If there’s something that people who have type 1 diabetes (T1D) can share in the same way, it’s the fact that we have a difficult time getting the best night’s sleep.
Between extreme low and high blood sugar levels, late-night alarms from devices or visits to the bathroom, and the nighttime anxiety T1D often brings, There is often not enough space to rest within our routines.
Research shows the fact that insomnia is frequent with all types of diabetes. It also shows that when you have T1D, “sleep could be disturbed because of both physiological and behavioral aspects… and can negatively affect the progression of the disease and the development of complications.”
Let’s discuss the impact of T1D on sleep and what you could do to enhance the quality and quantity of your sleeping.
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A lack of sleep is a risky venture.
As per the Centers for Disease Control and Prevention (CDC)Trusted Source, more than 1/3 of American adults aren’t getting enough sleep. The American Academy of Sleep Medicine defines adults aged 18 and 60 as seven or more hours per night.
The people who live in cities or the Northeast are getting minor amounts of sleep, according to the CDCTrusted Source, and more than eleven percent of Americans get less than 6 hours of sleep each night.
Sleep deprivation is linked to the risk of developing obesity and heart disease Type 2 diabetes, stroke, hypertension, increased stress, a higher risk of accidents, and premature death.
The CDC further notes that students who sleep less than 7 hours each night in a Trusted Source are at a higher risk of engaging in risky activities. Activities could be the lack of a helmet while riding bikes or using a seat belt driving, or drinking while driving, compared to those who sleep more than 9 hours each night.
Sleeping well is essential for people suffering from T1D. Sleeping can insufficiently lead to an increase in insulin resistance trusted Source and mental stress and make the disease more difficult in general.
The health benefits of sleeping
It’s no surprise that just like eating healthy and regular exercise, getting enough sleep is essential for healthy mental and physical health. While sleeping, the body repairs and regenerates damaged cells caused by stress and strain. Sleep helps clear blood vessels, which reduces inflammation and also prepares the body for the following day.
It also helps to regulate the body’s hormone levels. It plays an essential function in the level of serotonin, cortisol, adrenaline, ghrelin, melatonin, and leptin present in the body. These hormones aid the body in managing everything from managing stress to energy levels to control the intensity of anger, maintain the drive to control hunger and satiety, and ensure emotional wellbeing.
Sleep can also help protect the body’s immune system, allowing people to fight everyday infections and viruses more effectively. For instance, one study trusted Source discovered that, in the event of exposure to the virus that causes the common cold, those who slept less than 7 hours a night for two weeks were three times more likely to get an illness than those who had slept for eight or more hours every night for two weeks.
Disorders of sleep that impact those with T1D
Although some sleep disorders are linked to T2D (T2D), people who have T1D typically suffer from sleep disorders, including adolescents, children, and adults. A study showed that patients who had T1D reported subjectively poor quality of sleep for 35 per cent of the time compared to 20 percent of people who don’t have T1D.
Sleep disorders that are commonly linked to T1D are:
- Nocturia is the condition where you are frequently awake at night because of the urge to flush your bladder. It is more common among those who suffer from T1D because of excessive glucose (overly elevated blood sugar) that causes frequent urinary frequency.
- Obstructive sleep Apnea Trusted Source and sleep-related breathing disorders happen when the muscles supporting the soft tissues of your throat are temporarily relaxed. In this case, the airway may become narrow or even close, and breathing can be temporarily stopped.
- Central sleep apnea Another type of sleep apnea is which you stop breathing for a short period of sleep, as your brain’s signals to control breathing in sleep are confused.
- Restless leg syndrome is the condition in which uncontrollable leg jerking and cramping during the night disrupt both qualities and quantity of rest. People with diabetes have an increased risk of developing this disorder than the general population.
- Sleep disturbances that are general in nature and poor quality sleep. In a 2020 study conducted by the Trusted Source, Children with T1D had more insomnia than children with T1D. A separate study conducted by Trusted Source implies that people with T1D between the ages 30 and 40 said the quality of their sleep was lower than those with T1D, in line with six measures of the quality of their lives.
According to Trusted Source, individuals with T1D and T2D experience the highest rates of these conditions. The disorders usually correspond with increased nerve damage (nerve-damaged damage) and nephropathy (kidney illness).
