Easy before bed routines for people with diabetes

Having diabetes can make it hard to fall asleep and stay asleep, but there are things you can do to improve your bedtime routine.

Managing diabetes — whether you have type 1 or type 2 — is more than a full-time job. Your condition doesn’t clock out at 5 p.m. when you’re ready to take a break. Juggling blood sugar checks, medication, exercise, and eating habits are all part of managing your blood sugar.

The mental load doesn’t stop in the evening. There are things you can do before bed to help blood sugar levels stay stable overnight. There are also strategies that may improve your sleep. 

Sleep is important for everyone, especially if you live with diabetes. Lack of sleep can increase insulin resistance and affect your mood and appetite. 

For some people, living with diabetes can affect sleep. Blood sugar can drop or rise overnight, interrupting your sleep. 

Before you set the alarm and settle in under the covers each night, here are a few bedtime to-dos. They can help you feel more in control of your diabetes overnight and sleep more soundly.

Check your blood sugar level

Regular blood sugar checks are a big part of managing your diabetes. You may already be checking your blood sugar at different times of the day, including in the morning before eating, before all meals in general, and 1 to 2 hours after a meal.

Bedtime is another good time to test. It’s natural for blood sugar to be on the higher end of that range if you’ve eaten a meal in the last 2 hours. If it’s on the lower end of that range, you may consider having a snack to prevent blood sugar from going too low. Testing at bedtime for at least 1 or 2 weeks can allow you to see some patterns.

If your blood sugar level is high before bed, it’s more likely to stay high overnight and be above target in the morning. Having the occasional high blood sugar before bed can happen to anyone with diabetes. 

If you start to notice that your blood sugar is often above target before bed, there are things you can do. Talk with your doctor about managing blood sugar at this time of the day.

Here are some steps that may help lower blood sugar in the evening:

• Change the type, timing, or dose of medications or insulin.

• Eat supper earlier.

• Decrease the amount of carbohydrates in your supper meal or bedtime snack.

• Increase the amount of protein at your supper meal or bedtime snack.

• Get out for a walk or do another activity after supper.

Be aware of the dawn phenomenon

When you live with type 1 or type 2 diabetes, you might experience something that experts named the “dawn phenomenon” or the “dawn effect.” 

Early in the morning, often between the hours of 2 a.m. and 8 a.m., your blood sugar might spike. This means that your blood sugar may be high in the morning, even before you eat anything.

A few things can cause this surge in blood sugar, including:

• hormone release early in the morning that increases insulin resistance

• insufficient insulin or medication left in your body from the night before

• high carbohydrate consumption at supper or before bed

• glucose release into your blood from your liver

Food can affect different people’s blood sugar in different ways. If you’re curious about how a certain bedtime snack may affect your blood sugar, you can do some extra testing.

Managing the dawn phenomenon

A high morning blood sugar often has nothing to do with what you eat the night before. Medication or insulin changes may be the best way to manage the dawn phenomenon. Medications and insulin are important parts of managing diabetes. It’s natural if your body needs some extra help from these treatments. 

It can be helpful to first find out more about what your blood sugar does overnight. There are a few ways to do this. A continuous glucose monitor (CGM) does constant blood sugar checks and collects this data for you to review. If you don’t use a CGM, talk with your healthcare professional about trying one. 

Another option is to check your blood sugar before bed, wake up around 3 a.m. to check again, and test first thing when you wake up. If your blood sugar is on target at bedtime but starts to rise overnight and is high in the morning, it’s likely the dawn phenomenon.

For some people, low blood sugar overnight can cause a rebound high level by morning. This is called the Somogyi effect. Checking your blood sugar around 3 a.m. will capture if your blood sugar drops at that time. Your body can release some stored sugar when this happens, causing a high blood sugar level by morning.

Insulin pumps may help keep blood sugar stable overnight. You can fine-tune your insulin dose delivery with an insulin pump to match the rise in blood sugar due to the dawn phenomenon. 

If you take long-acting insulin or medications in the evening and your blood sugar is high in the morning, it’s possible that your dose isn’t enough to get you through the night. Talk with your doctor about how to adjust the dose.

Limit stimulants

Avoid caffeine if it’s a few hours before bedtime. Sources of caffeine include coffee, some teas, chocolate, and fizzy drinks. Caffeinated foods and drinks are stimulants and can keep you awake. For some people, having caffeine anytime in the afternoon makes it hard to sleep later. Pay attention to how caffeine affects you.

Limit alcohol intake, especially if you find it affects your sleep. For some people with diabetes, alcohol can raise or lower blood sugar levels. If you drink alcohol, it’s smart to do some extra blood sugar checks to see how alcohol may affect your blood sugar.

Take a walk

Exercise helps your body use insulin more efficiently. Activity can also be a way to reduce stress and settle your mind before bed. 

Taking a walk just after dinner or before bed may help keep your blood sugar more stable overnight. Exercising too close to bedtime may impact how fast you fall asleep. However, this isn’t the case for everyone. Some people sleep fine after a workout before bed. 

Get to know your body and find what works best for you.

Prepare your bedroom for sleep

To optimise your ability to fall asleep and stay asleep, it’s a good idea if your room is quiet, cool, dark, and comfortable.

Set the thermostat between 15.6°C and 19.4°C — the optimal temperature for sleep. 

Lighting matters. Our bodies produce a hormone called melatonin, which helps you sleep. Light slows melatonin production. The greater light exposure you have, the less melatonin you produce, and the harder it can be to fall asleep. 

Dim the lights as it gets closer to bedtime. Close the shades and curtains in your bedroom so that the rising sun won’t wake you up in the morning. Consider installing room darkening or blackout curtains.

Noise can disturb your sleep too. Move your mobile phone to another room or put it in a drawer so that incoming texts and calls don’t wake you up. If you’re sensitive to noise, get a fan or white noise machine, or use earplugs to block out any unwanted sounds.

Get into a bedtime routine

Many people in the UK do not get enough sleep. Experts recommend that adults get at least 7 hours of sleep a night. However, many people simply don’t get enough. 

Many things can affect your sleep. Nerve pain, frequent thirst, the need to urinate, and hunger can all keep you awake. It’s a good idea to talk with your GP if you have any of those concerns. One way to maximise your sleep hours is to get into a bedtime routine.

Just before bed, do something to relax your body and quiet your mind to prepare for sleep. Try the following:

• Take a warm bath or shower.

• Do some gentle yoga or stretching.

• Read a book.

• Listen to relaxing music.

• Try a guided meditation

Keep the lights low. Limit your screen time. Screens emit a type of blue light that can stimulate your brain and make it harder to fall asleep.

If you can’t fall asleep right away, leave the room and read or do another quiet activity for 15 minutes, then climb back into bed and try again.

Extracts taken from Stephanie Watson from www.healthline.com