Your diabetes secret weapon: A good night’s sleep

The latest National Sleep Foundation poll finds that most of us don’t get the amount of sleep needed for good daily health, safety and optimum performance in life. For those with diabetes or prediabetes, lack of sleep is even more common—and more detrimental.

• Poor sleep and sleep disorders are especially prevalent, with insomnia (difficulty falling asleep, staying asleep, or sleeping well), obstructive sleep apnea (loud snoring or interrupted breathing), and restless leg syndrome (uncomfortable sensations in legs and urge to move them) topping the list.
• Poor sleep impacts every aspect of your ability to self-care effectively—like how you feel emotionally, what you eat or how much you exercise—which, in turn, affects your ability to sleep well.
• Frequent sleep disturbances and diabetes puts you at greater risk of dying earlier than for either condition alone.

According to the Centers for Disease Control and Prevention (CDC), “Too little sleep can increase insulin resistance, make you hungrier the next day and reduce how full you feel after eating, make you more likely to reach for junk foods (those that are high in carbs and sugar) make it harder to lose weight, raise blood pressure and seriously increase the risk of a heart attack, make your immune system less able to fight infections, [and] increase your risk of depression and anxiety.”

Good sleep, then, is paramount to good diabetes care—and vice versa. Let’s talk about how to get a good night’s sleep on a regular basis, so you can feel better and have energy to take on life with diabetes.

Are you tracking your sleep?

Assessment of sleep pattern and duration is recommended by the American Diabetes Association since evidence connects poor sleep quality, short sleep and long sleep with higher A1Cs.  Yet, some experts warn that sleep evaluation in diabetes care is often under-recognized and under-performed by healthcare providers.

“Sleep is a highly underrated diabetes tool, especially because it is changeable almost immediately,” said Adam Brown, type 1 diabetes author of “Bright Spots & Landmines: The Diabetes Guide I Wish Someone Had Handed Me.” “I can always get more sleep tonight if I make it a priority.”

Focus on sleep quantity AND quality.

How much sleep is enough? The American Academy of Sleep Medicine recommends at least 7 hours of sleep per night for adults, more if you’re younger. But how well you sleep matters, too. There are formal self-assessment tools, such as the SATED questionnaire that’s been used to measure different factors of poor sleep quality for people with diabetes. But anyone with diabetes can start by asking three simple questions about the quality of their own sleep:

1. Am I not feeling rested (or alert) even after sleeping enough hours?
2. Am I repeatedly waking up during the night?
3. Am I having symptoms of sleep disorders such as snoring or gasping for air?

Popular consumer sleep technologies like wearable nighttime trackers may encourage better sleep awareness but are not yet approved for the medical diagnosis of sleep disorders.

Look at your overall lifestyle habits.

A variety of practical daily do’s and don’ts should help anyone with nightly rest:

• Be physically active earlier in the day.
• Avoid beverages with caffeine in the afternoon and evening.
• Stop watching TV or using electronic devices at least 30 minutes before bedtime.
• Follow a comfortable routine before bed, like a warm bath or meditation, to reduce stress.
• Go to bed at the same time every day.

With diabetes, it’s also important to prioritize your blood sugar control, as blood sugar that’s too high or too  low can wake you up at night. Here are a few tips:

• Check your blood sugar level before bed, correcting lows with a snack like a small apple, just enough to get back to your target.
• Adjust meal and medication timing with your provider to account for consistently lower-than-expected morning blood sugars or higher-than-expected morning blood sugars (commonly known as the dawn phenomenon, a result of the body producing hormones early in the morning to give it the energy it needs to wake up).
• Leverage technology where appropriate—talk to your doctor about trying a pump that releases insulin automatically while you sleep if your blood sugar gets too high. Or, use a continuous glucose monitor with alarms set to a high and low blood sugar level that you’re comfortable with to help wake you only if damage control is needed.
• Record how well you perceive you’re sleeping as a part of your daily data log, which should include your blood sugar levels and specific meal and exercise choices, and repeat what’s given you both the best blood sugar levels and best nights of sleep in the past.

If you’re still not catching quality Z’s, get with a diabetes care and education specialist or sleep specialist for added help.