The Link Between Quality Sleep and Balanced Blood Sugars: The Definitive Guide for Type 1 Diabetes

Quality sleep is key for stable blood sugars and well-being in type 1 diabetes.

Research shows that poor sleep can (1):

disrupt glucose control
increase insulin resistance and
elevate A1C levels

Long-term, these can all raise the risk of diabetic complications when they are constantly present.

But what about when type 1 diabetics get enough sleep?

Read on to learn the positive connection between quality sleep and better blood sugars backed by research, expert insights, and actionable tips.

Let’s roll!

How Poor Sleep Commonly Affects Blood Sugar Levels

In my post, “How Poor Sleep Impacts Unstable Blood Glucose Levels,” I reviewed the negative hormonal snowball effect bad sleep can have on insulin resistance and blood sugar stability.

The quick summary is that when quality sleep is missing, many hormones can affect one another, causing:

(more) insulin resistance
increased blood sugar instability
added blood glucose management frustrations

For those who haven’t read that article, it’s important to note:

Your pancreatic beta cells are where insulin is produced
This is also where the immune system attacks before being diagnosed with type 1 diabetes
Your pancreatic β-cells also contain melatonin receptors

Melatonin is the hormone that kicks in when it’s dark.

It helps regulate your sleep-wake cycle, also known as your circadian rhythm, by making you feel tired enough to fall asleep (2).

However, blood sugar issues can disrupt sleep by causing hormonal imbalances.

In addition, prolonged artificial light at night from phones, tablets, computers, or other nightlife activities can disrupt your sleep hormones, making it more difficult to rest.

These hormones can then affect insulin function, leading to even more trouble in Hormone Town with poor sleep and insulin resistance.

Do you see how this all comes full circle? Chicken or egg? It’s a common problem in type 1 diabetes, autoimmunity, and gut dysfunction.

Dr. Terry Wahls is a doctor with severe multiple sclerosis. Her condition got so bad that she had to be wheelchair-bound, but she later regained her ability to walk.

She did this by treating her gut health and feeding her body cells the nutrition they needed to function better for her.

In her book, Wahl’s Protocol, she states four things that are always present in any sickness or disease (3).

These are:

Chronic inflammation
Cortisol dysfunction
Mitochondrial dysfunction
Imbalance of gut microbes (or gut bugs, as I’ve been calling them for simplicity’s sake)

You may know that cortisol levels rise when the immune system is activated.

However, you may not know that chronically high cortisol reduces immune function (4)

Consistent unrest typically affects many hormones, including stress hormones.

When poor sleep is a daily occurrence, we’re now already dealing with two of the four conditions that make managing blood sugar even harder:

Chronic inflammation
Cortisol dysfunction

Just one night of partial sleep deprivation among non-diabetics is capable of increasing insulin resistance to the likes of type 2 diabetic levels the very next day (5)!

If these results can occur in non-diabetics after one night of poor sleep, it follows that type 1 diabetics should be worse off after sleeping less than 6.5 hours, right (6)?

(Pssssst!…the answer is, “YES!”)

To make matters worse, there is a bi-directional relationship between poor sleep and autoimmunity (7).

Meaning that the more you experience poor sleep, the less effective your immune system can become.

Another vicious circle!

How Does Better Sleep Improve Blood Sugars?

I admit, it’d be pretty lazy of me to just say, “Better sleep will do the opposite of what poor sleep will do to your blood sugars!”

So, let’s go over these in more detail, shall we?

Better Regulation of Insulin and Glucagon

A diabetic with troubled sleep will normally be more insulin sensitive after a good night’s rest (8).

This means your cells can more easily respond to your diabetic medication.

From personal experience, I have found that as I became more insulin sensitive, I needed less insulin to stabilize my blood sugars.

It also cut the cost of buying my insulin vials. I use fewer of them monthly!

Glucagon is a hormone that raises blood sugar. It tells the liver to release its glucose stores (glycogen) when blood sugar drops or if the cells need glucose but aren’t getting any (9).

This is very common in poor blood sugar control.

Glucagon can raise blood sugars due to various stress responses, including mental, physical, emotional, and work or family stressors.

Your body naturally becomes stressed by lack of sleep. As a result, poor sleep can activate glucagon.

Cortisol and other stress hormones increase glucagon’s call for “help.”

They ask your liver to release the stored glucose your body thinks it needs.

However, when you’re resting easy-peasy-lemon-squeezy, glucagon doesn’t trigger your liver to release glycogen into your blood.

But why are insulin and glucagon so happy during restful sleep?

