Solving sleep problems with healthy habits

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Sleep complaints are common among those with diabetes, according to Elizabeth Bashoff, M.D., Clinic Physician, at Joslin Diabetes Center.  “The important thing to do first is to pinpoint why you are not sleeping.”

There are a wide variety of reasons for disrupted sleep in people with diabetes.  Some of the causes of sleep problems can include:

  • Sleep Apnea: This is increasingly common for everyone, but is more frequent among those with type 2 diabetes.  Sleep apnea is also linked to obesity, a risk factor for diabetes.  Symptoms include daytime fatigue and exhaustion, and nighttime snoring or irregular breathing.  “Weight loss is by far the most effective treatment,” Bashoff says.
  • Neuropathy and Leg Pain: This sort of pain is a very common reason why people with diabetes have sleep problems. “There are many medications to treat neuropathy, some of which can also have a beneficial sedative effect,” Bashoff suggests.
  • Nighttime Lows: Another reason some with diabetes have disrupted sleep is nighttime hypoglycemia.  At risk, are people with type 1 and those with type 2 who are being treated with insulin or sulfonylurea. Symptoms include waking up suddenly with a feeling of impending doom, nightmares, night sweats and morning headaches. Sometimes, the only symptom is a high-fasting blood glucose.

Women going through menopause may also experience drenching night sweats, which can be confused with nighttime hypoglycemia. “It’s important to find out if the cause is menopause or a low blood glucose reaction,” Bashoff advises.

There may be a link between sleep and blood-glucose levels. “Clinically, we see that people who keep regular sleep schedules seem to maintain better blood sugar control,” Bashoff says. “It is more of a challenge if sleep is disrupted.”

There is also some evidence that disrupted sleep affects insulin resistance and may contribute to the development of type 2 diabetes.

When it comes to diabetes and good sleep, healthy habits always help.  Some evidence shows that those who exercise have better quality and quantity of sleep — as long as you don’t exercise right before bedtime.

“Getting enough sleep and creating healthy sleep patterns are prescriptions for good diabetes health,” Bashoff concludes.

For more information: Avoiding Nighttime Lows, by  Howard Wolpert, M.D., Director of the Joslin Diabetes Center Insulin Pump Program

To make an appointment with a Joslin physician, please call 617-732-2400.

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