Too little sleep puts stress on your body, causing it to release hormones, including cortisol. “Cortisol increases insulin resistance and increases blood sugar levels,” Dr. Faiman says. On the other hand, too much sleep may also pose health dangers for people with type 2 diabetes. In a study published in 2020 in Diabetologia, individuals with diabetes who slept more (or less) than seven hours had an elevated risk of dying early, compared with those who got a full seven hours. The following strategies can help ensure that you’re getting optimal rest when managing type 2 diabetes.
1. Check for Sleep Apnea
Sleep apnea, a sleep disorder, is common among people with type 2 diabetes, says Kingman Strohl, MD, a sleep medicine specialist at University Hospitals Case Medical Center in Cleveland. According to the American Academy of Sleep Medicine, 7 in 10 people with type 2 diabetes have obstructive sleep apnea, which is often just called sleep apnea. When you’re overweight and have excess fat in your neck, it can cause sleep apnea, a condition in which breathing starts and stops while you’re asleep, as the National Sleep Foundation (NSF) notes. This abnormal breathing during sleep affects the body’s oxygen supply and leads to lower-quality sleep, the foundation reports. Symptoms of sleep apnea include loud snoring, excessive sleepiness during the day, irritability, and morning headaches. If you or your partner suspects that you have sleep apnea, ask your doctor about a sleep test. Sleep apnea can be treated with breathing devices, such as a positive airway pressure machine, as well as lifestyle changes, including losing weight, the National Heart, Lung, and Blood Institute reports.
2. Prioritize Blood Sugar Management
When your blood sugar is too high or too low, it can wake you up at night, says Joy Pape, NP, of the Comprehensive Weight Control Center at Weill Cornell Medicine and NewYork-Presbyterian in New York City. “One of the best things for better sleep with type 2 diabetes is to keep your blood sugar levels within your target range so you’re not having highs or lows that prevent you from sleeping well,” she says. Have a visit with your diabetes healthcare provider, and together you can decide on a personalized treatment plan, which includes your personal food, activity, medication, and monitoring plan, Pape says. “I highly recommend monitoring your glucose using a continuous glucose monitor, so that you can look at your glucose levels for 24-hour periods,” she adds.
3. Practice Good Sleep Hygiene
Most adults need at least seven to nine hours of sleep a night, according to the NSF. Many people don’t allow themselves adequate time for sleep, Faiman says, but if you have type 2 diabetes, it’s critical that you do so. Dr. Strohl agrees, adding that it’s essential that everyone, and especially those with chronic conditions like diabetes, plan for adequate sleep — just as you do other activities. “Never think sleep isn’t as important as watching TV or talking on the phone,” he says. Another thing to keep in mind: It’s important not to overdo it with naps. According to the NSF, naps should be kept relatively short — around 20 minutes — and limited to the early afternoon. Napping any later is likely to throw off your ability to get to sleep that night.
4. Keep a Regular Bedtime
Some of the tips for quality sleep with type 2 diabetes are the same as those for the general population, Faiman says. Near the top of the list for better sleep is having a regular routine for the time you go to bed and the time you wake up — on both weekdays and weekends, Pape says. When your sleep schedule is consistent, it helps your body’s internal clock (circadian rhythm) work best. Most people know the importance of a regular bedtime for children. Studies show that kids with consistent bedtime routines have better-quality sleep, and they also perform better on tests of executive function, memory, and attention. Other research shows that regular bedtimes are beneficial for adults as well. A study published in Chronobiology International found that having a stable bedtime and wake time every day is associated with better sleep quality and shorter sleep onset. Furthermore, a study published in 2018 in Scientific Reports suggests that a regular sleep routine is important for overall health. Researchers observed more than 1,900 adults and found that those with irregular sleep patterns weighed more, had higher blood pressure and blood sugar, and were at a higher risk of heart attack and stroke, compared with those with regular sleep schedules.
5. Turn Off Electronic Devices
Exposure to bright light — even from a smartphone — not only disrupts sleep but can also alter your metabolism and mess with your weight. A study published in PLoS ONE in 2016 found that blue-light exposure was linked to an increase in insulin resistance (which means the body has a decreased ability to move blood sugar from the bloodstream to cells to be used for energy). According to a study published in JAMA Internal Medicine in 2019, blue-light exposure at night may increase the risk of weight gain and obesity. These studies highlight the importance of turning off light sources — including your phone, TV, and computer — well before bedtime. The NSF recommends shutting off devices at least 30 minutes before bed, though doing so an hour or two earlier, if realistic, is ideal. Keep your bedroom dark throughout the night, too, and you’ll sleep better, according to the NSF.
6. Don’t Drink Alcohol Before Bed
Alcohol affects blood sugar levels. Alcohol impairs the release of glucose into the bloodstream, and it takes about two hours for your body to completely metabolize any alcohol you’ve consumed, according to the InDependent Diabetes Trust, an England-based advocacy organization for people living with diabetes. If you drink alcohol, do so in moderation and only with food, the organization says. The 2015–2020 U.S. Dietary Guidelines for Americans defines “moderation” as up to one drink per day for women and up to two drinks per day for men. To reduce the risk of sleep disturbances, the NSF recommends stopping alcohol consumption four hours before bedtime. Not to mention, not drinking too much before going to sleep might also help you avoid having to get up to go to the bathroom during the night. “Alcohol is a fragmenter of sleep,” Strohl says.
7. Exercise During the Day
You will sleep better at night if you get in some physical activity during the day, with as little as 10 minutes of aerobic exercise showing benefits, the NSF says. That’s because exercise increases your internal body temperature, and then later in the day, when it drops back down to normal, it triggers a feeling of drowsiness and helps you drift off to sleep, the foundation reports. Exercise can also help you burn calories and maintain a healthy weight, Strohl says. If you’re overweight, even a small amount of weight loss can help you better control type 2 diabetes.
8. Find Ways to De-Stress
Everyone deals with some stress, but people with type 2 diabetes are often under even more pressure due to managing a chronic condition on top of everyday stresses. When that stress becomes too much, there’s a term for it, according to the ADA — “diabetes burnout” — and it can affect your sleep. Stress causes the body’s nervous system to release the hormones cortisol and adrenaline, which regulate the fight-or-flight response in stressful or dangerous situations, according to the American Institute of Stress (AIS). Typically, once the external threat is removed, these hormones subside and the body relaxes again. But with chronic stress, this aggravation of the nervous system doesn’t go away, and the increased adrenaline and cortisol can lead to tossing and turning and feelings of restlessness, AIS says. To counteract this situation, it’s important to find ways to de-stress before you go to bed. Research shows that mindfulness techniques, such as deep breathing, visualization, and meditation, can encourage better sleep. A study published in JAMA Internal Medicine, for example, found that participating in a mindfulness program led to fewer episodes of insomnia and less daytime fatigue in adults with moderate sleep problems. If you’re awake at night for more than 20 minutes, get out of bed until you’re sleepy again, the NSF suggests.
