9 Tips for Getting Better Sleep
Stop counting sheep. These tips will help you get a better night’s sleep
There’s no doubt that more than an occasional poor night’s sleep is harmful to your health. Studies consistently link not getting enough shut-eye with an increased risk of high blood pressure, type 2 diabetes, obesity, depression, heart attack, and stroke. But the stakes are higher when you have type 1 or type 2 diabetes. “Just one night of insomnia can lead to problems with glucose control the next day, both because your brain isn’t working as efficiently and because your body releases increased levels of stress hormones, such as cortisol, to compensate,” says Timothy Morgenthaler, MD, past president of the American Academy of Sleep Medicine and a professor of medicine at the Mayo Clinic in Rochester, Minnesota. “That, in turn, affects blood sugar levels.”
People with diabetes are also more likely to experience sleep problems, adds Morgenthaler. High blood glucose levels, for example, can leave you feeling thirsty, so as a result you drink more water and have to wake up during the night to go to the bathroom. Low blood glucose (hypoglycemia) can also keep you up or wake you up with symptoms such as feeling light-headed, sweaty, or dizzy. If you develop nerve damage in your feet (peripheral neuropathy), the pain may make it hard to doze off or stay asleep. People with diabetes are also more prone to restless legs syndrome, a condition characterized by an uncontrollable urge to move the legs.
If any of these symptoms are keeping you up at night, see your doctor. You may need to adjust your diabetes medications. And you might need to add medications—such as a drug to alleviate neuropathy pain or the uncomfortable sensation of restless legs syndrome—if diabetes-related complications are keeping you awake. If you feel tired even though you seem to be getting enough sleep, it’s important to get screened for sleep apnea (see “When Sleepiness Is More Serious,” below).
Once these conditions are treated, sleep problems can still persist. Read on for ways to find relief.
1. Stop Hitting Snooze
Ideally, you’ll keep your sleep and wake times consistent, even on the weekends, says Michael Breus, PhD, a sleep medicine specialist in Los Angeles. But if you stay awake until the wee hours, make sure you set your alarm—and drag yourself out of bed—at your usual up-and-at-’em time. “Your wake-up time is the anchor for all your circadian rhythms,” Breus says of your body’s 24-hour internal clock. Research shows that disrupting this delicate balance can have consequences. One review of studies published last year in the journal Endocrine Review, for example, noted that a sleep shift of even an hour was enough to decrease insulin sensitivity, which means your body doesn’t absorb as much glucose, so your blood glucose levels become higher.
2. Let the Sun Shine
Open the shades as soon as you wake up. In a study published last year in the journal Sleep Health, people exposed to greater amounts of light during the morning hours fell asleep more quickly at night and had fewer sleep disturbances than those exposed to lower levels. “It helps to set your body’s circadian clock,” explains Morgenthaler. Try to increase your exposure to outdoor light in the morning and early afternoon. Go for a before-work walk or eat your lunch outdoors.
3. Drink Less Caffeine
Caffeine will keep you awake, so if you have trouble falling asleep, cut the caffeinated drinks after about 2 p.m. That may sound early, but it can take at least six hours for your body to eliminate all caffeine, according to the National Sleep Foundation. There are also good reasons why people with diabetes need to tread carefully when it comes to java: When researchers had people with type 2 diabetes consume 500 milligrams of caffeine a day (the equivalent of four 8-ounce cups of coffee), they found that their blood glucose was higher on the days they had caffeine than on days that they didn’t. Because the participants swallowed the caffeine in pill form, the rise in glucose wasn’t related to coffee—or the milk and sugar added to it—but more likely the caffeine itself.
4. Hold the Water
It’s crucial to stay hydrated when you have diabetes, but drinking too much late in the night can backfire by waking you up with the urge to go to the bathroom. Try to cut back on fluids about 90 minutes before bedtime, advises Michelle Routhenstein, MS, RD, CDE, a registered dietitian and certified diabetes educator in New York City. If you find you’re still parched, pay attention to your blood glucose. Chronically high blood glucose levels can lead to excessive thirst, so you may need to discuss a medication adjustment with your doctor.
5. Skip the Nightcap
While alcohol isn’t off limits if you have diabetes, drinking it can cause a drop in blood glucose because alcohol blocks your liver’s glucose production. This can cause fitful sleep throughout the night—and raise your risk of overnight lows. Research also shows that even just a drink or two up to an hour before bedtime may reduce the production of melatonin (a natural, sleep-promoting hormone made by your body) by nearly 20 percent. So you can have your vino; just have it earlier in the evening.
