Worried asian woman in bed unable to sleep

If you have diabetes, you may have problems sleeping well. This is because diabetes is linked to a number of factors which can contribute to sleep problems. Understanding how diabetes and sleep are related can help you manage your diabetes better.

How Does Diabetes Rob Me of a Good Night’s Sleep?

Business woman yawning while at work

Blood glucose levels which are too high or too low can both interfere with your sleep. The symptoms of high blood glucose may cause you to wake up several times at night to get a drink or use the toilet. Low blood glucose may also disturb your sleep by causing you to wake up at night drenched in sweat or feeling shaky, dizzy or hungry.

Nerve damage and blockage to blood vessels carrying blood to your legs as a result of diabetes complication, can cause painful cramps in your feet and keep you awake at night.

Other factors disrupting your sleep may include worrying over issues related to the long-term care of your diabetes such as the cost of treatment and hospitalisation, as well as uncertainty over your future and family care.

In addition, certain sleep disorders (problems) are more common among people with diabetes[1]. Sleep problems such as those described in the table below can stop you from enjoying a deep, restful sleep. If you have any of these, see your doctor who can assess what might be causing the problem.

Sleep Disorder

What Happens

Treatment

Sleep apnoea

Your airway closes in your sleep and causes you to snore, stop breathing or wake up choking or gasping for breath. If this happens too often, it can prevent you from going into a deep sleep. A common type of sleep apnoea is obstructive sleep apnoea, and is more commonly seen in people who are overweight or obese.

Lose weight, change your sleeping position, review your diabetes medications, or use a special device to help you breathe during sleep.

Restless legs syndrome

You are kept awake by a tingling feeling in your legs that makes you want to move or stretch. Moving your legs relieves you of the annoying sensation for a while only to have it return the moment you stop moving your legs. This is believed to be the result of diabetic neuropathy (nerve damage).

Stretch and take a warm bath before going to bed, take medications, or take iron supplements.

Insomnia

You have problems falling asleep, or you may find yourself waking up frequently in the night. This might be caused by depression, anxiety, stress and worry, frequent urination or could be due to the effects of medications.

Treat the underlying cause. For example, by managing stress or treating the cause of frequent urination.

Related: Being Hospitalised When You Have Diabetes

Can a Lack of Sleep Cause Diabetes?

Senior woman sitting on the couch and having a cup of tea

Studies[2] have found that people with sleep problems such as difficulty falling or staying asleep, sleeping fewer than five to six hours a night or more than eight to nine hours, are more likely to develop Type 2 diabetes than sound sleepers.

Why is this so?

It seems that poor sleep can increase insulin resistance[4], making it harder for your body to move glucose from the bloodstream into the cells.

Another reason is that sleep deprivation increases the likelihood of weight gain and obesity, which is a risk factor for Type 2 diabetes[4]. In one study[5], women who slept less than six hours a night and more than nine hours a night were more likely to gain weight compared to women who slept seven hours a night.

When you do not sleep enough and feel tired through the day, you are more likely to reach for comfort foods (coffee and snacks) to stay awake and are less likely to exercise. These can raise your blood glucose levels which interfere with sleep, creating a vicious cycle.

In addition, a lack of sleep disrupts the hormones that regulate your appetite and hunger, and control the amount of food you eat.

Related: Are You Getting Enough Sleep?

When Should I Seek Help?

Young man yawning while working

If you persistently:

  • wake up in the morning not feeling refreshed
  • wake up with a headache
  • feel sleepy and tired during the day
  • have no energy to exercise or take care of your diabetes

It is time to seek help and see a doctor. If you don’t get treatment for your sleep problems, you are going to find it harder and harder to cope with your day-to-day diabetes care.

Consider one or more lifestyle changes to improve your sleep. Even one small change can make a big difference as long as you keep at it every day until it becomes a habit. Don’t let diabetes rob you of your sleep.


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References

  1. Plantinga, L., Rao, M. N., Schillinger, D. (2012). Prevalence of self–reported sleep problems among people with diabetes in the United States, 2005–2008. Preventing Chronic Disease.
    Retrieved from https://www.cdc.gov/pcd/issues/2012/11_0244.htm

  2. Shan, Z., Ma, H., Xie, M., et al. (2015). Sleep duration and risk of type 2 diabetes: A meta-analysis of prospective case studies. Diabetes Care. 38(3), 529–537.
    Retrieved from http://care.diabetesjournals.org/content/38/3/529

  3. Knutson, K. L., Ryden, A. M., Mander, B. A., Cauter, E. V. (2006). Role of sleep duration and quality in the risk and severity of type 2 diabetes mellitus. Archives of Internal Medicine. 166(16), 1768–1774.
    Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/16983057

  4. Ohkuma, T., Fujii, H., Iwase, M., et al. (2013). Impact of sleep duration on obesity and the glycaemic level in patients with type 2 diabetes. Diabetes Care. 36(3), 611–677.
    Retrieved from http://care.diabetesjournals.org/content/36/3/611

  5. Patel, S. R., Malhotra, A., White, D. P., Gottlieb, D. J., Hu, F. B. (2006). Association between reduced sleep and weight gain in women. American Journal of Epidemiology. 16410, 947–954.
    Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3496783/