If you have diabetes, you may already know that good blood glucose (sugar) management is key to preventing heart disease, nerve damage and kidney problems. But did you know that blood sugar can also affect your sleep? Alok Sachdeva, M.D., a neurologist and sleep medicine specialist at Henry Ford Health, explains this connection and how to get the rest you need.
Blood Sugar Problems and Sleep Issues
If you have hyperglycemia (high blood sugar) when you go to bed, your body can’t fully focus on sleep. Instead, it has to figure out what to do with that extra glucose.
“As excess glucose escapes into the urine, fluid follows it,” explains Dr. Sachdeva. “This means if your glucose is high at night, you will likely need to get up several times to urinate.” This frequent nighttime urination, called nocturia, breaks up your sleep and can leave you feeling exhausted the next day.
On the flip side, low blood sugar (hypoglycemia) creates its own sleep problems. “When your sugar drops too low during sleep, your body releases adrenaline and other stress hormones to help increase it,” Dr. Sachdeva says. “This can cause sweating, rapid heartbeat and even nightmares that wake you up.”
Restless Legs Syndrome and Diabetes
Restless legs syndrome (RLS) causes tingly or crawly sensations in your legs and an overwhelming urge to move them, and it tends to get worse at night. People with diabetes may be more likely to have RLS, creating yet another barrier to restorative sleep.
“There are a few connections between diabetes and RLS,” says Dr. Sachdeva. “First, diabetes can negatively affect how your body processes and stores iron. Low brain iron levels can trigger restless legs syndrome.”
In addition, uncontrolled diabetes can cause diabetic neuropathy (nerve damage from chronic high blood sugar). “Neuropathy and RLS can coexist in patients with diabetes, causing additive sleep disruption,” Dr. Sachdeva says.
Sleep Medicine at Henry Ford Health
How Poor Sleep Affects Diabetes Management
Sleep and diabetes have another link, too. Regularly getting a bad night’s rest can make it harder to manage diabetes. “When you don’t get enough sleep, you become insulin resistant,” Dr. Sachdeva says. “This means your cells don’t use insulin as well, so your blood sugar levels rise.”
Sleep deprivation also increases stress hormones like cortisol, which can raise blood sugar levels. At the same time, it disrupts the hormones that regulate appetite.
“Poor sleep affects the balance of leptin and ghrelin, hormones that control hunger and fullness,” Dr. Sachdeva explains. “Insufficient sleep can increase hunger, making blood sugar control even more difficult.”
Sleep Tips for People With Diabetes
If you’re struggling to get the shut-eye you need, these tips can help you get better sleep:
- Aim for 7 to 9 hours of sleep each night. Consistency matters as much as duration. Try to go to bed and wake up at the same time every day, even on weekends.
- Watch what you eat before bed. “Avoid high-carbohydrate meals close to bedtime,” Dr. Sachdeva advises. “These can cause blood sugar spikes that disrupt your sleep.” Similarly, skip sugary beverages and alcohol in the evening, as both can interfere with blood sugar regulation and sleep quality.
- Talk to your doctor about medication timing. If you’re experiencing nighttime hypoglycemia, talk to your healthcare provider. They may consider changing your medication timing or dose.
- Consider using a continuous glucose monitor (CGM). These devices track your blood sugar levels throughout the night, helping you and your doctor identify patterns and make adjustments. “CGMs can be incredibly helpful for understanding what’s happening with your blood sugar while you sleep,” Dr. Sachdeva says.
- Create a sleep-friendly environment. Keep your bedroom cool, dark and quiet. Limit screen time before bed, as the blue light from devices can interfere with your body’s natural sleep signals.
Talk to Your Provider About Sleep Issues
Sleep isn’t a luxury—it’s a crucial part of diabetes management. If you’re struggling with sleep problems, don’t ignore them. Talk to your healthcare provider about your symptoms. Together, you can develop a plan to improve your sleep and blood sugar control. By breaking the cycle of poor sleep and uncontrolled diabetes, you can improve your overall health and quality of life.
Reviewed by Alok Sachdeva, M.D., a neurologist and sleep medicine specialist who sees patients at Henry Ford Medical Center – Bloomfield Township.
