It is not uncommon for diabetic patients to seek medical attention for various sleep disorders. It is important to find out all the factors that disrupt a good night’s rest, since lack of sleep increases the level of stress, which negatively affects metabolic processes, including blood sugar levels. One of the reasons may be polyneuropathy, which provokes pain in the legs or constant awakenings to go to the toilet. In addition, the causes of sleep disturbances can be respiratory disorders — sleep apnea syndrome associated with overweight. The medications taken by patients may also have some influence. Therefore, it is important to always understand the causes of insomnia and eliminate them as much as possible.
Sleep disorders in diabetics
Doctors keep repeating that a good night’s sleep, proper nutrition and maintaining a healthy weight are beneficial for all people. But these good habits are especially important for those people who have been diagnosed with diabetes. Often, patients come to the doctor with complaints that they do not sleep well: in the evenings they cannot fall asleep for a long time, sleep is restless, with frequent awakenings, or superficial, in the morning there is a feeling of weakness and lethargy. There are several typical reasons why sleep may be disturbed during the development of diabetes. It is important to find out which of them affect the patient.
Blood sugar fluctuations and trips to the toilet
First of all, pronounced fluctuations in blood sugar levels at night can disrupt sleep. Very high blood glucose levels can lead to profuse urination, and sleep can be interrupted by frequent trips to the toilet. This is possible if blood sugar levels are poorly controlled due to eating disorders, medication, or insulin administration. If blood sugar becomes too low at night, symptoms such as restless sleep, excessive sweating, and tachycardia may occur. This leads to awakening, requires immediate correction of the situation.
Respiratory disorders: sleep apnea
A breathing disorder such as sleep apnea is significantly more common in diabetes. The term “apnea” literally means “lack of breathing”. Thus, sleep apnea refers to short-term disorders of pulmonary ventilation, lasting no more than 1–2 minutes, when breathing is extremely weak or absent during sleep. Another cause of sleep disturbances may be snoring associated with overweight, which often accompanies diabetes.
Usually sleep apnea, nighttime snoring is noticed by the patient’s spouse or family members, and such intermittent breathing can be seriously scary. The patient himself may feel tired or sleepy during the day, suffer from impaired concentration. Breathing disorders increase the likelihood of heart attack and stroke, and the more severe the sleep apnea, the greater the risk for severe diabetes itself.
Complications of Diabetes Affecting Sleep
Another common problem in some people with diabetes is diabetic polyneuropathy. It can cause pain in the legs, such as a burning or tingling sensation, which can disturb sleep. Another sleep disorder called restless legs syndrome can make you want to move your legs while falling asleep and create unpleasant, uncomfortable sensations that prevent you from sleeping normally. Because of these problems, people with diabetes are more likely to experience nighttime insomnia and daytime sleepiness.
Other causes of insomnia: stress, medications
Insomnia can also occur as a side effect of certain medications, such as antidepressants, and depression may be more common in people with chronic conditions, such as diabetes.
Sleep disruption can cause an increase in stress hormones that make it difficult to control weight. This forms a vicious cycle that is associated with diabetes, obesity and sleep disorders. To find out what is causing your sleep problems, your doctor will likely recommend a sleep study. During the study, heart rate, body movements and brain activity are monitored. This is to assess how well the patient is sleeping and to determine what may be causing insomnia.
Approaches to the treatment of sleep disorders in diabetics
It is important to find out all the causes of sleep disorders and eliminate them, so that patients with diabetes have a good rest at night and do not feel lethargic and sleepy during the day. For example, if a doctor has identified sleep apnea, CPAP therapy is indicated, the use of a special mask for the mouth and nose, which helps prevent respiratory arrest during sleep and the development of tissue hypoxia, including the brain. Treating sleep apnea can help with blood sugar control, insulin resistance, and other symptoms associated with heart disease. In addition, weight loss can help improve and possibly eliminate sleep apnea.
To maintain blood sugar levels, some patients are shown the use of a continuous monitoring system. It is sometimes okay to wake up once or twice a night during the week to check your blood sugar levels and track fluctuations. Typically, medication or dietary adjustments can help resolve this issue.
For restless leg syndrome, your doctor may prescribe medication. You may also need to check your iron levels, as low levels can contribute to the problem, especially in premenopausal women.
Tips for Patients
There are several things you can do on your own to improve sleep:
- Make sleep a priority. It is important to go to bed at the same time, leaving unfinished business, and be sure to sleep for at least 8 hours.
- Sleep in a dark, calm, cool room, remove all gadgets, TV and electrical appliances from the bedroom.
- Sleeping pills and strong sedatives should be avoided. They can worsen sleep apnea and have other side effects.
- Use the bed only for sleeping. If you have problems falling asleep after 15–20 minutes, you need to get out of bed and read a book (preferably not on a tablet or electronic device).
- Make exercise a habit. This will help you sleep better at night.