Taking care of your diabetes means addressing behaviors that can contribute to blood sugar control, such as managing stress, eating healthy, and exercising regularly. Adequate sleep is also important. On average, adults need roughly seven to nine hours of sleep, and kids need even more. Research indicates that lack of sleep can increase the risk of diabetes, but can diabetes cause insomnia?

This article explores the relationship between diabetes and insomnia, as well as treatment options.

Diabetes and sleep are connected—if one is not optimal, the other can be impacted. For example, high blood sugar (hyperglycemia) can cause increased thirst and urination. When this occurs overnight, sleep is disrupted by frequent trips to the bathroom. A person experiencing low blood sugar (hypoglycemia) may wake up irritable or from sweating, palpitations, or confusion.

Insufficient sleep disrupts hormonal balance, dropping leptin (satiety hormone) levels and increasing ghrelin (hunger hormone) levels. This hormonal disruption can lead to excess consumption of food, which can increase blood sugar.

Studies show that inadequate sleep is associated with an increased risk of type 2 diabetes. In addition, difficulty falling and staying asleep, daytime drowsiness, and poor sleep quality have been reported by people with type 2 diabetes. Research suggests that the prevalence of insomnia (symptoms) is 39% in people with type 2 diabetes.

Sleep Issues Associated With Type 2 Diabetes

Studies show a relationship between sleep problems and insulin resistance, prediabetes, and diabetes. Insulin is a hormone; its main function is to assist glucose in reaching the cells so it may be used for energy. Lack of sleep can increase insulin resistance (the cells become resistant to insulin) and overtime elevated blood sugars can increase the risk of prediabetes and type 2 diabetes.

People with type 2 diabetes are more likely to have conditions that impact sleep, such as sleep apnea, peripheral neuropathy, and restless leg syndrome.

Sleep Apnea

Sleep apnea, also referred to as Obstructive Sleep Apnea (OSA), affects about two-thirds of people with type 2 diabetes. It is a sleep disorder in which a person’s breathing starts and stops throughout the night due to recurrent upper airway collapse and is associated with full-body inflammation and oxidative stress. OSA can cause impaired glucose tolerance with insulin resistance. The more severe it is the greater impact it will have on glycemic control.

Peripheral Neuropathy

Diabetic peripheral neuropathy is nerve damage caused by diabetes that impacts the feet, legs, hands, and arms. This is the most common type of neuropathy in people with diabetes and affects about one-third to one-half of people with diabetes.

Peripheral neuropathy can cause pain, numbness, tingling, and a burning sensation. It is associated with sleep disturbances and poor sleep quality. Lack of sleep also increases pain sensitivity. Researchers suggest that because these conditions are connected, they should be treated simultaneously.

Restless Legs Syndrome

Restless legs syndrome (RLS) affects about 21% of people with type 2 diabetes and is the fourth leading cause of insomnia. The compulsion to move the legs typically occurs at night or when at rest. Symptoms of RLS are very similar to peripheral neuropathy and include things such as pain, burning, numbness, tingling, and electrical simulations.

Although frequently unrecognized, RLS impairs sleep quality and is associated with increased drug consumption at night and depressive and anxious symptoms. RLS may be a risk factor for hypertension and cardiovascular disease.

Primary Insomnia

Primary insomnia is defined as difficulty sleeping and staying asleep that typically lasts three weeks or longer. This type of insomnia also makes you feel tired and irritable during the day. Primary insomnia is not caused as a result of a medical condition or medication. There is no known cause.

Treatment

Insufficient sleep can impact your quality of life. Management of sleep disorders often requires multiple steps, including relief of symptoms and treatment of the contributing conditions. If you have diabetes, and your sleep is impaired as a result of inadequate blood sugar control, the best thing to do is get your blood sugars in a healthy range.

You will need to investigate why your blood sugar is elevated. Are you exercising enough, taking medication as prescribed, eating a healthful diet? These are just some of the variables that can impact blood sugar control. Reach out to your medical team for support.

If another condition is causing your sleep trouble, you will need to receive treatment for that condition. For example, if you have sleep apnea, your healthcare provider may recommend a Continuous Positive Airway Pressure (CPAP) machine, Bilevel positive airway pressure (BiPAP), or other alternative treatments.

Lifestyle changes can help improve symptoms. These include:

Proper sleep hygieneAdequate sleeping conditionsLimiting caffeineCorrecting vitamin deficienciesGetting regular exerciseLosing weight (for those that need to)

However, if another health condition is causing your sleep problems, you will want to treat that condition. In some instances, when lifestyle isn’t enough, medications can be prescribed to treat underlying conditions.

Summary

People with diabetes are at increased risk of having sleep-related issues. These issues can be caused by a secondary condition associated with diabetes, such as neuropathy or OSA, or as a result of diabetes symptoms, like excessive thirst or urination. If you are having trouble managing your blood sugars and as a result, your sleep is impaired, you should contact your medical team. Improvements in sleep quality can improve your glycemic control and vice versa.

A Word From Verywell

It is not uncommon for people with diabetes to have difficulty sleeping. Sleep disruption can lead to feelings of fatigue and irritability. Sometimes changing your routine, by limiting screens before bed, and reducing caffeine is enough to improve sleep. However, in many instances, treatment of the underlying issue will be necessary. Find the support and education you need to get better rest and feel more energized.