Ways to Sleep Better With Diabetes

Sad but true: If you have diabetes, quality sleep may be hard to get.

However, you should work with your doctor to try and pinpoint just what’s causing your sleep problems.

“While a good night’s sleep and maintenance of a healthy weight are good for everyone, those good habits promise special health benefits for people with diabetes,” says Dr. Paris Roach, an endocrinologist with Indiana University Health in Indianapolis.

There are a few reasons why you may not get the restful sleep you need when you have diabetes.

First, major swings in your blood sugar at night can disrupt your sleep. “Very high blood glucose levels can lead to excessive urination, and sleep may be interrupted by frequent visits to the bathroom if blood sugar is poorly controlled,” Roach says. If your blood sugar gets too low at night, symptoms like restless sleep, excessive sweating and a pounding heart can occur.

A common condition called sleep apnea is more common when you have diabetes. “Apnea literally means ‘not breathing,’ and sleep apnea refers to brief periods of a minute or two when breathing is extremely shallow or absent during sleep,” Roach says. Usually, it’s a partner who spots this problem because you’re snoring or breathing shallowly at night. However, you also may feel fatigue or sleepiness during the day or have trouble concentrating.

Sleep apnea increases your chance of a heart attack and stroke, and the more severe the sleep apnea, the more severe the risk for diabetes, says Dr. Christopher Winter, medical director of Sentara Martha Jefferson Hospital Sleep Medicine Center in Charlottesville, Virginia, and author of “The Sleep Solution: Why Your Sleep Is Broken and How to Fix It.”

Another common problem in some people with diabetes is diabetic neuropathy. That can cause painful sensations in the feet like burning or stinging that can disrupt sleep. Another sleep disorder called restless legs syndrome can cause an urge to move your legs when you fall asleep. “Diabetic neuropathy and restless legs syndrome can be present in the same person, making the two sometimes difficult to separate diagnostically,” Roach says.

Because of these problems, insomnia is often more common in people with diabetes, says Dr. Rajkumar Dasgupta, an assistant professor of clinical medicine at Keck Medicine of USC in Los Angeles. Insomnia also can occur as a side effect of certain medications such as antidepressants – and depression can be more common in people with chronic diseases such as diabetes.

That lack of sleep can cause an increase in stress hormones, which then make it harder to control your weight. It can start a tricky cycle that connects to diabetes, obesity and sleep deprivation, Dasgupta explains.

To find out what’s causing your sleep issues, your doctor will likely recommend a sleepstudy. During a sleep study, your heart rate, body movements and brain activity are monitored to see how well you sleep and to determine what may cause your sleepproblems. Although these tests are often done in a lab, they can also now be done at home, Dasgupta says. This makes these tests more common and less of a hassle.

It’s important that you get treatment for any sleep disorders so you can have deeper rest at night and better function during the day. For example, if your doctor says you have sleep apnea, one common treatment is a CPAP mask, short for continuous positive airway pressure. You wear the mask over your mouth and/or nose, and it helps provide pressure to the upper airway so it stays open during sleep. “Most people can be fitted with a mask they can sleep with comfortably and are often surprised how much better they feel during waking hours when their sleep apnea is effectively treated,” Roach says.

Sleep apnea treatment may help with blood sugar control, insulin resistance and other signs associated with heart disease, Winters says. Also, losing weight can help improve and possibly eliminate sleep apnea.

For less-severe sleep apnea, doctors may recommend a dental device that moves your jawbone slightly forward while you sleep.

For blood sugar swings, some people will use a continuous glucose monitoring device, Roach says. Another solution is waking up once or twice at the night for a week to check your blood sugar and track trends. Usually, adjustments in medication or diet can help address this problem.

For RLS, your doctor may prescribe medications. You may also have to get your iron level checked, as that can contribute to the problem, especially in premenopausal females, Dasgupta says. If you smoke and you have RLS, there’s yet one more reason to quit: Smoking cessation can help alleviate the problem, Roach says.

There are some things you can do on your own to help improve your sleep:

Make sleep a priority. Sleep at consistent times and in adequate amounts, advises says Susan M. De Abate, a nurse and certified diabetes educator and team coordinator of the diabetes education program at Sentara Virginia Beach General Hospital. Many Americans are not getting the recommended seven to eight hours. Make a commitment to better sleep.

Sleep in a dark, quiet cool room, De Abate recommends. And put the technology away, as it can work against going to sleep.

Avoid sleep medications. They can make sleep apnea worse and have other side effects.

Use your bed for sleep only. If you have trouble going to sleep after 15 to 20 minutes, leave the bed and go read a book (preferably not on a tablet or electronic device, Dasgupta cautions). Do something that’s not stimulating for your brain.

Make exercise a habit. It will help you sleep better at night.

Talk about sleep problems with your doctor. Dasgupta sees a lot of focus on what’s happening in patients’ lives during the day and how that relates to health problems, but he’d like more talk about sleep issues. By diagnosing and treating sleep issues, you can improve your quality of life and your health, he says.