6. Change Your Bulbs
Some bulbs in lamps and ceiling fixtures emit blue light, a type of light that boosts your attention, reaction times, and overall mood. That can make it harder for you to fall asleep. You may have noticed advertisements for light bulbs that block blue light, but these can be expensive. Instead, use red bulbs in any night table lamps, suggests the National Sleep Foundation. Red wavelengths of light are most conducive to sleep. Not thrilled about your room being lit with a Christmas tree glow? Incandescent bulbs (those soft white ones) give off a warm, soothing light.
7. Don Blue Glasses
Exposure to high levels of artificial light—for example, from your iPad or TV screen—suppresses your brain’s production of melatonin. That’s because this type of light carries high levels of blue wavelengths. Those same wavelengths can prevent you from falling asleep at night, which is why experts recommend turning off all electronic devices two to three hours before hitting the sack. Sometimes, that’s just not practical, which is why Breus recommends blue blockers, glasses that filter out wavelengths in the blue part of the spectrum. (You can order blue blockers, such as Uvex Skyper, online.) One study published in 2015 in the Journal of Adolescent Health found that boys who wore blue blockers during the evening when they were glued to their computer or iPad felt significantly sleepier than those who wore clear lenses.
8. Slip on Socks
Research shows that warm feet may help with insomnia. According to a study published in 2007 in the journal Physiology and Behavior, people who wore socks to bed managed to fall asleep faster. “Warmer feet promotes sleep by causing vasodilation, or dilation of your blood vessels, which helps your brain redistribute heat throughout your body to prepare for sleep,” says Breus. This is particularly important for people with diabetes, who may have poor circulation, especially in the hands and feet.
9. Get in a Workout
When it comes to exercise, the jury is in: “Working up a sweat is important both to improve sleep and diabetes,” says Morgenthaler. Sleep experts aren’t exactly sure why, but they think that exercise may help relieve stress and anxiety, which are linked to insomnia, and also may help to normalize your body’s circadian rhythms so you feel sleepy when you should. What’s the best time to work out? Whenever you can squeeze it in. “When you look at all the research about exercising in the morning versus the afternoon versus the evening, it’s a wash,” says Morgenthaler.
Still, if you find you’re full of energy for a few hours after evening exercise, shift your workout to earlier in the day. Exercise raises your body’s temperature for about four to five hours. “Some people are more sensitive to that, which can make it harder for them to fall asleep,” says Morgenthaler. You can always throw in some light yoga or stretching exercises before bed: Harvard researchers found that women who struck a yoga pose before turning in reported less insomnia and better sleep quality. Don’t forget strength training either. People who engage in resistance training at any time of the day fall asleep faster and sleep better than those who don’t, according to a study published in 2015 in the Journal of Strength and Conditioning Research.
When Sleepiness Is More Serious
People with type 2 diabetes have a higher rate of sleep apnea, a disorder in which your upper airway becomes blocked during sleep, causing you to temporarily stop breathing. “We think this most likely happens because people are overweight or obese,” explains Timothy Morgenthaler, MD, past president of the American Academy of Sleep Medicine and a professor of medicine at the Mayo Clinic in Rochester, Minnesota.
Sleep apnea is associated with higher blood glucose levels. “When you have sleep apnea, you have many abrupt nighttime awakenings, which stresses out your body, causing it to release stress hormones like cortisol, which, in turn, increase your blood sugar,” says Morgenthaler. Sleep apnea is also linked to a higher risk of high blood pressure and stroke.
- Has your partner noticed you gasping for air during sleep?
- Are you exceedingly sleepy during the day—so tired that you NOD OFF when sitting?
- Do people tell you that you snore?
- Do you have frequent morning headaches or high blood pressure that’s difficult to get under control?
If you answered yes to any of these questions, ask your primary care physician for a referral to a sleep specialist, who can conduct an overnight sleep study.
The gold-standard sleep apnea treatment is a continuous positive airway pressure (CPAP) device: A small mask fits over your nose, and the machine creates air pressure in your throat to keep your airway open. Research shows that consistently using a CPAP device can improve blood glucose levels in people with type 2 diabetes. There are other benefits: “When you treat sleep apnea, people often find that their blood pressure is better controlled,” says Morgenthaler.