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How Blood Sugar Affects Your Sleep: Diabetes And Sleep Trouble

 
Medically reviewed by
Dacelin St Martin, MD
Triple board-certified in Sleep Medicine,
Internal Medicine, and Pediatrics.

 
 
Diabetes And Sleep | Sleep Disorders Related to Diabetes | How Diabetes Affects Your Sleep | How Can People With Diabetes Improve Their Sleep?

 

Overview

For people with diabetes, sleeping well at night can be a challenge. Just as sleep deprivation can increase the risk of becoming diabetic, diabetes may be why you can’t sleep. What’s the link between diabetes and sleep? 

People with high blood sugar are more likely to develop sleeping problems such as obstructive sleep apnea (OSA), restless legs syndrome (RLS), and insomnia. 

Diabetes symptoms, such as hyperglycemia, hypoglycemia, and depression, may trigger these sleep disturbances. So how can you deal with diabetes-associated sleep problems?

Following a healthy diet, exercising regularly, monitoring your blood sugar, maintaining a healthy weight, and managing your stress levels can help get your blood sugar down naturally and get a better night’s rest. 

Continue reading to learn more about the link between diabetes and sleep and how you can manage your blood sugar at home to sleep better. 

 

Diabetes And Sleep

Diabetes is a chronic health condition characterized by high blood sugar levels (hyperglycemia). It occurs because the body is unable to produce or properly use insulin. 

Over time, having too much glucose in the bloodstream can lead to serious health complications, such as heart disease, kidney disease, and vision loss.[1]

Studies also show an intricate relationship between sleeping difficulties and high blood glucose levels. Sleep disturbances can significantly increase the risk of developing diabetes, and conversely, high blood sugar can disrupt your sleep.[2] 

Researchers found that people with obstructive sleep apnea (OSA) are more likely to develop insulin resistance and hyperglycemia.[3]

Moreover, clinical research showed that up to one-third of patients with type 2 diabetes (Diabetes Mellitus) suffer from some form of sleep troubles, including difficulty falling asleep, difficulty maintaining sleep, and poor sleep quality.[4]


 

Sleep Disorders Related to Diabetes

Several sleep disorders are more common in people with high blood sugar,[5] such as:

●      Obstructive Sleep Apnea: A study published in 2009 showed that over 86 percent of patients with diabetes also had obstructive sleep apnea.[6] Another medical evaluation assessment in 2019 estimated that one of every four diabetic patients also suffers from OSA.[7] 

●      Restless Legs Syndrome: One study published in 2018 found that over 28 percent of the patients had type 2 diabetes in addition to restless leg syndrome (RLS) – a condition that disrupts sleep.[8]

●      Insomnia: A systematic review was conducted in 2018 and revealed that 39 percent of diabetic patients also had insomnia – a common sleep disorder. 

 

How Diabetes Affects Your Sleep

Being diabetic doesn’t necessarily mean you’re going to toss and turn in bed all night; however, some diabetes symptoms can cause issues when you’re trying to sleep:

●      Frequent Urination: If you have high blood sugar (hyperglycemia) at night, you’ll often feel the urge to urinate.[9] Constantly getting out of bed to use the bathroom can make it difficult to fall back asleep or maintain a good night’s sleep. 

●      Thirst: People with diabetes often have too much sugar in their bloodstream. Excessive blood sugar draws out more water from the tissues, which can cause feelings of thirst and dehydration.[10] Consequently, blood sugar spikes at night can regularly wake you up feeling thirsty and needing a glass of water. Moreover, more water means more toilet visits at night. 

●      Hypoglycemia: Low blood sugar (hypoglycemia) is a common side effect of diabetes treatments. A drop in blood sugar levels at night can cause nightmares, sweating, shakiness, and drowsiness, disrupting your sleep.[11]  

●      Depression: Depression is around three times higher in people with diabetes than non-diabetics.[12] Moreover, about 90 percent of patients with depression have trouble sleeping.[13] Therefore, feelings of depression can lead to sleep trouble in diabetic patients.    

 

How Can People With Diabetes Improve Their Sleep?

Sudden changes in your blood sugar at night can cause discomfort when trying to rest and prevent you from sleeping well. Fortunately, there are several tips to lower your blood sugar levels naturally and improve sleep: 

●      Diet: The number of carbs you eat affects the glucose levels in your blood.[10] On the other hand, food rich in fiber can slow down carbohydrate digestion and regulate your blood sugar.[14] 

In addition, foods rich in chromium (meats, fruits, vegetables, nuts) and magnesium (tuna, bananas, avocado, beans) can reduce the risk of blood sugar problems.[15] Follow a balanced diet plan to control your blood sugar and improve your sleeping. 

●      Exercise: Regular physical activity can increase insulin sensitivity. Thus, when you exercise regularly, your body will be able to stabilize your blood glucose and reduce hyperglycemia during sleep.[16] 

●      Maintain a Healthy Weight: Maintaining a moderate and healthy weight can help you manage your blood sugar and prevent any associated sleeping difficulties.[17] Losing only 5 percent of your body weight can significantly improve your blood glucose levels and decrease the need for diabetes medication.[18]

●      Keep an Eye on Blood Sugar Levels: Regularly monitoring your blood glucose can help you manage it better. Check your blood sugar at different times during the day and before you go to bed. 

If your blood glucose is higher before bed than during the rest of the day, then you probably need to adjust the meals you eat around the evening or at dinner. Then, you can modify your insulin intake and manage your diabetes medications accordingly.  