These issues cause not just sleepiness but also insomnia too. This can have negative consequences not just on the management of diabetes but also on general well-being. If you don’t get enough sleep, you’ll probably require additional insulin (due to insulin resistance resulting from increased cortisol levels) to manage blood sugars.
Your body is naturally more hungry when your hormonal leptin levels are out of equilibrium, making eating, managing your meals, and counting carbs more difficult.
Even more, you’ll feel exhausted throughout the day. This can affect not only your academic and work efficiency, but you could also be unable to find the motivation to exercise, cook, or generally take treatment of your body. All this can lead to the management of diabetes as a catastrophe.
Another issue can arise if you experience daytime sleepiness and have a nap in the middle of the day; it can be challenging to fall asleep that night, which could lead to insomnia for a long time, only aggravating the problem. This can result in increased blood sugar levels and A1C levels and overall more challenging management.
People who have diabetes have trouble sleeping.
Glen McCallum, a software engineer and T1D patient from Vancouver, Canada, tells DiabetesMine, “I’ve been diagnosed with an endocrinologist-diagnosed condition known as “positional sleep apnea. I’m prone to waking up every couple of weeks with a headache that is pounding, and I am unable to look at screens. It’s like having jetlag that lasts throughout the day.”
He goes on to say, “That’s why I never set a timer for my morning routine. I was always discouraged by having goals set and then not doing any workouts because I was unable to get up.”
Leo Koch, a teenager who has been living with T1D for the bulk of his life and a resident of Waterville, Maine, has been suffering from sleep disorders since he was diagnosed when he was two years old.
Her mother, Hilary herself, has told DiabetesMine anything ranging from “a pump obstruction, a sequence of lows triggered by exercise, or a spike caused by stress or growth hormones can result in a turbulent night’s sleeping in Leo.”
“The different is that his age is getting him more involved in the management of his own affairs, and he’s not as well at sleeping as he was. It’s like due to having type one diabetes, he can’t get enough sleep,” she adds.
The sleep problem is all too familiar for Abby Burch of northern Indiana, who lived with T1D for nine years. Abby Burch tells DiabetesMine that “I’ve been up and down to pee during the night and was in tears on the bathroom since I was unable to make the toilet paper fall away… Then I realized that I was awake because I was dehydrated but not because I needed to go pee.”
Even if you’re neither high nor low, managing your diabetes all day can disturb sleep, mainly if you do not continuously monitor glucose (CGM).
Kiran Kumar, of Faridabad, India, tells DiabetesMine, “My child was just diagnosed with T1D on August 2020. However, since we’re not yet connected to the CGM, We’ve been instructed to monitor your blood sugar twice throughout the night, once between two a.m. and another time after five a.m.” This takes an impact on the entire family’s sleeping.
“Another limitation to a restful night is that you administer his insulinat 10:00 in the night. This requires all family members to be awake, and with alarms on several devices. It has also significantly impact on the quality of sleep and the quantity.”
Recent calls for sleep guidelines to T1D
These problems have prompted experts and researchers to advocate for new sleep guidelines for those suffering from T1D (and, in some instances, their family members). Dr. Michelle Perfect, associate professor of psychoeducational studies and disability at the University of Arizona, has been vocal about her need for specific recommendations for sleep screening for people suffering from T1D after reviewing more than 60 studies related to sleep.
In an article that she published within the journal Nature and The Science of Sleep, She states that there is an overwhelming amount of evidence to show that good sleep is linked to healthy outcomes for those suffering from T1D. She recommends that quality and quantity of sleep must be taken into consideration when you have regular health screenings for patients who suffer from T1D (just as getting your blood pressure or weight taken, for instance.).
A few tools she recommends to evaluate sleep in the clinical setting are The Children’s Sleep Habit Questionnaire and the Pittsburgh Sleep Quality Index for children. In addition, she has advised that CGMs provide crucial insight into the patterns of sleep (as blood sugar levels that are high or low could impact REM cycles). She adds that adjusting insulin levels before bed could help prevent blood sugar imbalances.
She is a proponent of more studies to determine the relationship between better management of T1D and better sleep.
