Is there any definitive link between diabetes and sleep issues?

[scottwatters]

Hi folks,

I've been diagnosed diabetic for just under a year now, and for the longest time (even before diagnosis) I've been struggling with sleep. I struggle to fall asleep, and often wake up during the night and start tossing and turning. My girlfriend has also commented that throughout the night I decide to stop breathing momentarily, which sounds a lot like sleep apnoea. For most of my life I've also had issues with constantly shaking my legs, and feeling 'antsy' when they're not moving in some way.

I've seen a few articles that link diabetes and sleep apnoea/RLS. I was wondering if anyone here has had any experience with this.

Honestly, I think I'm starting to get affected physically and mentally. I don't get good quality sleep, and often struggle sleeping more than 3/4 hours a night. I'm becoming exhausted and I often struggle concentrating on tasks, throughout the day struggling to keep my eyes open. I actually phoned my GP yesterday morning for an appointment about this, but I was told it was urgent appointments only, and I've now got an appointment on Feb 7th. I thought I was okay with this until I had more trouble sleeping last night.

Last night I went to bed before my girlfriend to try and fall asleep distraction-free. I had trouble keeping my eyes open all day, as on Monday night I got about 4 hours sleep in bed, and on Sunday I had about 3 hours sleep on the sofa, but when it came to falling asleep, I lay in bed for two hours tossing and turning, and not being able to doze off. My eyes were heavy, but my mind was going 100mph. Eventually I had to get up and went back through to the sofa. I was so close to what felt like breaking down, and I was starting to hold back tears. I just feel drained because this has went on for, honestly, the best part of a couple of years now.

I also struggle with noise. My girlfriend takes about 5 minutes to fall asleep, and she does snore. This keeps me awake, and then I can sometimes faintly hear the baby who lives in the flat downstairs crying, that'll keep me up too. That's why I tried going to bed before my girlfriend this time. I often find myself having to put on my noise cancelling headphones and putting on white noise or something, but that doesn't help.

I've tried everything at this point. Sleeping tablets, 'sleep' tea, meditation, white noise, earplugs/face masks, music, focused breathing, even counting sheep! I maybe should have went to the doctors' sooner about this, but I don't want to feel like I'm wasting anyone's time.

Like I say, has anyone had any similar experience?

Also, I checked my BG levels when I went back through to the sofa, this was 4 hours after dinner and it was at 14.1 (after taking gliclazide with dinner too). So whether high BG levels play a part, I'm not sure. I messaged the nurse at the diabetes clinic, but he wasn't sure of any link between them, so is asking around the doctors. I honestly don't think I'll survive until Feb 7th without crashing out in the middle of a Zoom call!

 

[Leadinglights]

There is a recognised link between high blood glucose levels and poor sleep, often that is something that sends people to the G P and they get a diagnosis. Equally poor restless sleep can elevate blood glucose levels as will stress.
What are you doing to try to get your blood glucose levels lower, I know you say you take medication but what about dietary changes.
I sympathise with the snoring issue, I often end up head to toe with my OH although he has been better since losing weight.
Have you tried meditation or similar, my daughter found something called Headspace useful.

 

[scottwatters]

There is a recognised link between high blood glucose levels and poor sleep, often that is something that sends people to the G P and they get a diagnosis. Equally poor restless sleep can elevate blood glucose levels as will stress.
What are you doing to try to get your blood glucose levels lower, I know you say you take medication but what about dietary changes.
I sympathise with the snoring issue, I often end up head to toe with my OH although he has been better since losing weight.
Have you tried meditation or similar, my daughter found something called Headspace useful.

Thing is, my diet is definitely not bad at all. Much, much better than what it was before I got diagnosed! I've swapped out any white rice/pasta for the wholegrain options, and been eating much more fruit and veg, whilst cutting out fizzy drinks and water almost entirely.

My girlfriend swears by Headspace but it's never worked for me. I use a different app called Waking Up (ironically), but even then it never makes me sleepy. I've tried sleep sounds playlists, white noise, you name it!

 

[helli]

Do you do any physical exercise?
I find I sleep much better when I am physically tired.
I can have a long stressful day with lots of thinking but my mind is still active when I go to bed. However, if I fit in a 30 minute cycle ride where I really push myself, I sleep like a baby ... and my blood sugars are reduced.

I appreciate high intensity exercise is not possible for everyone but I recommend trying it if you can.

 

[Leadinglights]

Thing is, my diet is definitely not bad at all. Much, much better than what it was before I got diagnosed! I've swapped out any white rice/pasta for the wholegrain options, and been eating much more fruit and veg, whilst cutting out fizzy drinks and water almost entirely.