●      Stay Hydrated: Drinking water regularly can help stabilize your blood glucose and prevent hyperglycemia.[19] Water helps your kidneys flush out extra sugar through the urine and lower blood glucose levels.  

●      Manage Stress Levels: When stressed, your body releases glucagon and cortisol – hormones that can increase blood sugar levels.[20] Practice meditation and relaxation exercises to reduce stress, keep your blood glucose in check, and get a better night’s sleep. 

●      Practice Good Sleeping Habits: You can follow several sleeping habits to improve your sleep quality. Healthy sleeping habits include following a sleep schedule, avoiding stimulants (caffeine, alcohol, nicotine) around your bedtime, and cutting down on screen time before bed.

You can also optimize your sleeping space by keeping your bedroom cool, dark, and quiet for good quality sleep. 

 

What’s the Takeaway?

If you have diabetes and can’t sleep well at night, contact a sleep specialist near you to learn more about ways to sleep better when you have diabetes.

Living with diabetes can compromise your sleep, and lack of sleep can make it harder to manage your diabetes. 

Consequently, many patients become trapped in a vicious cycle of less sleep and worse diabetes symptoms, which can lead to life-threatening health consequences.

 

References:  

  1. CDC. What is Diabetes? Centers for Disease Control and Prevention. Published July 7, 2022. Accessed August 18, 2022. https://www.cdc.gov/diabetes/basics/diabetes.html
  2. Chattu VK, Chattu SK, Burman D, Spence DW, Pandi-Perumal SR. The Interlinked Rising Epidemic of Insufficient Sleep and Diabetes Mellitus. Healthcare. 2019;7(1):37. doi:10.3390/healthcare7010037
  3. Ogilvie RP, Patel SR. The Epidemiology of Sleep and Diabetes. Curr Diab Rep. 2018;18(10):82. doi:10.1007/s11892-018-1055-8
  4. Surani S, Brito V, Surani A, Ghamande S. Effect of diabetes mellitus on sleep quality. World J Diabetes. 2015;6(6):868-873. doi:10.4239/wjd.v6.i6.868
  5. Sridhar GR, Madhu K. Prevalence of sleep disturbances in diabetes mellitus. Diabetes Res Clin Pract. 1994;23(3):183-186. doi:10.1016/0168-8227(94)90103-1
  6. Foster GD, Sanders MH, Millman R, et al. Obstructive Sleep Apnea Among Obese Patients With Type 2 Diabetes. Diabetes Care. 2009;32(6):1017-1019. doi:10.2337/dc08-1776
  7. American Diabetes Association. 4. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020;43(Suppl 1):S37-S47. doi:10.2337/dc20-S004
  8. Akın S, Bölük C, Türk Börü Ü, et al. Restless legs syndrome in type 2 diabetes mellitus. Prim Care Diabetes. 2019;13(1):87-91. doi:10.1016/j.pcd.2018.08.006
  9. Gundamaraju R, Vemuri R. Pathophysiology of Greedy Colon and Diabetes: Role of Atropine in worsening of diabetes. Euroasian J Hepato-Gastroenterol. 2014;4(1):51-54. doi:10.5005/jp-journals-10018-1096
  10. Goyal R, Jialal I. Diabetes Mellitus Type 2. StatPearls Publishing; 2022. Accessed August 18, 2022. https://www.ncbi.nlm.nih.gov/books/NBK513253/
  11. Hyperglycemia and Hypoglycemia in Type 2 Diabetes. Institute for Quality and Efficiency in Health Care (IQWiG); 2020. Accessed August 18, 2022. https://www.ncbi.nlm.nih.gov/books/NBK279510/
  12. Roy T, Lloyd CE. Epidemiology of depression and diabetes: a systematic review. J Affect Disord. 2012;142 Suppl:S8-21. doi:10.1016/S0165-0327(12)70004-6
  13. Fang H, Tu S, Sheng J, Shao A. Depression in sleep disturbance: A review on a bidirectional relationship, mechanisms and treatment. J Cell Mol Med. 2019;23(4):2324-2332. doi:10.1111/jcmm.14170
  14. Vlachos D, Malisova S, Lindberg FA, Karaniki G. Glycemic Index (GI) or Glycemic Load (GL) and Dietary Interventions for Optimizing Postprandial Hyperglycemia in Patients with T2 Diabetes: A Review. Nutrients. 2020;12(6):1561. doi:10.3390/nu12061561
  15. Mehri A. Trace Elements in Human Nutrition (II) – An Update. Int J Prev Med. 2020;11:2. doi:10.4103/ijpvm.IJPVM_48_19
  16. Richter EA, Sylow L, Hargreaves M. Interactions between insulin and exercise. Biochem J. 2021;478(21):3827-3846. doi:10.1042/BCJ20210185
  17. CDC. Manage Blood Sugar. Centers for Disease Control and Prevention. Published April 28, 2021. Accessed August 18, 2022. https://www.cdc.gov/diabetes/managing/manage-blood-sugar.html
  18. Aras M, Tchang BG, Pape J. Obesity and Diabetes. Nurs Clin North Am. 2021;56(4):527-541. doi:10.1016/j.cnur.2021.07.008
  19. Roussel R, Fezeu L, Bouby N, et al. Low Water Intake and Risk for New-Onset Hyperglycemia. Diabetes Care. 2011;34(12):2551-2554. doi:10.2337/dc11-0652
  20. Dias JP, Joseph JJ, Kluwe B, et al. The longitudinal association of changes in diurnal cortisol features with fasting glucose: MESA. Psychoneuroendocrinology. 2020;119:104698. doi:10.1016/j.psyneuen.2020.104698
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