Diabetes And Sleep: A Vicious Cycle
The relationship between diabetes and sleep is complicated, and experts still have a lot to learn about how the whole thing works. What they do know? How much sleep you get could play a role in whether you develop type 2 diabetes in the first place.
First, theres the growing connection between sleep and obesity. Being overweight is a major risk factor for type 2 diabetes. Whats more, evidence shows that there are several ways that skimping on sleep could lead to weight gain:
- When youre zonked, you dont have the energy to exercise.Research suggestsVerified SourceAmerican Academy of Sleep MedicineSociety focused on sleep medicine and disorders, and the AASM is who authorizes U.S. sleep medicine facilities.View sourcethat people who stay up late spend more time sitting than people who wake up early.
- Feeling tired means youre less likely to make healthy food choices, too. When youre exhausted, pizza or takeout just feel easier than a big kale salad.
- Staying up late means more time to eat. People who stay up into the wee hours at night have been found to eat 550 more calories than those who go to bed early.
- Lack of sleep messes with your hormones. Sleep deprivation causes your body to pump out more of the stress hormone cortisol, which is linked to weight gain. Youre also flooded with more of the appetite-stimulating hormone ghrelin.
How To Differentiate Between The Two Effects If You Suspect High Fasting Blood Sugar
If your sugar level shoots up every morning after you wake up, then always check your 3:00 am sugar.
If sugar at that time comes low then this is a Somogyi effect. You should always consult your doctor as root cause analysis of hypoglycemia is required. There may be a need for drug dose reduction but it all depends on clinical judgment.
But if your 3:00 am sugar comes out to be normal or on the higher side, then its a dawn effect. It requires clinical judgment, your dose may need to be increased or changed.
Hypoglycemia or low blood sugar levels should be managed at priority since low sugar causes our body to get deprived of energy and causes symptoms such as tiredness, weakness, fatigue, lethargy, shivering, and extreme hunger.
If sugar levels are not managed at this stage, it can further lead to unconsciousness or coma. Unawareness of hypoglycemia phases could be dangerous due to the same reason and hence must be looked for!
On the other hand, hyperglycemia or high blood sugar levels are also important to be managed as it can further lead to complications. Constant high blood sugar levels can impact kidneys, eyes, nerves, heart and brain.
You must work on managing your blood sugar levels within the normal range in order to live a healthy and happy life. Do improve your lifestyle by eating timely, exercising daily, going for doctor follow-ups and taking insulin or medicines on time. For more information, read this .
People With Diabetes Generally Take 2 Types Of Insulin:
- Short-acting insulin and
- Long-acting insulin.
Short-acting insulin such as APIDRA or NOVORAPID or HUMALOG reaches the bloodstream within 30 minutes after injection and peaks anywhere from 23 hours.
However, long-acting insulin such as LANTUS is peakless insulin that works in the background and lasts more than 24 hours.
The effect of these two insulins gets combined and the peak of short-acting insulin shifts to early morning hours. This increases the risk of hypoglycemia around 3:00 am.
How To Monitor Your Blood Sugar Levels For Better Sleep
The only way to get the full picture of what is going on with your glucose levels overnight is to use a Continuous Glucose Monitor . A can track your glucose levels while you are sleeping, helping you identify the highs and lows that are disrupting your sleep. You can then use this information to make adjustments to your evening and sleep hygiene routine to improve your overnight glucose levels. It also brings awareness of how your current sleep patterns are affecting your overall glucose levels. Best of all, itâs actionable data that can drive positive change.Â
The NutriSense Continuous Glucose Health Program makes monitoring your glucose levels simple. It demystifies the science behind metabolic health by combining CGM technology with clinical support.Â
Keeping Blood Sugar Under Control
Its not enough for those with diabetes to faithfully take glucose readings.
A person with diabetes , even when theyre not hungry, should not go long periods without eating.
Snack items should include fruit, nuts, salads and other foods with limited processing.
For many years Lucille Hughes has worked as a certified diabetes educator for inpatient acute care, home care, private endocrinology practice and outpatient diabetes education centers.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. Shes also a former ACE-certified personal trainer.
Top image: Shutterstock/ Hdc Photo
High Blood Sugar Symptoms
is the medical term for high blood sugar. Hyperglycemia happens when the body doesnt have enough insulin or when it cant use insulin correctly. Many things can cause high blood glucose levels like Type 1 diabetes, Type 2 diabetes, stress, illness, or the dawn phenomenon. If you have hyperglycemia or suspect you may have it, talking with a healthcare provider is always a good idea. A doctor can help you determine whats causing your high blood sugar levels and lower it to a healthy range.