Additionally, Dr. Samantha Carreon, a pediatric psychologist from the Resilience and Diabetes Behavioral Research Lab in Houston, Texas, presented research at the 2021 American Diabetes Association’s Scientific Sessions. It shows that parents of children who had T1D faced more challenges with sleep in the COVID-19 epidemic than pre-pandemic periods, even though there were fewer sleep disruptions and minor impairment.
This could be because of new pandemic-related stressors causing panic, different routines that are often unpredictable, and more demanding management of T1D in these incredibly challenging times.
How can you get better (and much more!) sleep
So, what do we do accomplish in the face of all this?
Diabetes experts, such as Adam Brown, have written extensively on the importance of sleep for people with diabetes. Brown was the former diabetes technology editor at diaTribe and the author of the hand-held guidebook on living in T1D and using technology to get better health outcomes.
In one of his articles, he says: “Lack of sleep gets very little attention in the world, especially in the field of diabetes. I would like to see this article highlight the tragic error that it is. Happily, the issue of sleep is something that can be fixed; there are effective free, effective, and inexpensive ways to make it better!”
He is currently telling DiabeteMine the following “my personally No.1 sleep aid for me is an automated insulin delivery system or hybrid closed loop. I’ve started the the [Tandem DiabetesControl-IQ System this morning and am expecting my sleep success to be the same! The other recommendation that I can offer to increase sleep is to cut down on caffeine consumption, especially at 2 p.m.”
Making good sleep habits takes some time, says the author; however, the following tips can assist you in improving your sleep and help improve not just the management of diabetes but also your overall health too:
- Take a walk in the sunshine and exercise regularly to get tired at the end of the day.
- Beware caffeine (coffee, soda, tea, etc.) in the afternoons and evenings.
- Limit your liquid intake in the evenings to don’t have to use the bathroom throughout the night.
- Avoid naps.
- Make sure you follow a routine for sleeping by sleeping in the evening and rising in the same order each day, even on weekends.
- Make sure to check your blood sugar levels right before bed and make sure that it’s within a healthy limit for you.
- Remove unnecessary notifications from your smartphone (keep the CGM or insulin pump alerts active but do not turn off insulin pump notifications!)
- Reduce your thermostat to 65 degrees Fahrenheit (18degC).
- Make sure you invest in high-quality curtains to ensure that your bedroom is as dark as it can be.
- Relax in a warm bath before going to you go to bed.
- Ensure that your pets are kept out of your bedroom, especially off your bed.
- Avoid screens before bed (especially watching newspapers or checking work emails that can increase anxiety).
- Consume foods that contain melatonin like cherries, oatmeal and pomegranate, and walnuts. You can also eat grapes or walnuts.
- Make a night-time routine that includes meditation or yoga, reading, or writing before going to bed.
- Make sure you invest in purchasing a White noise maker to assist you in getting to go to sleep.
- Check out Sleep As Android, a Sleep as Android application that tracks patterns of sleep and tracks deep sleep percentage and notifications for time for bed as well as snooze limits, sleeping recommendations, and more.
- Check out your hand at the Hatch Gentle Alarm Clock, which mimics the sunrise to get you up instead of abrupt, loud alarms like the traditional alarm clock. It has soothing sound effects, too, to provide an unwinding and natural way of waking up.
If the strategies you’ve tried aren’t successful, you should consult with your health care provider to determine whether other strategies might be needed to increase how much and quality of sleep you get.
The bottom line
All types or forms of diabetes may be prone to sleeping disorders than those who do not suffer from the condition. As time passes, inadequate sleep can lead to various health issues such as increased risks of heart disease, obesity, stroke, and premature death.
The population further exacerbates the issues with T1D due to poor sleep, which leads to insulin resistance, decreased immunity, greater hunger, poorer decision-making, and a higher chance of accidents. This can result in an even more challenging diabetes management.
Many people are soliciting screening for sleep disorders in people suffering from T1D to detect the various conditions that range from sleep apnea to the nocturia syndrome and restless legs syndrome and, therefore, early intervention can be implemented. Early intervention can enhance the overall health and overall health and significantly improve the management of diabetes and clinical outcomes.
If you notice that T1D is affecting your ability to rest well, Don’t ignore it. There are ways to improve your sleep and your overall quality of life.
