When Sleep Becomes "Sleep"
Sleep has a huge influence on how my blood sugars map out.
November 2013 — On a normal night, I get about seven hours of sleep. Sometimes, it's a nice, uninterrupted sleep, where my head hits the pillow and I'm out cold until my daughter wakes up in the morning. But more often, my nights are interrupted by any combination of chaos: the BEEP!ing of my Dexcom continuous glucose monitor, alerting me to a high or a low, or my daughter waking up with a bad dream, or our small kitten, Loopy, attacking unassuming fingers or toes underneath the blanket. A "good night's sleep" is becoming a relative term, mostly assigned to a night where I slept through the night, instead of waking up to address one of the aforementioned. (Or to address something entirely different, like a ringing phone or the birds that took up residence in the trees outside of our bedroom window and tweeted their faces off at all hours.)
But it's the diabetes-related interruptions that set me straight into slept debt. Sleep becomes "sleep," with the necessary and accusatory quotation marks.
Oddly enough, my blood sugars aren't impacted throughout the night, regardless of the sleep quality being good or bad. It's the next day, and sometimes the day after that, when my meter results seem to be in cahoots with the lack of caught Z's. There's no pattern to it, either; sometimes I'll see very hard-to-shake lows that cling on for hours, no matter how many carbs I consume, and sometimes I see highs that linger so long that I feel like I'm bolusing saline instead of Humalog.
A sleepless night also instigates a slower response time up in my brain, so instead of reacting immediately to the beeping Dexcom or acting upon clear symptoms of highs and lows, I'll get lost in my own exhaustion, forgetting to follow through on correcting my blood sugar. This adds to the diabetes circus, making it harder to get the reins on my numbers.
So what can I do to achieve a good night's sleep? Is it even possible? It's hard to hit that target, but I do a few things to improve my aim.
On the bedside table, every night, I keep my glucose meter, my Dexcom receiver, a jar of glucose tabs, and a bottle of water at the ready. That way, if the beeping alarm of my CGM goes off, I can confirm the result with my glucose meter and either treat the low or quiet the thirst that can come with a high. This minimizes time out of bed and interrupted sleep.
I also rely on my husband to help on mornings when the night hasn't gone smoothly. Normally, I wake up with our daughter and start her day, but if I've been up for some of the night due to diabetes or other chaos, he'll be the early riser, leaving me to catch up on sleep.
And on nights when I can see a diabetes-related issue coming, I'll take a preemptive strike against the coming low or high. If I have a late workout, or go to bed with a concerning amount of insulin on board (IOB), I'll set my alarm for 2.30 am to check my blood sugar. Sometimes catching the low or high before it's gone too far over the threshold can keep a small sleep interruption from becoming an all-night disaster.
A little planning keeps my sleep patterns and my diabetes as cool as the flip side of the pillow.
dLife's Viewpoints columnists are not all medical experts, but everyday people living with diabetes and sharing their personal experiences, most often at a set point in time. While their method of diabetes management may work for them, everyone is different. Please consult with your diabetes care team before acting on anything you read here to find out what will work best for you.
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