Here are some of the most common symptoms that may indicate hyperglycemia:
- Vision loss
You should seek immediate medical attention if your blood sugar reaches 400 mg/dL or higher.
When patients experience any of these accompanied by elevated blood sugar levels, diabetic patients are advised to go directly to the ER to avoid diabetes-induced coma, says Vikram Tarugu, MD, a gastroenterologist and the CEO of Detox of South Florida. Patients who have elevated blood sugar may also present with frothy, ketone-like smelling breath.
Here are some lifestyle changes and medical treatments that can help treat hyperglycemia:
Late Night Meal High In Fats And/or Protein
High protein and fat meals may rise blood glucose levels during the next 5-6 hours. If you had a fatty steak dinner at 10pm it is very likely you will still be experiencing blood glucose rise at 2am. If you are using injected insulin, the solution to this might be extended bolus on the pump, or split bolus injections.
I personally prefer to eat earlier before bed. This way I sleep better and dont have to worry about extra insulin injections in the middle of the night. But I have plenty of examples from my own cgm on blood glucose rise at night caused by late night snacking on chocolate and peanut butter or having very late dinner:
Improve Your Blood Sugar
An egg for breakfast may lower your blood sugar levels for the rest of the morning and improve overall blood sugar levels. A study published in “Nutrition Research” in 2010 gave men an egg breakfast for one week and a bagel breakfast for one week. Their blood was drawn to measure glucose, insulin and appetite hormones for the following three hours. When participants had the egg breakfast, their blood sugar and insulin were lower compared to when they consumed the bagel breakfast. In a 2010 study in the “British Journal of Nutrition,” people with diabetes showed improved blood sugar and cholesterol levels when they consumed eggs as opposed to other animal protein.
Why Is My Blood Sugar High At Night
There can be various reasons for your blood sugar levels to increase at night. Too little insulin or diabetes medication, too little exercise, too much food, menstruation, pregnancy, injury or medical operation, illness or infection, stress or non-diabetic medication are all factors that can cause the blood sugar spike at night.
How To Treat Low Blood Sugar At Night
Having a low blood sugar at night is the worst. THE WORST! If you are treating your diabetes with insulin, you know what Im talking about. That feeling when you wake up in the middle of the night soaked in sweat and shaking due to low blood sugar.
Your whole body goes into stress mode, and all you can think about is EATING! I absolutely hate it, so I wanted to share my approach on how to treat low blood sugar at night with you guys.
How Can High Blood Sugar Levels In The Morning Be Controlled
Once you and your doctor determine how your blood sugar levels are behaving at night, he or she can advise you about the changes you need to make to better control them. Options that your doctor may discuss depend on the cause of the morning high blood sugars.
For dawn phenomenon:
- Changing the timing or type of your diabetes medications
- Eating a lighter breakfast
- Increasing your morning dose of diabetes medication
- If you take insulin, switching to an insulin pump and programming it to release additional insulin in the morning
For Somogyi effect:
Causes Of High Blood Sugar At Night
There are many causes of high blood sugar at night, including:
- A dinner or bedtime snack high in carbohydrates: Eating starchy or high-sugar foods late in the day can lead to high blood sugar at night, as well as high blood sugar in the morning.
- Illness or injury: Trauma can trigger a hypermetabolic response , leading to high blood sugar.
- Too little exercise: Exercise helps the body more effectively use insulin, so lack of exercise could contribute to high blood sugar.
- Too little insulin or diabetes medicine: When the body does not produce insulin or does not use insulin effectively and you dont properly take your injectable insulin or diabetes medicine, glucose can accumulate in the bloodstream.
- Menstruation: Estradiol and are two hormones linked to a decreased production of insulin, which affects glucose metabolism and can potentially lead to high blood sugar.
- Pregnancy: Hormone levels fluctuate during pregnancy. Diabetes that occurs during pregnancy is known as gestational diabetes.
- : Stress, as measured by levels of a hormone called cortisol, is linked to decreased insulin production. When your body doesn’t have enough insulin, glucose cannot get into your cells and be used for energy. As a result, glucose builds up in the bloodstream, leading to high blood sugar. When people are stressed, they may also overeat sugary foods or adopt other unhealthy eating habits.
Why Do We Get Stressed While Sleeping
People with insomnia might experience cortisol spikes when there should be none. Cortisol is a stress hormone that raise blood sugar levels and it could be that your blood glucose goes up due to spike of cortisol during the night.