Reduced Cortisol Levels

Unfortunately, it’s less about what insulin or glucagon are doing. It’s more about what cortisol is NOT doing.

Remember, stress hormones shut down your “rest and digest” system and trigger your “fight or flight” responses.

This activates glucagon. It signals your liver to release glucose into your blood. Your body thinks it needs energy to respond to this “stress.”

By nightfall, and when stress isn’t a factor, cortisol, insulin, and glucagon drop while melatonin increases.

By morning, cortisol levels should be high, and melatonin should be low.

When having proper sleep, cortisol isn’t disrupted nor triggered to cause many of the hormone imbalances previously discussed.

Also, other stress hormones drop along with cortisol. This further stabilizes blood sugar levels (10, 11).

Melatonin and Glucose Regulation

When melatonin works properly, it helps keep blood sugars stable.

It does this by regulating insulin secretion via the sleep-wake cycle (12).

What’s that you say? Some of you aren’t producing any insulin?

Got it.

Well, there’s still good news for those of you with insulin resistance or dysfunction.

Melatonin signals the body to optimize glucose uptake in the cells during restful sleep.

It can do so because insulin sensitivity is naturally higher during this time, contributing to more stable blood sugars (13).

Don’t forget that stress hormones and glucagon are not activated.

This keeps blood glucose levels steady, assuming your diabetic medication is at the right doses.

Proper Growth Hormone Function

During a restful night, growth hormone is released.

Growth hormone (14):

supports glucose metabolism by promoting fat breakdown (aka lipolysis)
reduces glucose uptake in the body’s tissues and cells
maintains more stable blood glucose levels
helps build stronger bones and muscles and
aids with cell and tissue repairs
supports insulin function

Adiponectin Enhances Insulin Sensitivity

Adiponectin is a hormone released by fat cells that improves insulin sensitivity while reducing inflammation.

It does so through several ways:

Adiponectin binds to muscle and liver cells.

After doing so, it activates a regulatory enzyme called activated protein kinase (AMPK).

AMPK regulates energy balance.

AMPK stimulates the glucose transporter GLUT4 to the muscle cell membranes (15, 16).

Remember that I wrote about GLUT4 in this physical activity post. It helps create more insulin sensitivity in the muscles.

AMPK also promotes the breakdown of fatty acids for energy instead of storing them as fat.

Lastly, it signals the liver to stop glucose production.

Geek Speak: AMPK slows down gluconeogenesis (17).

Activating these cellular components increases PPAR-α activity in the liver.

PPAR-α is a receptor protein that stimulates fat breakdown and reduces triglycerides.

It also improves fat metabolism by reducing its toxic effects. This toxicity is commonly associated with insulin resistance (18).

Adiponectin suppresses inflammation (19). This protects insulin receptors and boosts sensitivity to insulin.

In addition, by reducing inflammation, this also improves the insulin signaling pathways in the body.

Better sleep enhances these adiponectin functions.

Now that you know the benefits of better sleep and blood sugars, let’s shift gears and review how common disruptive sleep is.

How Common is Poor Sleep Among Diabetics and Other Autoimmune Conditions?

Reports indicate that 50 – 70 million Americans have some form of sleep disorder (20).

However, poor sleep is a common symptom in those with autoimmunity.

Just how common?

Here are some of the more common autoimmune illnesses in the U.S., along with an estimated range of people with these conditions who also experience some form of unstable sleep:

Type 1 diabetes: 26 – 67% (21)
Type 2 diabetes: 50 – 81% (22, 23)
Lupus: up to 81% (24)
Rheumatoid arthritis: 50 – 75% (25)
Multiple sclerosis: 25 – 54% (26)
Celiac disease: 33 – 47% (27)
Hyperthyroidism/Graves’ Disease: up to 66% (28)
Hypothyroidism/Hashimoto’s: 47 – 73% (29)

I know what many of you may be thinking:

As a matter of fact, I do!

Tips for Improving Sleep Quality in Type 1 Diabetes

Let me review a few options that may help you develop a better sleep routine.

You can discuss these with your diabetes physician.

Optimize Your Blood Glucose Levels

Reviewing the numerous factors that commonly better influence blood glucose profiles can be a whole book’s worth of info!

