Sleep and Diabetes
Wherever you live, no matter the climate, whatever job you have or family commitments, we all need sleep; and we all sleep differently.
Some like to create a huge nest, comprising of literally thousands of cushions (here’s looking at you ladies), others prefer minimalist, perhaps with just a single pillow. Some sleep for 9 or 10 hours and others seem to get by with only 4 or 5. Whatever the case, we love our little den where we can forget about life’s stresses and dream of a time which didn’t involve bills, commitments, disease or responsibility in general. Adulting is tough.
Then there‘s adulting with diabetes.
Open any self-help, get rich quick or entrepreneur book and there is a chapter on sleep. Historically, we have looked at success and lack of sleeping as partners - “oh, John only sleeps an hour a night, then he’s back up working and making his millions”. It’s almost been a right of passage in some industries where new staff are expected to stay late and work seven days a week. That is until people started getting sick and in some cases, dying.
We have learnt a lot about sleep in recent years and it’s huge benefit for our overall health. But is it so important that diabetics need to take notice? Why yes, yes it is.
What happens when we don’t get enough sleep?
You know the feeling; You’ve worked all day and then something comes up at night which has resulted in you getting little to no sleep. Maybe your child was sick or you were studying for a big test.
The next day it’s hard to concentrate, you’re irritable, moody, even simple tasks are more difficult to accomplish. That’s one day without proper sleep.
In the workplace, it leads to reduced productivity and efficiency, errors and accidents.
Studies have shown chronic sleep deprivation leads to increased risk of high blood pressure, mental health disorder, stroke, cardiovascular disease, type 2 diabetes, and even early mortality.
Diabetics face the added ‘bonus’ of erratic blood sugars when sleep deprived. This often lasts the entire next day or at least until we‘ve caught up on our sleep.
Lack of sleep also impacts our immune system, so you’re more susceptible to getting sick. Any diabetic knows that this is something to be avoided at all costs as we risk unstable, high blood sugars and rising ketones.
Reduced sleep can also result in weight gain. This may be because people who are sleep deprived have lower levels of leptin (the chemical that makes you feel full), and increased levels of ghrelin (a hormone that stimulates hunger). Regardless of what type of diabetes you have, putting more food on your plate than you need isn’t good for you and places you at increased risk of hyper and hypo-glycemia.
So we‘ve identified a few annoying and some more serious consequences of a lack of sleep, is there anything else we need to watch out for?
Well, a common stressor with diabetes is overnight hypoglycemia. The insurgence of CGM’s has decreased the risk slightly as we can be woken up by an alarm telling us our blood sugars are going too low or high, but that doesn’t solve the problem - it puts a band-aid on it.
The major cause of overnight hypos is insulin. The medicine that keeps us alive is also a major contributor to added stress.
Reducing evening meal bolus and perfecting our basal requirements and times of injection are very important.
If you’re in constant fear of an overnight hypo, the quickest and simplest way to reduce this risk is to eat a low carb dinner and bolus less. It really is that simple, and the impact can be profound on your quality of sleep but also your mental health.
Note: Not all diabetics can eat a low carb meal, bolus less and solve this problem. Brittle diabetics face a tougher path and there are many factors that can play a role, like exercise, stress and sickness.
Perfecting your basal is a bit more tricky as you’ll need to test, and test again. One, two or three injections a day? Speak with your medical team, write down all meals, blood sugars, basal and bolus injections in a log book for a couple of weeks and assess trends, impacts of food, exercise, sleep etc.
Once you’re confident in your insulin regimen, you can start on trialling different meals for dinner and checking your blood sugars overnight (3am) a couple of times to see what they’re doing whilst you sleep.
This really is the best and simplest way to ease the stress of overnight hypoglycemia.
Benefits of a good night sleep
When we sleep our body repairs itself. It also builds new connections in your brain helping memory function. Here’s a list of benefits of proper rest:
1) Reduces stress
2) Lowers Blood pressure
3) Strengthens immune system
4) Increases sex drive / libido
5) Helps you lose weight
6) Increases mood
7) Decreases risk of anxiety and depression
As you can see, diabetics need their sleep. It has so many positive effects on our health, we can’t ignore it. Deep, uninterrupted sleep needs to be part of a healthy, daily routine.
So next time you’re lying in bed, phone in hand scrolling, then scrolling some more, think about what time you need to be up and whether you’re really going to achieve a full nights rest, because if you do, your blood sugars will thank you by being more stable and lower the next day. You’ll also decrease you chances of fatigue and it’s related side effects. Add the fact you’ll get sick less often, be more productive in work, have better memory and have a better sex life.
Who would have thought getting more sleep improves your sex life? Maybe my wife has been right all these years.
Believe the hypo