Sleep No More: Diabetes and Sleep Deprivation

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Without adequate sleep, I read in a recent Boston Globe article, “you get sick, fat, and stupid.” You’re at greater risk for problems including cancer, heart disease, weight gain, neuro-degenerative disease, and, yes, (type 2) diabetes. What’s more, according to a New York Times article published the same week, the problem isn’t just that so many Americans are sleep deprived—it’s that our sleep is interrupted. The Times article examined newly published research showing that the brain has a “cleaning” system that only works well when we get uninterrupted sleep. “As your body sleeps, your brain is quite actively playing the part of mental janitor: It’s clearing out all of the junk that has accumulated as a result of your daily thinking.” Without that daily cleaning, “There is a buildup of the types of proteins that the glymphatic system normally clears out during regular sleep, like beta-amyloids and tau, both associated with Alzheimer’s and other types of dementia.” And, the article continues, if someone’s sleep is interrupted repeatedly over time, the “trash” builds up, and the brain’s cleaning system can never catch up. “It’s like the difference between a snowstorm’s disrupting a single day of trash pickup and a prolonged strike. No longer quite as easy to fix, and even when the strike is over, there’s likely to be some stray debris floating around for quite some time yet.”

Diabetes and Sleep DeprivationMy guess is that anyone who has type 1 diabetes, or who has a child with type 1 diabetes, can only look at such research with a rueful shake of the head. Yes, I know Mark and I need to get more sleep. I know all about the dangers of sleep deprivation. We used to get more sleep, during those few golden years when our whole family was sleeping through the night. But now, there’s that little issue that whenever Bisi’s blood sugar is unpredictable—I’d say these days that’s about 2 or 3 nights a week—one of us needs to set the alarm and wake up at around 2; and probably again at 5. Also, if she eats dinner late, or has a late snack, we need to stay up for three hours after that to test her, once the insulin in her system has run its course.

On vacations the ratio of wakeful nights is much worse, since she’s usually not eating the low-carb foods we tend to eat at home. So we inevitably come home from a week away feeling like we’ve been run over by the sleep-deprivation express.

When you or your child has diabetes, waking up to check for lows or correct highs is an essential, constant, and especially wearying part of managing this disease. I’ve talked with several parents who wake up to check their children every single night. Someday, the one setting the alarm will be Bisi, not us. She’ll be the one to have to drag herself up out of sleep to check on her blood sugar. But I’d like this to be Mark’s and my task for as long as possible (on most nights, Bisi doesn’t seem to rouse at all when we check her; though having your finger pricked has to have some effect on quality of sleep). Her body is dealing with enough already—the daily assaults of fluctuating blood-sugars, and the continuing auto-immune attack of the disease. I’d like to keep sleep deprivation out of the mix. Someday, when Bisi’s off at college, or once an artificial pancreas has come online, Mark and I will (I hope) go back to a healthier way of sleeping.  At that point, I think we’ll have to pay our “mental janitors” some overtime.

 

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Natalie
Natalie

Our young daughter was recently diagnosed with T1D and I have also tried to keep her on relatively low- carb diet, still including fruits and lots of vegetables and legumes, but little bread, rice, pasta etc. I have always eaten this way myself and have to believe this is healthier for someone who has to manage blood sugar levels. I find the traditional recommendation to include large amount of carbs counterintuitive…however we are still very new at this…

Julie

We have a CGM for our daughter and we are up many many nights, there are lots of surprises in her blood sugar that you don’t even see when you aren’t looking.  I like having the CGM, because it means I don’t have to check unless it alarms. But of course, it means I am well aware of all the alarms…  I have said this before when I was reading your posts on your personal blog.  I don’t quite understand your choice to feed Bisi a low carb diet. I know this is the choice you’ve made for Bisi, but… Read more »

type1teacher
type1teacher

Thank you for this – I can really sympathise! As a T1D who’s been on new medication for stress recently, my blood sugar has been all over the place in the last few weeks, including several overnight hypos. I always wake up when my blood sugar gets too low, but it’s leaving me exhausted and apprehensive about returning to work next week. Plus, when I’m tired, it’s much harder to rely on ‘gut feeling’ to tell whether I’m high or low. I can’t imagine what it must be like for you worrying about your daughter though – I was diagnosed… Read more »

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