A few things to consider are:

Don’t stress your insulin levels. You can’t eat anything you want just because you have enough insulin! I’ve written extensively on how the more insulin you demand, the more insulin resistant you likely become. A low-carb diet with plenty of supplemental and/or fermentable fibers may be useful.
Avoid highly processed and refined foods as much as possible, as these routinely spike blood sugars. This commonly results in blood sugar roller coasters. If you don’t already know, you’ll be quite surprised by gluten’s effects on the diabetic population in the medical research!
Get as active as possible! The fitter you become, the more insulin sensitive you get, especially in your skeletomuscular system. Please note that insulin resistance mainly affects the liver. However, adding as many helpful tools for diabetes management as possible can speed up and help results last.

Establish a Consistent Sleep Routine

Image source: https://quotefancy.com/quote/146892/John-C-Maxwell-Small-disciplines-repeated-with-consistency-every-day-lead-to-great

Talk to anyone successful in business, relationships, or parenting. Also, talk to those who excel at controlling healthy and stable blood sugars.

You’ll likely see a pattern of consistency, which will make it easier to accomplish these actions once they become a habit.

Personal experience has given me tremendous freedom with my disciplined routine of blood sugar management protocols.

I share these with you on all my platforms.

Don’t be mistaken. It’s simple but not easy, especially with other demands on your plate.

Maintaining a reliable pattern of sleep and wake times can benefit your sleep goals.

But, if you work graveyard shifts or late-night hours, this may cause problems until you can avoid these situations.

Create a Relaxing Sleep Environment

Let’s look at a few ways to create a more suitable sleep environment to attain this hopeful consistency!

A few ways to do this are:

Only use your bedroom for sleep and sexual activity. Keep all electronics out of your bedroom. If you can’t remove devices like your phone, put them on airplane mode while you sleep.
If you can control the temperature of your mattress or bedroom, research suggests that sleeping between 60 – 68 degrees Fahrenheit is optimal for the best rest (30, 31)!
A comfortable bed is a strong factor that may help with better rest. Although these types of beds are more costly, you tend to get what you pay for when it comes to mattresses. Not only that, but they commonly last at least 5 – 10 years. Quieter surroundings can lead to more restful sleep. I go to my Apple Music and shuffle pink noise to drown out any unwanted noise. And for the record, my phone is out of reach and in airplane mode across the room.
Sleep in your own cave! What I mean is to blackout your windows and unplug any light-emitting devices in your bedroom. You might also get a door draft stopper to block light from under your door. The more pitch-black your room is, the better (remember melatonin activation)!

Avoid Blue-Ray Lights 1 – 2 Hours Before Bed

I mentioned earlier that blue-ray lights come from LEDs, which are also used in tablets, phones, TVs, and light bulbs.

These blue-ray lights signal your brain to acknowledge it is daytime.

As a result, it should make sense that the most extravagant source of blue-ray light comes from the sun.

These blue-ray lights make our brains think it’s daytime. So, nightly exposure to them may harm our sleep.

Aside from the sleep hormone melatonin, these blue-ray lights at night can be harmful.

Chronic exposure to them can disrupt your sleep. To address their effects, you can try:

Wearing blue-ray light blockers. Many of you may have seen them before, as they commonly have amber-colored lenses blocking many of the blue-ray effects just mentioned. Note that they’re all not always amber-colored. I recently got a pair of prescribed reading glasses that have blue-ray blockers instilled in them that are clear and not colored at all.
You can also install blue-ray light filters on your electronic devices through free programs like f.lux.
Consider buying incandescent light bulbs. They emit minimal blue light at night.

Avoid Eating Meals 1 – 2 Hours Before Bed

I remember bartending at Disney when I was in college.

When I got out early enough, some coworkers and I would grab finger foods, like wings, mozzarella sticks, and fries (aaaaaaand maybe a couple of drinks 😉).

Gif source: https://tenor.com/qY4aOvtozBB.gif

The next morning, I would almost always have sky-rocket blood sugars.

Want to know why?

Delayed Carb-Digestion – Remember that insulin levels, cortisol, and other stress hormones should be low upon settling down before sleep. Blue-ray lights can throw insulin off this path when the brain tells the body it’s still awake after the sun goes down. If your body doesn’t think it’s getting ready to sleep at this time, it responds by getting ready to use or metabolize energy by ensuring insulin levels don’t drop. Of course, this insulin effect is in response to healthy, non-diabetic. For type 1 diabetics with little or no insulin production and for type 2 diabetics who are insulin resistant, these altered hormones can hinder diabetic medication efficacy.

So, when eating within two hours of sleep, these hormones tend to make it more difficult for your body to digest food (32).

During sleep, the digestive process naturally slows down as your body prioritizes rest and repair over digestion.