My girlfriend swears by Headspace but it's never worked for me. I use a different app called Waking Up (ironically), but even then it never makes me sleepy. I've tried sleep sounds playlists, white noise, you name it!

If you are getting those blood glucose levels then I suspect your diet is not as good as you think it is. Wholegrain options have just as many carbs as the white version but maybe convert a bit more slowly. Fruit is quite high carb and most people stick to berries and certainly avoid tropical fruits and go easy on apples, pears and oranges. As long as your fizzy drinks are zero sugar they are usually Ok for people.
It would be useful if you keep a food diary noting everything you eat and drink with quantities and a estimate of how much TOTAL carbohydrate you are having as that will help to see where some savings could be made. Many people find around 130g per day or less is where they need to be to keep blood glucose levels down.
You could compare what you are having to see how near you are to that. Reducing portions of some of the high carb food could improve things.
As you have a monitor then testing before you eat and 2 hours after your meals you could identify any problem meals.
The diary would also give your evidence to take to your GP.

 

[scottwatters]

Do you do any physical exercise?
I find I sleep much better when I am physically tired.
I can have a long stressful day with lots of thinking but my mind is still active when I go to bed. However, if I fit in a 30 minute cycle ride where I really push myself, I sleep like a baby ... and my blood sugars are reduced.

I appreciate high intensity exercise is not possible for everyone but I recommend trying it if you can.

I don't do intense exercise, but I do do 30-40mins of yoga each morning. It's not overly intense, but it's enough to get the heart rate raised.

I used to go to the gym, but I was finding myself struggling to keep up with my levels, as I'd come back and they'd either be through the roof, or I'd be having a hypo depending on what I was doing.

 

[scottwatters]

If you are getting those blood glucose levels then I suspect your diet is not as good as you think it is. Wholegrain options have just as many carbs as the white version but maybe convert a bit more slowly. Fruit is quite high carb and most people stick to berries and certainly avoid tropical fruits and go easy on apples, pears and oranges. As long as your fizzy drinks are zero sugar they are usually Ok for people.
It would be useful if you keep a food diary noting everything you eat and drink with quantities and a estimate of how much TOTAL carbohydrate you are having as that will help to see where some savings could be made. Many people find around 130g per day or less is where they need to be to keep blood glucose levels down.
You could compare what you are having to see how near you are to that. Reducing portions of some of the high carb food could improve things.
As you have a monitor then testing before you eat and 2 hours after your meals you could identify any problem meals.
The diary would also give your evidence to take to your GP.

So I did have an initial consultation with a dietician too. I told her what my diet was like (before improving it now) and she said it was pretty good, just to cut out some of the usual snacks and other indulgences.

Portion size could possibly be an issue. My BG levels were always highest at night, so the hospital put me initially on 40mg gliclazide, but I was having way too many hypos, so it was brought down to 20mg, which I take daily with dinner. I only stick to strawberries, blueberries and grapes (which for me is a miracle, as someone who hated all fruit and veg growing up!). Any berries I have are usually in a smoothie, and some blueberries in the morning with breakfast. Normally we have dinner around half 6/7 and I test in the evening before bed around 10pm.

I've got a diary of my readings which I send to the clinic every month to monitor what's happening. I always send what I had for dinner, which is what they were most interested in (because of the high bedtime readings). I could start taking a note of everything I eat though for a while to give an overall record. Like you say, it should give me a good idea of what my carb intake actually is.

 

[EmmaL76]

Yes yes and yes! 100% it effects sleep. Before my diagnosis I was insomniac, I mean I could go nights and nights without even a wink of sleep! I would also go downstairs and watch tv on the sofa. If I did sleep I had terrible night sweats, I mean like I just got out of the shower. It’s only the last couple of months with real stable sugars 4-5 through the night that this has changed. I still have the odd bad night like last night but on the whole it is so much better. It is very stressful and your senses are heightened when you can’t sleep so hearing noises makes it worse. Try earplugs. Not eating anything after 7. RLS I also have, magnesium helps with this for me. Hope that’s some help, I know how much it can ruin your life, but it can get better

Just to add …. berries in a smoothie can be a bit of a sugar hit.. how’s you BG after those ?

 

[helli]

I used to go to the gym, but I was finding myself struggling to keep up with my levels, as I'd come back and they'd either be through the roof, or I'd be having a hypo depending on what I was doing.

I guess this is common but there are techniques to maintaining more stable levels during exercise without giving up.
There are quite a few threads about this and I think Diabetes UK was running a program to get people moving. @everydayupsanddowns is this activity program still ongoing?

 

[Leadinglights]

So I did have an initial consultation with a dietician too. I told her what my diet was like (before improving it now) and she said it was pretty good, just to cut out some of the usual snacks and other indulgences.

