Diabetes and Sleep

How can sleep affect diabetes?

Research has shown that there is a link between diabetes and not getting a good night’s sleep. You may find that you have difficulties falling asleep, staying asleep, or that you sleep for too long.

A lack of sleep can also increase your risk of getting type 2 diabetes or cause more problems if you already have it. So, what’s the reason behind this?

Raised blood glucose levels

If you are tired, the hormone that regulates your blood glucose level, insulin, doesn’t work as well. Other hormones that your body produces when you are stressed also impact how well insulin works, so this can cause blood glucose levels to increase.

If you’re tired during the day, it’s common to compensate for the lack of sleep through food to get a boost of energy. This can lead you to you eating more than normal or eating calorie-dense foods such as sugary snacks and carbohydrates to get that energy your body is looking for. This can also cause your blood glucose levels to increase.

A lack of sleep also increases your risk of obesity and consequently, being overweight or obese also increases your risk of developing type 2 diabetes.

How can diabetes affect sleep?

Unless your blood glucose levels go very high or very low (hypo), it is unlikely to affect your sleep patterns.

High blood glucose

If blood glucose levels are very high;

Low blood glucose

Low blood glucose levels can also have an impact on your sleep. If you use insulin or sulphonylureas (tablets with names like gliclazide) you may be at risk of low glucose levels (hypoglycaemia or ‘hypos’). If you have a hypo (blood glucose <4mmol/L) during sleep, it will often wake you up, and you may feel sweaty, shaky and hungry.  

Chronic low blood glucose levels overnight will affect your quality of sleep. If you are at risk of overnight hypos, then it is important to keep a blood glucose meter and hypo treatment at the side of your bed. If you are having regular overnight hypos, you should speak to your healthcare team as you may need to adjust your diabetes treatment.

Sleep conditions related to diabetes

There are some sleep disorders that are associated with diabetes. These include:

• Sleep apnea

This is a condition that affects your breathing when you sleep and is characterised by loud snoring and pauses in breathing. This can be due to excess weight which causes deposits of fat to build up in the upper airway which obstructs your airway.

Speak to your GP or healthcare team if this affects you. Losing weight if you’re overweight can help, and there are treatments such as wearing a breathing device when you sleep which will provide oxygen into your airways.

• Restless leg syndrome (RLS)

This can be described as a crawling, itching or tingling sensation in your legs which comes on when you are resting. This feeling causes you to constantly move your legs which can make it difficult to fall asleep or stay asleep.

There are a number of things that can cause RLS including high blood glucose levels, a deficiency in iron and problems with your kidney or thyroid. Smoking and caffeine can also cause RLS. Regular exercise, leg massages and using a cold cloth on them can help but speak to your GP or healthcare team if this continues to affect you.

Is there anything I can do to help me sleep better?

There are a number of things you can do to help you get a better night’s sleep, which includes:

Keep your blood glucose under control:

For the reasons we’ve discussed above, this is a very important factor for improving your sleep.

Avoid all electronic devices:

The blue light that emits from devices (including TVs) suppresses the natural production of melatonin– the hormone you need to feel sleepy – and disrupts your body’s natural sleep and wake cycle, making it harder to fall asleep and stay asleep.

Avoid napping:

If you nap during the day this disrupts your sleep pattern which can stop you from falling asleep when you go to bed.

Stay away from stimulants:

Caffeine, smoking, working and exercising late at night all stimulate the body which will make it harder to fall asleep.

Implement a routine:

Having a regular time when you wake up and go to sleep will get your body into a natural rhythm.

Wind yourself down:

Reading a book or listening to relaxing music in bed can help calm your mind and thoughts.

Remove distractions:

Put your phone on silent or leave it in a different room so you aren’t disturbed by notifications. If you use it as an alarm it’s worth investing in an alarm clock so you can completely switch off from any distractions.

Doing some physical activity:

Try and do some physical activity during the day as it promotes better sleep at night.

Room temperature:

Make sure your room is not too warm and well ventilated.

Further resources

For further information about sleep and tiredness in general, have a look at the NHS website.