Your child’s sleep

How does type 1 diabetes affect sleep?

Type 1 diabetes may disturb you and your child’s sleep for a number of reasons:  

• Alarms from continuous glucose monitors or insulin pumps 
• Needing to wake to treat a hypo 
• High blood glucose causing your child to get up to pee during the night 
• Worry or anxiety about type 1 diabetes management 

What happens to your child’s blood glucose when they’re asleep?

Your child’s blood glucose levels continue to rise and fall while they’re asleep. They do this for various reasons. For example, if your child has eaten or exercised before bed or had too much insulin.

Can lack of sleep affect your child’s type 1 diabetes?

Research has found that people with type 1 who reported disrupted sleep can have higher HbA1c levels. They were also found to need more insulin the day after not sleeping well. If this is happening with your child, don’t feel bad. Not everything in their type 1 management is within you or your child’s control. We have tips to help you improve their sleep – and yours.

Can your child have hypos at night? 

Your child’s blood glucose levels go up and down in the night, so it’s possible that they might have nighttime hypos. Some people wake up when they have a hypo, but others might not be aware that they’re having a hypo while they’re asleep, which can be dangerous. Your child may also wake up with a headache and feeling fuzzy headed if they’ve had a hypo during the night.  

Using a continuous glucose monitor (CGM) can help alert you and your child about hypos when they’re sleeping. You can set alarms on both your child’s phone and your own to alert you if their glucose levels are going low during the night. 

Speak to your Diabetes Healthcare Team as soon as possible if your child is experiencing nighttime hypos and not waking up so they can help support with this.

The dawn phenomenon

Blood glucose can rise in the early morning, usually around 4am – 8am. This is known as the dawn phenomenon. This happens to everyone, whether they have type 1 or not, because of the release of hormones which causes the liver to release glucose. It may even cause a short period of insulin resistance, which affects how your child’s body is able to use insulin to turn blood glucose into energy.  

You can check if the dawn phenomenon is affecting your child by checking their glucose levels in the early hours of the morning, between about 2 – 4am, to see how they change. This is easier to do if your child has a continuous glucose monitor, as you can look back on your child’s data from the previous days, weeks or even months. If you use a blood glucose meter, you will need to manually check your child’s glucose levels during these hours. 

If their levels rise sharply after 4am, then the dawn phenomenon may be affecting them.  

Talk to you Diabetes Healthcare Team if you think the dawn phenomenon is affecting your child’s type 1 management and for advice on how what to do.  

Tips to help your child sleep

There are things you can try to help improve your child’s sleep. These tips are useful for anyone struggling to sleep, whether they’re managing type 1 or not. Always talk to your Diabetes Healthcare Team if sleep is becoming an issue for you and your child.

Adjust their technology

CGMs are great for detecting nighttime hypos and hypers, but being woken up regularly can be difficult – for both parent and child. Talk to your Diabetes Healthcare Team about ways to minimise the disruption to your child’s sleep. For example, they may suggest using different alarms settings for high and low blood glucose to reduce alarms during the night (do not do this without medical advice and support).  

Try different technology

Hybrid closed loops (HCL) systems deliver insulin based on glucose readings from a sensor. HCL can reduce the number of decisions and calculations that you and your child need to make on a daily basis. It can also reduce the amount of times you and your child need to wake in the night to treat hypos, or go to the toilet because of high glucose levels.  

Find out more about HCL and if it’s available for your child.

Reducing anxiety

If worries about type 1 diabetes are keeping you or your child awake, talk to their Diabetes Healthcare Team or GP.

Going to bed

Having a routine for going to bed can help your child get to sleep and have better quality rest.  

• Try to get them to bed at the same time and get up at the same time every day (including weekends) 
• Regular physical activity during the day can help your child sleep 
• Try and avoid them eating too much just before going to bed 
• Create a relaxing sleeping environment –make their bedroom quiet, shut the curtains or blinds to keep light out and try and ensure it’s at a  comfortable temperature. 
• Keep electronics out of their bedroom as much as possible including computers and TVs. If they use a smart phone to check their levels, you can set limits on other apps so they’re not tempted to use their phones when they should be winding down

Tips to manage your own sleep

If your child has type 1 diabetes, it has an impact on your sleep too. You can follow the same going to bed routine as outlined above, to help you have a solid night’s sleep. 

If you have a partner or other caregiver, talk about sharing the nights you get up to care for your child, so that you get an opportunity to get a full night’s sleep.  

Lack of sleep can affect your mental health and emotional wellbeing, especially on top of looking after a child with type 1. If you’re struggling with sleep talk to family and friends or connect with other parents looking after a child with type 1 for advice and support. You can also contact your GP and organisations like the Samaritans or Mind, or find information in our Parents Guide.