Peter Attia MD, the longevity expert and researcher describes his own night time glucose spikes caused by stress:
What was interesting to me is it was very easy for me to predict, before looking at the glucose meter in the morning, how high my glucose was that night, based on not just the quality or lack thereof of my sleep, but also just the amount of sort of ruminating that I was doing during my sleep.
Learning to manage stress is so important for diabetes care. I believe it can truly improve blood sugars and overall health. Check out my article on how to cope with stress better.
What Can You Do
To keep your blood sugar in balance, try to get at least 7 hours of sleep each night.
If you work at night or have rotating shifts: Try to maintain regular meal and sleep times, even on your days off, if you can. And get some during your breaks, like short walks or stretches.
If youâre concerned about your sugar: Getting a good nightâs sleep on a regular basis will go a long way toward helping your body use insulin efficiently. Along with getting enough sleep, avoid eating late at night, and try to get some after dinner, like going for a walk.
If you have diabetes: If your blood sugar is often too high in the morning, talk to your doctor. You may need to do some extra blood sugar testing or use a continuous glucose monitor to figure out whatâs going on, which will determine how you should handle it. Your doctor may suggest a tweak to your diabetes medicines or your exercise routine.
National Heart, Lung, and Blood Institute: âWhy Is Sleep Important?â
National Institute of Diabetes and Digestive and Kidney Disorders: âPrediabetes and Insulin Resistance.â
American Diabetes Association: âDawn Phenomenon,â âHandling Morning Highs in Blood Glucose.â
Journal of Thoracic Disease: âInsulin resistance, glucose intolerance and diabetes mellitus in obstructive sleep apnea.â
Cleveland Clinic: âDiabetes and the Night Shift Factor.â
Sleep: âAdditional Sleep Duration Associates with Improved Blood Sugar Regulation.â
What Are Some Tips To Prevent Nighttime Blood Sugar Level Dips
How To Stabilize Your Blood Sugar Overnight
The most important thing you can do to stabilize your blood sugar is monitor your glucose levels at bedtime, during the night, and when you wake up to look for patterns. This will help you determine whats going on in your body and how you can fix it. While there are many strategies people use to stabilize blood sugar at night, every person is different youll have to look for trends in your body, experiment with ways to lower glucose levels over a period of time, and learn what works best for your body.
Check your blood sugar before bed. If its already high, your blood sugar levels may remain high throughout the night. To address this, youll want to start by adjusting when you eat your evening meal and what it consists of, and how much mealtime insulin you take to cover it.
Avoid eating lots of food close to bedtime. For diaTribe writer Adam Brown, the key to staying in range overnight is low-carb, early dinners, with no snacking after dinner.
Consider eating less food at night and taking more basal insulin to cover your evening meal.
Check your blood sugar during the night, between midnight and 3am. If you were in range before bed but have high glucose levels between midnight and 3am, you may need to adjust your basal insulin dosage and timing. If you are low during that time, you may experience a rebound high blood sugar later on this is usually associated with overcorrecting the low.
Understanding High Blood Sugar At Night
Blood sugar, also called glucose, is the body’s main source of energy. The body gets most of its glucose by metabolizing the carbohydrates in food, per Kaiser Permanente. For people with diabetes, their systems struggle to manage glucose correctly, leading to high blood sugar. But the treatment of diabetes can also cause low blood sugar .
“Some diabetes medications lower blood glucose levels during the night,”Jo-Anne Rizzotto, a registered dietitian nutritionist and director of educational services at Harvard’s Joslin Diabetes Center, tells LIVESTRONG.com. “But if blood sugar levels drop too low, the liver responds by releasing stored glucose.” This nocturnal release of glucose can cause high blood sugar during the night and into the next morning, known as the Somogyi effect. The good news? “People with type 2 diabetes don’t have this issue unless they’re on glucose-lowering medications,” says Rizzotto.
The Somogyi effect should not be confused with the so-called “dawn phenomenon,” another cause of high morning blood sugar, Rizzotto says. The dawn phenomenon is a product of human evolution; it occurs in all people and involves the body pumping out extra glucose in the early morning hours to get the body ready to wake up.
Low Blood Sugar Symptoms
happens when blood glucose levels drop too low. Low blood sugar can be caused by many things including the two different types of diabetes, certain medications, alcohol, endocrine disorders, eating disorders, pregnancy , and disorders of the liver, kidneys, or heart.
Here are some of the most common symptoms that someone with low blood sugar might experience:
- Tingling lips
If your blood sugar is low you might start to feel some of the first signs of hypoglycemia like dizziness, lightheadedness, or sweating. The only way to know for sure if your blood sugar is low is to test it with a glucose meter or other glucose monitoring device.
