Sleep problems in diabetes: breathing disorders, pain, going to the toilet

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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

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

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.

By Yraa

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