Key takeaways:
About 1 in 3 people with diabetes have a related sleep disorder.
The most common diabetes-related conditions and symptoms that affect sleep are excessive urination, low blood sugar, high blood sugar, peripheral neuropathy, restless leg syndrome, sleep apnea, and depression.
If you have diabetes, creating a healthy nighttime routine and practicing good habits throughout the day are important.
Sleep and diabetes are very connected: Studies show that around 1 in 3 people with diabetes have a related sleep disorder. Getting fewer than 6 hours of sleep per night can also increase blood sugar levels and contribute to insulin resistance and diabetes.
The good news is that following a few good sleep hygiene tips can help with some of the symptoms that may be keeping you up at night.
The most common diabetes-related conditions that can affect sleep are:
Excessive urination (polyuria)
Low blood sugar (hypoglycemia)
High blood sugar (hyperglycemia)
Peripheral neuropathy
Restless leg syndrome
Sleep apnea
Depression
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Polyuria, or excessive urination, is one of the most common signs of diabetes. And it’s often the first symptom people notice.
When blood sugar is high, the kidneys try to balance levels by pulling in more water and creating more urine. This frequent need to pee can wake you up throughout the night. Nighttime polyuria, or nocturia, may also be connected to sleep apnea.
Blood sugar fluctuations are a hallmark symptom of diabetes. They’re also one of the most common causes of interrupted sleep.
“Low sugar can cause vivid dreams or nightmares. It can also cause restless sleep and sweating,” says Romy Block, MD, a board-certified specialist in endocrine and metabolism medicine. “High sugars can disturb sleep by causing frequent urination and thirst.”
Peripheral neuropathy refers to nerve damage in the peripheral nerves, or any nerves outside of the brain and spinal cord. Diabetes is the leading cause of peripheral neuropathy, and more than half of people with diabetes experience it.
“Many people with diabetes suffer from neuropathy, which can cause burning or numbness in your hands and feet. This can make it difficult to fall or stay asleep,” says Dr. Block.
Also called Willis-Ekbom Disease, restless leg syndrome causes uncomfortable feelings in the legs and an intense need to move them. While it can happen any time of day, it’s most severe at night when someone is relaxing or lying in bed.
Restless legs syndrome is one of the most common causes of sleep deprivation, and it affects people with diabetes at a much greater rate.
More than half of those with Type 2 diabetes also have obstructive sleep apnea (OSA), and your risk for OSA goes up even more if you’re overweight.
This sleep disorder develops when the muscles in the back of the throat and tongue become too relaxed and block the airway, preventing normal breathing patterns. People with obstructive sleep apnea can wake up 5 to more than 30 times per hour throughout the night.
“Many overweight people suffer from this condition, and even if they get enough sleep (hours-wise) they don't feel rested because they are not getting quality sleep,” says Kimberly Gomer, MS, RD/LDN, nutrition director at Body Beautiful Miami and former director of nutrition at the Pritikin Longevity Center.
People with diabetes are more likely to develop depression than those without diabetes, according to a 2017 report. While many people associate depression with too much sleep, it’s actually one of the leading mental health-related causes of insomnia and poor sleep quality.
Good sleep habits (often referred to as sleep hygiene) can help improve your chances of getting a better night’s sleep. While many of these tips apply to anyone, there are some specific things people with diabetes can do to get some quality shut-eye.
Regularly checking your blood sugar level is one of the most important things you can do to get better sleep and improve your health in general.
“Monitoring your sugars during the day and before bedtime allows for corrections and improved control. Continuous glucose monitors can also help,” says Dr. Block, who recommends regular visits with your physician to make sure you have the right tools and education to maintain a healthy blood sugar level.
Your nutrition has a major impact on your blood sugar levels.
“The most effective way to keep blood sugar steady throughout the day and overnight is to keep insulin as low as possible,” says Gomer. “This means eating enough protein and vegetables, limiting carbohydrate intake, and avoiding processed carbohydrates, which spike blood sugar. In some individuals who are very carbohydrate intolerant, [this even means] limiting what we think of as healthier carbohydrates such as fruit and whole grains.”
It’s also a good idea to:
Eat dinner earlier in the day.
Limit the amount of carbohydrates in your dinner meal and nighttime snack.
Eat more protein at dinner time or with a nighttime snack.
Go out for a light walk after dinner. Even just 2 to 5 minutes can help lower your blood sugar and insulin levels.
Since alcohol is a depressant, it may seem like it can help you sleep, but it actually works against you. Studies show that alcohol can delay sleep onset (the time it takes you to fall asleep) and decrease overall sleep quality. Alcohol can also make sleep apnea worse and trigger low blood sugar levels that can wake you up in the middle of the night.
The temperature of your room is one of the most important factors in getting a good night’s sleep. It’s also ideal to keep the temperature between 60 and 67 degrees, if possible. Make sure your room is dark by removing electronics and covering the windows with blackout curtains.
If you’re not sleeping well, it’s always best to check in with your doctor. Gomer says nighttime blood sugar dips may be caused by too much diabetes medication, so it’s worth making sure your dosage is still correct.
And many people don’t know they have sleep apnea, which can worsen blood sugars, according to Dr. Block. “If you snore or have increased daytime sleepiness, talk to your doctor about being evaluated for sleep apnea,” she says.
You can also try these general sleep tips:
Wind down before bed by reading, meditating, and/or listening to relaxing music.
Avoid caffeine within 6 hours of bedtime.
Avoid screens (computer, phone, TV) right before bed.
Go to bed and wake up at the same time every day.
Many diabetic-related conditions can interfere with your sleep. If you’re not getting enough rest, it’s important to develop a healthy nighttime routine that’s conducive to better quality sleep.
Check in with your doctor, too. You may have an underlying condition, like sleep apnea, that can be better managed with the proper treatment.
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