Diabetes and sleep disturbances
A third of our lives on average is spent sleeping. This is the time needed by the body to regenerate itself. Many people experience difficulties to find undisturbed sleep, and may have the feeling, after a period that should have been relaxing, that they are not well rested.
Especially chronically ill people, such as diabetics, often have limited energy resources. For these people, undisturbed sleep is paramount. Furthermore, lack of sleep and sleep disturbances increase the risk of diabetes and weight problems.
It is recommended to sleep between 7 and 8 hours every day in order for the body to be sufficiently rested and efficient. To ensure a restful sleep, it is usually advised to use the bed only for sleeping purposes, to eat a light meal in the evening, and to avoid taking stimulants such as coffee, black and green tea or alcohol. However, in addition to a diabetes diagnostic, other symptoms or pathologies may also appear.
Nocturia (waking up at night to pass urine)
Nocturia is the most frequent nightly disruptive factor affecting diabetic patients. Should the renal threshold for glucose (10 mmol/l) or the HbA1c values (8%) be significantly exceeded, the urine volume also increases considerably. Nocturia often occurs with people suffering from cardiac insufficiency, or whose therapy includes certain diuretic medication, or with older men having been diagnosed with a prostatic hypertrophy.
Hypoglycemia (low blood sugar)
Hypoglycemia can occur with almost all diabetic patients whose treatment includes insulin or sulphonylurea. Low levels of glucose in the blood streams are clearly a factor contributing to sleep disturbances. However, nocturnal hypoglycemia often goes unnoticed, which may cause, upon awakening, headaches, general exhaustion and irritability. In order to prevent hypoglycaemia, it is recommended to perform glucose measurements before going to sleep, and, if necessary, to increase the amount of carbohydrates.
Nervous disturbances of the legs and feet are an eventual consequence of diabetes and can be the cause of uncomfortable pains that are usually stronger in a restful state than when the patient is moving or walking. Because the medications are not always sufficiently efficient to alleviate the pains, it is often difficult to find the required nightly rest.
This illness, characterised by breathing interruptions during sleep, often occurs with diabetic patients, especially type-2 diabetics or patients who have been diabetics for a longer time. Sleep apnoea is characterised by a weakening of the pharyngeal muscles, leading to the occlusion of the respiratory airways. These will open again only once the level of oxygen in the blood has decreased significantly, thus triggering a strong stimulation of the breathing processes in order to bring back oxygen into the lungs. Such interruptions disturb the sleep rhythm extremely significantly. The risk of hypertension or illnesses such as a stroke or a heart attack increases considerably.
Restless legs syndrome
This syndrome occurs usually while the person is sitting or lying down and is characterised by a strong urge to move the feet and the legs, especially in the evening or in the night, that is, during normal sleeping hours. Should this syndrome cause a significant deterioration of the quality of life, a medicated treatment should absolutely be indicated. However, in the early stage, these symptoms should first be addressed with simple measures, such as avoiding to move the affected body parts (for example knitting) or abstaining from drinking coffee or alcoholic drinks, especially in the evening.
Diabetic patients suffer twice as much from depression than people with a healthy metabolism. Lack of interest and of motivation often has a negative influence on sleep.
Text: Medical Tribune public – 04/2017
Translation: MyH – 06/2017