system to release the hormones cortisol and adrenaline, which regulate the fight-or-flight response in stressful or dangerous situations.

Typically, once the external threat is removed, these hormones subside and the body relaxes again. But with chronic stress, this aggravation to the nervous system doesn’t go away and the increased adrenaline and cortisol can lead to tossing and turning, as well as a feeling of restlessness. To counteract the effects of daily stress, it’s important to find ways to de-stress before you go to bed.

8. Stick to consistent sleep times.

Near the top of the list for better sleep is having a regular routine for the time you go to bed and the time you wake up. Going to bed and waking up at the same time each night helps regulate your body’s own internal clock, so it is important to go to bed at the same time every day, even on the weekends, if you can. Try not to take a nap late in the day. naps should be kept relatively short — around 20 minutes — and limited to the early afternoon. Napping any later is likely to throw off your ability to get to sleep at night.

WHEN Should You See Your Doctor for Sleep Concerns?

If you have any concerns that are bothering you or if adopting basic lifestyle changes doesn’t improve your sleep, it’s important to talk to your doctor. Conditions that affect sleep can be serious and may lead to long-term health issues over time. Your doctor can assess whether you may have a more significant sleep issue, such as diabetic neuropathy or sleep apnea, and recommend further tests or treatment.