Diabetes And Sleep Apnea - RLS, Fatigue And Other Disturbances
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Living With Type 2

Diabetes And Sleep: What’s The Connection?

Feb 13, 2017

Diabetes and sleep related issues go hand in hand. For many diabetics, tossing and turning all night, only to wake up the next morning feeling exhausted and sluggish is an all too common occurrence. Unfortunately, poor sleep is another reason your blood sugar levels are not yet under control.

Sleep disturbance is often observed in patients diagnosed with Diabetes Type 2. Doctors believe it may be caused either by impaired glucose metabolism or the physical and psychological discomfort associated with diabetes. In fact, research shows that poor sleep also contributes towards decreased glucose tolerance and poorer insulin sensitivity.

Decode the Link between Diabetes And Sleep

The connection between sleep and diabetes is a bit of a vicious cycle. Sleep difficulties are a common result of uncontrolled diabetes as you may need to get up to urinate more often . Whenever your blood sugar rises, the kidneys try to remove the extra sugar by increasing urination, which means, you are getting up to use the bathroom all night and don’t sleep well. Also, diabetics are more susceptible to sleep-related ailments like sleep apnea and restless leg syndrome, further deteriorating sleep quality.

At the same time, poor sleep quality has a detrimental effect on blood glucose levels, and that is the reason that it is associated with an increased risk for developing type 2 diabetes in research studies. Exhaustion and poor energy levels often result in an increased desire to snack on sugary foods late into the night. The body needs energy from somewhere, and so, it turns to quick snacks. But these snacks result in high blood sugar levels, that only interfere with quality sleep. So how can you break this vicious cycle of poor sleep increasing diabetes and diabetes worsening sleep quality?

The answer – treat both conditions simultaneously. Because the truth is – well controlled diabetes leads to better sleep, and improved sleep patterns lead to better control of blood glucose levels. Research shows that sleep restriction makes our body react in a manner similar to insulin resistance, raising blood sugar levels. A good night’s sleep can improve glucose metabolism, your ability to follow your exercise and medication routine, and also help you feel less exhausted and emotional throughout the day.

Sleep Apnea and Diabetes

Sleep Apnea is the most common sleep disorder diabetics need to be aware of. If you suffer from sleep apnea, you will start and stop breathing suddenly while asleep, and the condition is more prevalent in overweight diabetics. Signs of sleep apnea include snoring, daytime drowsiness and poor quality of sleep.

For those who are overweight, studies show that sometimes sleep apnea can develop before diabetes type 2 and contributes towards uncontrolled blood sugar levels. Carrying excess weight around the neck increases risk for constricted airways during sleep, transforming into full-blown sleep apnea if not treated in time.

The correlation between sleep apnea and diabetes is well-proven in research, with interruptions to deep sleep being a key part of diabetes risk. The best way to reduce your risk is to follow a strict diet plan and exercise regularly to lose weight .

Restless Leg Syndrome and Diabetes

Restless leg syndrome is also known as Ekbom syndrome and is characterised by uncomfortable feelings in the legs during sleep, necessitating the need to move one’s legs to minimise the unpleasant sensation. It is linked to high blood glucose levels, thyroid disorders, and kidney problems.

Symptoms of RLS vary from uncomfortable to downright irritating and painful. Some patients experience a burning feeling, or an experience similar to insects crawling on the legs. Others notice numbness, muscle twitches and tingling. RLS overlaps with neuropathy or nerve pain and can sometimes be difficult to diagnose, especially in patients of diabetes type 2. The only differentiating factor is that RLS only afflicts the diabetic during sleep, whereas nerve pain continues in the morning even while the patient is awake.

Restless leg syndrome is treated by treating the underlying cause, which in diabetics means improving blood glucose levels.

Fatigue and Diabetes

Fatigue is caused by high blood sugar and by low blood glucose if the insulin dosage is too high

Fatigue is caused by high blood sugar and by low blood glucose if the insulin dosage is too high

With diabetes, fatigue is caused by a number of factors like high blood sugar, but can also be caused by low blood glucose levels if your insulin dosage is too high. If you feel tired despite a good diet and rest, it’s important to test your blood glucose level immediately and discuss a change in medicine/insulin dosages with your doctor.

Several diabetes related complications can also result in sleep disturbances. Low or high blood glucose can contribute to restless sleep, while diabetic neuropathies are another cause. The nerve pain is cause enough to wake up several times during the night. Unstable blood sugar levels will cause frequent urination, headaches, hunger, thirst and night sweats, none of which is conducive to a good night’s sleep.

Tips to Sleep Better

To improve quality of sleep, good sleep hygiene is a must – with or without diabetes. Follow these tips to get the rest you need, so you can wake up alert and refreshed every morning.

  • Keep a close check on your blood sugar levels around bed-time. Low or high blood glucose levels make it difficult to get a good night’s sleep. If you are on diabetes medication of insulin, ask your doctor to adjust dosage, diet and exercise to avoid hypoglycemia at night.
  • Maintain a sleep schedule so your body can follow its natural biological rhythm. A healthy sleep routine will make your body habitual to going to bed and waking up at the same time every day. Take a refreshing shower and read a book or listen to music until you feel sleepy. Keep your bedroom a ‘distraction-free’ zone.
  • Avoid any stimulants before bedtime, including checking your email or online chatting with long-distance friends and family. Coffee, alcohol, exercise and worrisome chores are also best avoided late in the evening.
  • A disruption-free environment goes a long way to assure a good night’s rest. Turn off the lights, maintain a cool (but not cold) temperature in your bedroom and get your fidgety pet off the bed!
  • Sometimes deficiencies can exacerbate sleep related problems. Magnesium (7), iron and calcium deficiencies can contribute towards poor sleep patterns.
  • Try natural sleep remedies . These are far less-harmful than sleeping pills, which are essentially nothing more than a Band-Aid for your sleep associated problems.
  • Lose weight . Regular exercise combined with a healthy diet can help with a good night’s rest to boost your energy levels in the morning. Losing weight also minimizes risk of obstructive sleep apnea.
  • If you snore or feel drowsy during day-time, get tested for sleep apnea. Wearing CPAP machines and masks in bed can alleviate sleep apnea and help you control blood sugar levels in the long run.
  • Quit smoking. It increases risk for Restless Leg Syndrome.
  • Some fresh and dried spices can also help sleep better. Use these while you cook a healthy diabetic meal at home.
Maneera Saxena Behl
Maneera is a health and fitness enthusiast who is also a firm believer in the power of dietary supplements. A health buff, she likes to help others improve their overall well-being by achieving the right balance between nutrition, exercise and mindfulness.


1)  Sleep loss: a novel risk factor for insulin resistance and Type 2 diabetes – https://jap.physiology.org/content/99/5/2008?ref=driverlayer.com/image

2) Sleep Duration as a Risk Factor for the Development of Type 2 Diabetes – https://care.diabetesjournals.org/content/29/3/657.short

3) cA Single Night of Partial Sleep Deprivation Induces Insulin Resistance in Multiple Metabolic Pathways in Healthy Subjects – https://press.endocrine.org/doi/abs/10.1210/jc.2009-2430

4) Obstructive Sleep Apnea Among Obese Patients With Type 2 Diabetes – https://care.diabetesjournals.org/content/32/6/1017.full

5) Type 2 Diabetes, Glycemic Control, and Continuous Positive Airway Pressure in Obstructive Sleep Apnea – https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/486425

6) Restless Legs Syndrome and Quality of Sleep in Type 2 Diabetes – https://care.diabetesjournals.org/content/28/11/2633.short