Portion size could possibly be an issue. My BG levels were always highest at night, so the hospital put me initially on 40mg gliclazide, but I was having way too many hypos, so it was brought down to 20mg, which I take daily with dinner. I only stick to strawberries, blueberries and grapes (which for me is a miracle, as someone who hated all fruit and veg growing up!). Any berries I have are usually in a smoothie, and some blueberries in the morning with breakfast. Normally we have dinner around half 6/7 and I test in the evening before bed around 10pm.

I've got a diary of my readings which I send to the clinic every month to monitor what's happening. I always send what I had for dinner, which is what they were most interested in (because of the high bedtime readings). I could start taking a note of everything I eat though for a while to give an overall record. Like you say, it should give me a good idea of what my carb intake actually is.

Grapes do have the reputation of being sugar bombs so I should not have too many of those,
I should start to test before and 2 hours after your evening meal since that is when your levels are high.
Do you know what your HbA1C is and how long have you been on the gliclazide. I assume you were put on that medication as you blood glucose levels were high but as you say if you were having hypos that would suggest your levels are very erratic so keeping to food diary might indicate what may be going on and you may need to be doing a bit more testing as well.

 

[scottwatters]

Yes yes and yes! 100% it effects sleep. Before my diagnosis I was insomniac, I mean I could go nights and nights without even a wink of sleep! I would also go downstairs and watch tv on the sofa. If I did sleep I had terrible night sweats, I mean like I just got out of the shower. It’s only the last couple of months with real stable sugars 4-5 through the night that this has changed. I still have the odd bad night like last night but on the whole it is so much better. It is very stressful and your senses are heightened when you can’t sleep so hearing noises makes it worse. Try earplugs. Not eating anything after 7. RLS I also have, magnesium helps with this for me. Hope that’s some help, I know how much it can ruin your life, but it can get better

Just to add …. berries in a smoothie can be a bit of a sugar hit.. how’s you BG after those ?

I've tried earplugs and they did dampen some of the noise, but for me it's so uncomfortable lying with something in my ears, especially since I'm a side sleeper!

I might try magnesium to help with the legs. I take multivitamins each morning, so I'll need to check how much I'm getting from that (if any).

BG seems to be pretty fine after the smoothies. Usually between 5-6.5 approaching dinner, when normally it's around 4.5. I don't have the smoothies often, they're mainly for breakfast or lunch and nothing else with them. Couple of handfuls of fruit along with spinach/kale, and a cup of oats if it's for breakfast.

 

[scottwatters]

Grapes do have the reputation of being sugar bombs so I should not have too many of those,
I should start to test before and 2 hours after your evening meal since that is when your levels are high.
Do you know what your HbA1C is and how long have you been on the gliclazide. I assume you were put on that medication as you blood glucose levels were high but as you say if you were having hypos that would suggest your levels are very erratic so keeping to food diary might indicate what may be going on and you may need to be doing a bit more testing as well.

I can't remember what my HbA1C was, I've not had any more testing done since my initial diagnosis back in Apr 21 unfortunately. I was initially put on gliclazide 40mg, but was quickly taken off it because of the hypos. Then, when I sent my next results I was put back to 20mg.

I've actually just set up a master spreadsheet here with all of my recorded BG levels, and a separate worksheet to act as a food diary, so I'll keep that up for a while and see if the hospital/myself can make some link between it.

 

[Leadinglights]

I can't remember what my HbA1C was, I've not had any more testing done since my initial diagnosis back in Apr 21 unfortunately. I was initially put on gliclazide 40mg, but was quickly taken off it because of the hypos. Then, when I sent my next results I was put back to 20mg.

I've actually just set up a master spreadsheet here with all of my recorded BG levels, and a separate worksheet to act as a food diary, so I'll keep that up for a while and see if the hospital/myself can make some link between it.

I think it would be worthwhile requesting another HbA1C so the results would be available for you upcoming appointment as it is relevant to your symptoms and medication decisions.

 

[scottwatters]

I think it would be worthwhile requesting another HbA1C so the results would be available for you upcoming appointment as it is relevant to your symptoms and medication decisions.

I do remember when I was last at the hospital they took I think 6 small vials of blood, so I'm not sure if that was to do with the hba1c or if it was something else. I was actually meant to have the hospital appointment last week, but it got cancelled from a phone appointment and now moved to a face-to-face one in March. I might contact the nurse/doctor and ask if that was specifically for that, and if not, see if I can get one arranged.

