There could be many reasons why you're not getting a good night's sleep if you have diabetes.
You may experience low blood sugar that causes headaches. Or you may have high blood sugar that leaves you thirsty, and then you have to wake up and use the bathroom throughout the night, says Dr. Daniel J. Donovan, director of clinical research for the Diabetes, Obesity and Metabolism Institute at the Icahn School of Medicine at Mount Sinai in New York City.
You also could have one of the many sleep problems that are more common in people with diabetes, including obstructive sleep apnea and restless legs syndrome.
Of course, there are day-to-day stressors that make it hard for many people to go to sleep.
A lack of a good sleep creates a vicious cycle, says registered dietitian and certified diabetes educator Teresa McArthur, clinical director of Fit4D in New York City. "Diabetes can create challenges to a good night's sleep and, in return, impaired sleep can make it challenging to manage diabetes," she says.
Take, for instance, how sleep changes your eating habits. Too little sleep on a consistent basis can lead to unhealthy eating habits, McArthur says. "Tired people might crave sweets or eat carbohydrates in an attempt to increase their energy. This then leads to weight gain and an increased risk for various sleep disorders," she explains. Of course, those sweets and carb cravings can make diabetes harder to manage.
Fortunately, sleep issues don't have to last forever. There are plenty of changes you can make to try and improve your sleep. There are things your health care provider can recommend as well. Here are several suggestions for better nighttime rest.
Don't eat a heavy meal before bed. Aim for a well-balanced dinner that is not your largest carb-containing meal of the day, McArthur advises. "A meal high in carbohydrates at night could lead to elevated blood sugars in the morning," she says.
Choose exercise carefully. Physical activity is important for everyone, but if you do something too strenuous within a couple hours of bedtime, you may have trouble sleeping. Try some yoga, stretching or a casual walk after dinner.
Wind down your time with devices. Set a time after which you're not reading work emails, listening to loud music or doing anything with your devices that can make sleep harder. Aside from the mental stress those activities can create, electronic devices emit a blue light that makes our bodies want to stay awake, Donovan says. If you must use a device right before bed, there are apps and smartphone or tablet settings that can block the blue light.
Try to go to bed and wake up at the same time every day. This helps your body establish a routine.
Avoid alcohol and caffeine before bed time. Also, watch the fluid intake. Too much liquid before bed could mean getting up to use the bathroom a lot, Donovan says.
Think #sleepgoals for your bedroom. "Make your bedroom a relaxing, disruption-free place to relax and sleep. Keep it cool, dark and calm," McArthur recommends. Pet owners, it may be best for your pets not to sleep in your bed, says Donovan -- although he realizes this is a tough order to follow. However, it's something to consider if your pets keep you up or wake you up a lot at night.
Consider tracking your sleep with an app. There are apps that will track sleep patterns. Some of them are free or low-cost, while others are pricier. There's no harm in trying a sleep app if you want information on your nocturnal habits, Donovan says. However, keep in mind that they are not always 100 percent accurate.
Additionally, you may want to think about where you are in your diabetes management. "It can be just another item that you feel you need to track," McArthur says. "This can be helpful for some and burdensome to others." Someone newly diagnosed with diabetes may feel that tracking sleep just adds too much work, while someone who has managed diabetes for a long time could be in a better place to track sleep, she says.
Set up a nighttime routine for your diabetes care. This will vary person to person, but it may include some of the following:
-- Take any medications.
-- Brush and floss your teeth. Dental health is important for diabetes health, McArthur says.
-- Inspect your feet. When you have diabetes, you may develop a condition called neuropathy that makes you not able to feel scrapes, cuts and other injuries on your feet. That's why daily foot inspections are important.
Consider losing a little weight. Extra weight can make you more prone to sleep issues like obstructive sleep apnea, Donovan says. Some symptoms of sleep apnea including snoring, daytime sleepiness and irritability. However, losing weight could help sleep apnea as well as improve blood sugar control.
Talk to your health care provider if sleep is consistently a problem. If you find that sleep problems affect your blood sugar, food intake or overall health, seek professional help. Your provider may have helpful suggestions or may want to test you for sleep problems such as obstructive sleep apnea. Sometimes, irregular sleep is a sign of depression, and that's something else you'll want to get help for, McArthur says.
One last thought on sleep: If you wake up on the middle of the night and have trouble falling back asleep, don't stress over it. Read a book, try a breathing exercise or leave the bedroom for a while and then go back to rest. The goal is to stay relaxed. "Don't turn on the TV and watch the world news," Donovan cautions.
If you think you're awake in the wee hours because you're experiencing low blood sugar, check your glucose level and follow steps to treat low blood sugar. "Once your blood glucose is normal, you should eat a small snack if your next meal is one to two hours away," McArthur says. If you're waking up in the middle of the night a lot, talk to your health care provider.
Vanessa Caceres is a Health freelancer for U.S. News. She's a nationally published health, travel and food writer, and she has an undergraduate degree in journalism and psychology from Hampshire College and a graduate degree in linguistics/bilingual education from Georgetown University. Connect with her on Twitter at @FloridaCulture.