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Sleepless (But Not in Seattle)

Jan Chait

December 5, 2006

Just for fun (and curiosity), I keyed "diabetes sleep" into a search engine and came up with all kinds of information. Sleep disturbances, various researchers say, are common in people with diabetes, with higher rates of insomnia, sleepiness during the day, and restless legs syndrome.

Research also says that lack of sleep can lead to insulin resistance, which is one of the cornerstones of Type 2 diabetes, and that improving sleep quality can improve blood glucose control. (For more about one of these studies, check out this previous blog entry.)

But does lack of sleep predict diabetes, or does diabetes predict lack of sleep? I have my theory: Diabetes leads to lack of sleep.

Take last Tuesday, for example. Somehow, I ended up with both grandchildren here for the night. The 13-year-old goes to an engineering program twice a month and thinks she has to sleep over on those nights. The 15-year-old decided he needed to do his homework here.

So I ferried teenagers around. From their house to mine. From my house to the engineering college. I had to go to the bank and the store. The 13-year-old wanted a burger and fries from one place. Her brother wanted a mint chocolate chip shake from another place. In and out and up and down steps I went.

Finally, the homework was done and they were showered and in bed. Now it was my turn. I set my alarm for 5:30 AM (the school bus comes early) and crawled into bed at a reasonable hour. Then I remembered that I hadn’t checked my blood glucose level and calibrated my continuous glucose monitor.

Up out of bed, where I checked my blood glucose—high. Now, where did that come from? Hmmm… I had eaten an unfamiliar sauce on the pasta I had for dinner. I probably miscalculated, I told myself. Shrugging, I gave myself a correction dose of insulin.

Back to bed. Ahhhh… My head sunk into the pillows and I snuggled under the duvet. My hand drifted to where my insulin pump infusion set was inserted to check that it was still well-adhered to my skin. It was wet. I hadn’t showered, so it shouldn’t have been wet. I sniffed my hand and breathed in the distinctive odor of insulin.

Cursing under my breath, I crawled out of bed. Again. After putting in a fresh infusion set (guaranteed to wake you up), I pondered my dilemma: How long had I gone without insulin? Did any of the correction dose I’d given myself actually get into my body? How long had my basal insulin been soaking the infusion set instead of dripping into my body?

Deciding that, if I went low, the continuous glucose monitor would wake me up, I gave myself more insulin and crawled back into bed…from which I arose about every hour or so to go to the bathroom because my blood glucose was high.

That was night one. The next night, I made it to bed OK and through the night. Almost. That was the morning I was awakened—way too early—to a cacophony of beeps, sirens, and clattering. My pump wailed that I was down to 20 units of insulin. My continuous glucose monitor vibrated and beeped that my blood glucose had dropped to less than 60 mg/dL.

OK. So my pump was low, I was low, and I had to get up and feed everybody. And it wasn’t even 5 AM yet.

Once I woke up a bit more, of course, I realized that 20 units of insulin would have bought me more sleep and that I had glucose tablets on my nightstand (I must have been saving them for an emergency).

One good night’s sleep: That’s all I ask. In the meantime, is the coffee ready? And is it time to take a nap yet?



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