 

[Windy]

I used to have terrible sleep before I was diagnosed - I'd regularly wake in a sweat at 3am and lay awake for hours, unable to go back to sleep. I assumed it was to do with the menopause, being a woman of a certain age! I used to watch v boring youtube videos about trains to try and help me drop off. I'm not into trains at all (full respect to people who are, they just aren't my thing), so I think the boredom helped put me back to sleep sometimes.
Since diagnosis, I've changed my diet (kitkats, crisps and mini cheddars don't feature any more) and lost some weight, and I'm sleeping like a baby now. I think my BG levels at diagnosis would have been into double figures, whilst now they're between 5 and 6.5, so I suspect the drop in BG has helped, along with the weight loss reducing my terrible snoring.

Can you access your medical notes online @scottwatters ? then you can see what the tests were for and google what the results mean (or ask us all)
Hope you get it sorted. Sarah
PS there's a research paper which backs this up "poor diabetes control is an important factor disturbing sleep quality"

 

[Leadinglights]

I used to have terrible sleep before I was diagnosed - I'd regularly wake in a sweat at 3am and lay awake for hours, unable to go back to sleep. I assumed it was to do with the menopause, being a woman of a certain age! I used to watch v boring youtube videos about trains to try and help me drop off. I'm not into trains at all (full respect to people who are, they just aren't my thing), so I think the boredom helped put me back to sleep sometimes.
Since diagnosis, I've changed my diet (kitkats, crisps and mini cheddars don't feature any more) and lost some weight, and I'm sleeping like a baby now. I think my BG levels at diagnosis would have been into double figures, whilst now they're between 5 and 6.5, so I suspect the drop in BG has helped, along with the weight loss reducing my terrible snoring.

Can you access your medical notes online @scottwatters ? then you can see what the tests were for and google what the results mean (or ask us all)
Hope you get it sorted. Sarah

My OH will put something on which he is interested in but I am not and promptly fall asleep leaving me with the boring thing but if I go to turn it to something else he immediately wakes up and says I was watching that.

 

[Windy]

My OH will put something on which he is interested in but I am not and promptly fall asleep leaving me with the boring thing but if I go to turn it to something else he immediately wakes up and says I was watching that.

Oh @Leadinglights, that's a terrible thing for him to do to you! I hope you get your own back, I can definitely recommend train videos.

 

[rebrascora]

I agree that a combination of high BG and lack of exercise is most likely causing your sleep problems.

It sounds like you have a fair bit of wriggle room to reduce your carb intake. NHS dietary advice for Type 2 is not always helpful and usually leads to progressively stronger medication in order to control the diabetes whereas either going the Newcastle/Fast 800 weight loss program or low carb diet can help you to reduce the medication. A cup of oats is rather a lot of carbs and blitzed in a smoothy you lose the slow release of benefit of them. Basically you have increased the speed at which your body can access the sugars and starches by pulverizing the oats and the fruit and veg. Really, smoothies are so much less healthy than people are led to believe, particularly for diabetics, even home made ones. The act of chewing is also an important part of the digestive process and helps you to feel more satified with the portion you eat, so again, smoothies will lead to you wanting to eat more and spike your BG levels higher and quicker.
Exercise can be as simple as a brisk walk and after your evening meal would be an ideal time to help lower your levels and make you less likely to hypo because your food will be releasing it's glucose as your muscles are using it.

I too stopped snoring when I lost weight. Just a stone and a half made all the difference and it will also improve sleep apnoea.

 

[BlueArmy]

I don't know what the science says, but I thought I had sleep apnea and got diagnosed with diabetes instead, and then sleep apnea afterwards in short form. When my sleep was better managed, so was my blood sugar levels and desire to snack. I think they all sit in the category of comorbidities as well.

 

[Leadinglights]

I used to have terrible sleep before I was diagnosed - I'd regularly wake in a sweat at 3am and lay awake for hours, unable to go back to sleep. I assumed it was to do with the menopause, being a woman of a certain age! I used to watch v boring youtube videos about trains to try and help me drop off. I'm not into trains at all (full respect to people who are, they just aren't my thing), so I think the boredom helped put me back to sleep sometimes.
Since diagnosis, I've changed my diet (kitkats, crisps and mini cheddars don't feature any more) and lost some weight, and I'm sleeping like a baby now. I think my BG levels at diagnosis would have been into double figures, whilst now they're between 5 and 6.5, so I suspect the drop in BG has helped, along with the weight loss reducing my terrible snoring.

Can you access your medical notes online @scottwatters ? then you can see what the tests were for and google what the results mean (or ask us all)
Hope you get it sorted. Sarah
PS there's a research paper which backs this up "poor diabetes control is an important factor disturbing sleep quality"

You want a boring video with trains then look at The Ghan, a three hour film about a journey across Australia. that will definitely put you to sleep.