Sleep and diabetes

Tuesday, 1 September 2020

Getting enough sleep is essential for good health but many people suffer from poor quality sleep at night. For people living with diabetes, sleep issues are common due to overnight variations in blood glucose levels (BGLs), BGL monitoring and alarms, or symptoms of high BGLs including a dry mouth or the need to pass urine during the night. Sleep apnoea may also be an issue.

What is sleep apnoea

Sleep apnoea is a common sleep condition, where a person’s throat becomes partially or completely blocked while they are asleep, causing them to stop breathing. As a result, blood oxygen levels fall. Typically, people stop breathing from a few seconds up to ninety seconds. The person wakes briefly and begins breathing again. This can happen many times in a night and is known as apnoea. The person is often unaware this occurs but generally feels tired.

Symptoms and causes

Adults and children can both experience sleep apnoea. The symptoms of sleep apnoea include:

  • Pausing in breathing while sleeping, that other people notice,
  • Tossing and turning,
  • Snoring,
  • Waking up and choking or gasping for air,
  • Feeling tired and unrefreshed after sleeping.

There is a strong link between sleep apnoea and type 2 diabetes. When people are diagnosed with diabetes, it is thought that between 50-80% also experience sleep apnoea. A small research study also found 40% of adults living with type 1 diabetes had sleep apnoea.

Adults

Adults who are middle-aged or older and who are above the recommended healthy weight range are more likely to be affected by sleep apnoea. Carrying excess weight can cause narrowing of the throat due to fatty tissue. A larger waistline can also make the area around the lungs smaller, causing the throat to collapse. People may also be born with a narrower facial structure and throat which can be the cause of sleep apnoea.

Children

In children, sleep apnoea is generally caused by enlarged tonsils or adenoids. However, children with type 1 diabetes are more likely to experience sleep apnoea compared to children who do not have type 1 diabetes. In addition, sleep apnoea episodes tend to be higher in children with haemoglobin A1C (HbA1c) results higher than 8.0%.

Treatment options

  • Mild sleep apnoea is often relieved or reduced by changing sleep positions. Sleeping on your side reduces the likelihood of sleep apnoea. Special pillows or wedges can also help.
  • Achieving or maintaining a healthy weight and waist circumference
  • Reducing alcohol consumption if you drink
  • Good sleeping habits and routine prior to bed can help improve sleep.

Moderate to severe sleep apnoea requires active treatment. This may require devices such as a continuous positive airway pressure (CPAP) machine or an oral appliance such as a mouth guard that is fitted by a specialist dentist.

If you think you or someone you know may be experiencing sleep apnoea, it is recommended to see a general practitioner for a referral for a sleep study. In the case of children, a request should be made to a paediatric sleep specialist.

 

Alison Crow, Pharmacist & CDE

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