And if you’re taking insulin medication, it may not align with this delayed absorption.

To add more fuel to this blood-sugar fire, late-night meals are rarely high in protein and veggies as they’re usually tasteful, palatable temptations loaded with yummy carbs!

This commonly leads to a prolonged state of high blood sugars (aka hyperglycemia) during the night and the next morning.

This can worsen with too much or too little insulin for this late meal.

It may then cause a string of roller coaster blood sugars (aka glycemic variability)!

Good times, huh?

Gif source: https://tenor.com/t37er6nVIi2.gif

Not a Fan of the Dawn Phenomenon? Well, I Have Bad News for You

If you’re a type 1 diabetic who experiences the Dawn Phenomenon, you may see higher-than-normal blood sugars in the morning upon waking up and shortly thereafter.This can become more problematic after a late meal from the previous night with all the reasons previously stated. It’s almost comparable to a “Perfect Storm” of sorts. This can also make it harder for many type 1 diabetics to lower their morning blood sugars.
When Quality Sleep Avoids You – Of course, these unstable blood sugars are likely to continue troubled sleep.Consistently high, low, or fluctuating blood sugars trigger stress hormones. This starts another vicious circle, causing poor sleep and unbalanced blood sugars.

Sleep Monitoring Devices and Apps for Type 1 Diabetics

Many tech options can help measure your sleep or blood sugar.

I’m not going to go through every option.

However, I will review some of the best options and devices I either use or would strongly consider.

Oura Ring – I’ve used this ring since 2018.It can categorize many rest, sleep, and activity markers. This helps assess how much your sleep routine is benefiting you. For example, when I see that I have slept less than 5 – 6 hours, I can already prepare for a more insulin resistant day with my blood sugars. Not only this, but I can also see the stages of my sleep that were worse compared to the others. This reduces the “surprise” I get when compared to the previous days I had more rest. The Oura Ring shows information about your sleep quality, heart rate, and body temperature, among other beneficial factors. This can help you find patterns. For example:

- Do high blood sugars affect your sleep?
- Does stress raise your heart rate?
- Could 30 more minutes of rapid eye movement (REM) sleep help your blood sugars?

The ring also tracks activity, so you can balance exercise with blood sugar control. By watching these signs, you can make better choices to keep your blood sugar steady and ready to feel your best daily. Many sleep devices may work well, but Oura is the only one tested by medical research (33).

F.lux – I’ll quickly mention this again.Their website has a PC and Apple version that can be downloaded. It reduces your screen’s blue-ray light at night to your desired level. This can help reduce blue-ray light effects you’d otherwise get from the screens you may be on in the evening. And don’t forget about the incandescent light bulbs, which may also help reduce the effects of blue-ray light beyond your screens!
Blue-Ray Blocking Glasses

If you can’t access f.lux, or want another sleeping tool, get some blue-ray-blocking glasses.Wear them at night after the sun goes down. Earlier versions of these glasses were amber-colored, but clearer versions are also available.
Continuing Glucose Monitors (CGMs) – If possible, use a sleep-tracking device to monitor your rest.Then, compare its data with your blood glucose readings from the same time period from your CGM. This may reveal connections to your blood sugar management results that you can measure while asleep.
Temperature-Cooling Options – I mentioned before that sleeping in a cooler place may help regulate body temperature to more desired sleeping levels.Again, there are many costly options to choose from. Some devices to consider that can cool your body for your sleep goals are:
–Eight sleep mattresses
–Bed Jet
–Brooklyn Bedding Aurora Luxe
–Helix Moonlight Luxe
Seek Functional Medicine Treatment – I’ve heard many patients’ angry frustrations as a functional medicine practitioner. They are no closer to solving their health problems despite following their doctor’s orders. If this is you, and you’ve already tried everything under the sun to get better sleep results (among other health issues), seek help from a functional medicine provider. We are trained to look where conventional medicine isn’t for your desired health results.

My practice is 100% online for anyone living in Florida, so you won’t need to leave home or deal with long waits at a clinic.

I will also open in other states, but for now, I’m starting at home!

Book a discovery call with me here for a free assessment (with no strings attached).

Please note that these recommendations are not essential for better sleep, but assessing progress without anything to measure it against can make it difficult to know if your actions are getting you closer to your goals.

If you can take advantage of these options, I hope they serve you well!

I hope this information sheds some light on how your blood glucose levels benefit from a good night’s rest with tangible options to get the rest you deserve!

Until next time, you take care!

References

Empower Your Blood Sugars to Overcome their Most Common Hurdles!

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