If you dont have access to these tools and start to feel the symptoms of low blood sugar, consume 15 grams of carbs or take a quick dissolve glucose tablet to raise your blood sugar levels and avoid further symptoms, according to the American Diabetes Association . Once your blood sugar is back in its target range, you can have a snack or meal to make sure it doesnt drop again.
Here are some other lifestyle and medicinal treatments that can help treat hypoglycemia:
- Eat a healthy diet full of whole foods that are minimally processed.
- Take or diabetes medications as recommended by your healthcare provider.
- Use a glucagon kit in emergencies. Glucagon is a hormone that raises blood sugar levels quickly.
Give Yourself Some Grace
Its important to keep in mind that diabetes management is HARD work. If it were easy, everyone would have perfect blood sugars and A1c! Our bodies are constantly growing and changing, and so should our diabetes management.
Be flexible with what your body needs, and work with your doctor when making any drastic changes to your insulin therapy. And perfection is not the ideal.
Continually making progress on diabetes management includes mental health and well-being too, so dont stress out too much over blood sugars that arent perfect overnight. If youre having stubborn issues, enlist the support of family and friends to help.
Managing the ups and downs of diabetes is hard any time of day, but can be especially difficult overnight when were supposed to be sleeping and getting the rest we need, but with these strategies, hopefully, overnight high blood sugars will become a thing of the past.
Always work with your medical team before instituting any major changes to your diabetes management and/or insulin therapy.
Tips For Managing Nighttime Hypoglycemia
Many people with diabetes experience hypoglycemia while sleepingthis is called a nighttime low . Many factors contribute to nighttime hypoglycemia. Being familiar with the causes will help you understand the signs and take steps to prevent nighttime lows.
Episodes of hypoglycemia can be uncomfortable and frightening. Severe hypoglycemia can cause seizures and be life-threatening so it’s important to recognize the problem and respond appropriately.Read on for tips to help you prevent hypoglycemia.
Recognizing the Signs
Shakiness and irregular heartbeats can be a sign of approaching hypoglycemia. Symptoms can develop when blood sugar drops below 70 milligrams per deciliter . Eating dinner much later than you normally do, drinking excessive amounts of alcohol or having an unusually active day can contribute to the condition. Sometimes exercising too close to bedtime can trigger it, too. Experts say it’s best to avoid exercising within two hours of bedtime.
Strategies for Preventing Nighttime Hypoglycemia
To reduce the risk of nighttime hypoglycemia, you need to come up with a way of ensuring you have more glucose in your body during the last few hours of sleep.Checking your blood sugar before turning in is the best way to ward off sugar trouble during the night. If your blood sugar level is less than 100 mg/dl at bedtime, you may need to double your regular snack.
Are There Any Newer Technologies To Prevent Hypoglycemia
We are lucky that in this day and age, we can predict hypoglycemia and prevent it through technology like continuous glucose monitors, explains Dr. Shah. Additionally, he notes that there are newer insulins available to help decrease episodes of hypoglycemia.
One of our roles as your doctor is to educate every patient about the self-management of diabetes and to create a personalized care plan, explains Dr. Shah. By self-managing your condition you will really feel empowered enough to take control of your health.
Dr. Shah is located at the Hackensack Meridian Health Medical Group Diabetes Center, part of Hackensack Meridian Health Medical Group. Call to schedule an appointment at the office in Old Bridge.
Our care network can help you better manage your health. Visit to find a practice near you.
The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.
Blood Sugar Spike Symptoms
Learning to recognize the symptoms of can help you keep your diabetes in control. Some people with diabetes immediately feel the symptoms of high blood sugar, but others go undiagnosed for years because their symptoms are mild or vague.
Symptoms of hyperglycemia typically begin when your blood glucose goes above 250 milligrams per deciliter . Symptoms get worse the longer you go untreated.
Symptoms of a blood sugar spike include:
- frequent urination
How Is It Determined If The Dawn Phenomenon Or Somogyi Effect Is Causing The High Blood Sugar Levels
Your doctor will likely ask you to check your blood sugar levels between 2 a.m. and 3 a.m. for several nights in a row. If your blood sugar is consistently low during this time, the Somogyi effect is suspected. If the blood sugar is normal during this time period, the dawn phenomenon is more likely to be the cause.
Some additional clues that the Somogyi effect may be the cause include nightmares, restless sleep and overnight sweating as these are all signs of low blood sugar levels.
Method 1 Of 3:avoiding Triggers Of Low Blood Sugar Levels At Night