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Home > Knowledge & support > Living with type 1 diabetes > Health and wellbeing > Sleep
If you have type 1 diabetes you may experience interrupted sleep. This can be because of alarms, changing glucose levels or stress and anxiety. We have information and advice about how to get a better night’s rest.
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 to you, it’s not your fault. Remember, not everything in your type 1 management is within your control.
Your blood glucoses levels continue to rise and fall while you’re asleep, the same as they do when you’re awake. Whether they rise of fall may be due to different reasons. For example, if you’ve eaten or exercised late or taken too much insulin.
Your blood glucose goes up and down in the night, so it’s possible to 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. You may wake up with a headache and feel fuzzy headed if you’ve had a hypo during the night.
Speak to your Diabetes Healthcare Team as soon as possible if you’re worried about nighttime hypos.
Using a continuous glucose monitor (CGM) can help alert you about hypos when you’re sleeping. You can set alarms to alert you when your glucose levels are going into a hypo (usually below 4mmol).
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. It happens 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 body is able to use insulin to turn blood glucose into energy.
To see how the dawn phenomenon is affecting you, check your glucose levels in the early hours of the morning, between about 2 – 4am, to see how they change. This is easier to do if you have a continuous glucose monitor, as you can look back at your data from the previous days, weeks or even months. If you use a blood glucose meter, you will need to manually check them during these hours.
If your levels rise sharply after 4am, then the dawn phenomenon may be affecting you.
Talk to you Diabetes Healthcare Team for help if you think the dawn phenomenon is affecting your type 1 management.
We have tips to help you improve your sleep or find help if you need to. These tips are useful for anyone struggling to sleep, whether they have type 1 or not. Always talk to your Diabetes Healthcare Team if sleep is becoming an issue for you. They can help you work through what could be affecting your sleep and support you.
Make sure that you don’t have any other medical issues contributing to your sleep issues. Some research shows that obstructive sleep apnoea (OSA) is more common among people with type 1 diabetes than those without. People with OSA stop breathing repeatedly and then start again throughout the night. Talk to your GP or Diabetes Healthcare Team about whether this might be affecting you.
CGMs are great for detecting nighttime hypos and hypers, but being woken up regularly can be difficult. Talk to your Diabetes Healthcare Team about ways to minimise the disruption to your sleep. For example, they may suggest using different alarms settings for high and low blood glucose to reduce alarms (do not do this without medical advice and support).
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 need to make on a daily basis. It can also reduce the amount of times you 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 you.
If worries about type 1 diabetes are keeping you awake, talk to your Diabetes Healthcare Team or your GP, who may be able to refer you for talking therapies on the NHS. Read more about looking after your emotional wellbeing.
Try to go to bed at the same time and get up at the same time every day (including weekends).
Getting regular physical activity and being active during the day can help you fall asleep. It can also help reduce stress, anxiety and improve your emotional wellbeing.
Avoid caffeine, alcohol, or eating a lot right before you go to bed.
Create a relaxing sleeping environment – make sure your bedroom is quiet, dark and at a comfortable temperature.
Keep electronics out of your bedroom as much as possible including computers and TVs. If you use a smart phone to check your levels, try and avoid using it for anything else, like scrolling through social media.
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