Tag: sleep

What It’s Like to Wake Up in the Middle of the Night with Low Blood Sugar

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You stir suddenly from a dreamless sleep, knowing that something must’ve disturbed your slumber but not quite sure what it may have been.

This blog post was inspired by a recent middle-of-the-night low that went…well, exactly as I wrote it here. I wrote in the second-person perspective so you might be able to imagine what it’s like, if it’s something you’ve never experienced before.

Reflexively, you reach over to where your phone is perched on your nightstand. You check your notifications and confirm what you’d been hoping wouldn’t be a problem tonight: Your blood sugar is low and you must do something to fix it.

You unroll a couple of Smarties from their package, almost surprised at how dexterously you do so. After all, it’s an odd skill to have honed over the course of your life to be really good at opening up packages of the food just moments after you were sleeping soundly, but you’re accustomed to it. You chew up the Smarties as quickly as you can, grimacing slightly as their sweet-sour taste mingles with traces of toothpaste from when you brushed your teeth before bed. You sink back against your pile of pillows, sighing, as you wait for your blood sugar to come back up.

You wait. You wait some more. You scroll mindlessly through various apps on your phone. You’re not feeling better. You wonder to yourself, how much more do I have to do to fix this? You wish you weren’t alone right now. Low blood sugars are scary to deal with on your own, especially when they sneak up like this in the middle of the night.

Your mind begins to spiral as those nasty “what ifs” enter your thoughts. What if you plummet further? What if you lose a lot of sleep over this one pesky low? What if you don’t recover from this low and…?

Just as you begin to think of the most unpleasant scenario, you realize that your shakiness has subsided. The sweat on your skin has dried and your vision seems to be less foggy – it’s hard to tell in the dark, but not wanting to turn on anymore lights, you settle back into bed more comfortably and close your eyes.

You hope you can go back to sleep quickly. You hope that you don’t have to wake up again for the rest of the night for any blood sugar-related issues. You hope that you aren’t exhausted because of this one tomorrow.

You hope that tomorrow night is different, but with diabetes, you never know.

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3 Nighttime Lows in a Row

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The night of the first low, I was “good” and treated with glucose tablets.

The night of the second low, I shamelessly treated with a leftover Halloween candy blondie (okay, two of them) that I had made earlier that day.

The night of the third low, I was exhausted. And feeling nothing other than a desire to sleep, I treated with both glucose tablets AND sour patch kids, because my body decided it needed that many carbs in order for my blood sugar to level out for the rest of the night.

By that third night, I was so dang tired. I’d had to go downstairs to get the sour patch kids, and by the time I was done eating them, I couldn’t fathom walking all the way back up the stairs to get into my big, comfy bed. So I just crumbled onto the couch, pulling a blanket over me, and snoozed there for a bit. I probably could’ve curled up into a ball on my carpet and slept just as soundly, even if only for awhile, because I was so spent from being woken up in the middle of the night for the third evening in a row to treat a low blood sugar.

I wish that people knew that diabetes is truly a 24/7/365 condition.

I hate having my sleep – which seems harder and harder for me to get enough of as I get older – interrupted by something as stupid as a low blood sugar.

I hate having to eat in the middle of the night and ruining the minty taste leftover from my brushed teeth prior to bedtime.

I hate that sometimes, the low is bad enough that I get woken up one or two or even three more times in the same night because I’ve got no choice but to consume more carbs.

It seems fitting to write about this – how disruptive my diabetes has been to my sleep over the course of three nights, let alone my entire life with diabetes – during National Diabetes Awareness Month. Because I don’t think the rest of the world really understands that diabetes truly does not have an “off” switch. People who live with diabetes don’t have the luxury of sleeping peacefully without having a single worry about diabetes: It can and will disturb the soundest of sleeps, and it’s frustrating, inconvenient, and annoying every time it does.

The 1 A.M. Cupcake

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Zzzzz…huh? What’s that? I was sleeping so deeply…

Oh, I’m low.

Dazed, I roll out of bed and suddenly become aware of how hot I am. Beads of sweat are rolling down my back, making my pajamas stick to my skin. I look at the number on my Dexcom – there isn’t one.

It just says LOW.

I grow more alert and turn to my test kit to do a fingerstick check and verify my Dexcom reading. My meter says that I’m 44.

And suddenly, I’m feeling that low. I need sugar, stat. I could open the bottle of glucose tabs conveniently perched on my nightstand, chew 5 or 6, and then get settled into bed and fall back asleep relatively quickly. But the desire to get downstairs and eat the contents of my kitchen strikes, even though it’s 1 A.M. and eating too much at this time of night wouldn’t be good for either my blood sugar or my sleep hygiene.

Ignoring my more rational side (as well as my glucose tabs), I grab my phone, my meter, my PDM, and my bathrobe and stumble down the stairs in the dark. I turn on the ceiling fan in my living room in a desperate attempt to cool down faster before I walk into the kitchen.

My eyes fall on a cupcake sitting innocently on the counter.

This isn’t a picture from this particular incident – nobody wants to see me when I’m this low – but this is one of the cupcakes that I’d made. Violet always wants me to share.

I don’t think twice – I tear the wrapper off and three bites later, it’s gone.

I collapse on the couch, directly under my ceiling fan. I am a sweaty mess. This low is hitting me hard. I put the TV on in a futile attempt to distract myself while I wait for the cupcake to kick in, but instead of paying attention to what’s on the screen, all I can feel is gross for choosing to eat a damn cupcake at 1 in the morning instead of doing the “right” thing and treating my low from the comfort of my bed with glucose tabs.

20 minutes later, I start to feel chilly. I’m no longer perspiring and I feel all of my low symptoms subside. I’m better, so it’s time to head back upstairs and try to fall back asleep.

I toss and turn for a bit, cursing diabetes and its middle-of-the-night low blood sugar curveballs, and the stupid 1 A.M. cupcake that my diabetes somehow convinced me to eat to treat a low instead of waiting to have it at a time that I could actually enjoy it.

Diabetes strikes again, I think as I drift back to sleep.

The Worst Time for a Low Blood Sugar

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There’s never necessarily a good time to have a low blood sugar: Whenever they happen, they’re bound to be at least a little inconvenient.

But I was thinking about it the other day and it occurred to me that there is most definitely a worst time for a low blood sugar…at least, for me.

And that time is the middle of the night.

I love sleeping, but like many adults, I simply don’t get enough of it. So when something like a low blood sugar interrupts my slumber, it’s downright intrusive and honestly a bit scary, because I always have an underlying fear that I’ll sleep through my Dexcom alarms.

Take a recent middle-of-the-night low blood sugar for example…I was dealing with a lingering low at 1:30 A.M. I’d only been asleep for a couple of hours when I heard my Dexcom sound. I ignored it the first 3 times it went off, but something – my intuition, maybe – told me to roll over and at least check to see the level that my Dexcom was reporting.

I was somewhere in the 60s: low enough that I needed a juice box. I promptly drank it and got settled back under my covers, assuming that I would shoot back up in no time.

Nothing like waking up to a screaming Dexcom that demands you to eat sugar, stat!

Not quite. I don’t know how many minutes later, but I looked at my Dexcom again and it said I was 56. I did the whole “confirm the number with my meter” shtick and ate some glucose gummies to supplement the juice box. I was irritated and my eyes were oh-so-heavy, but from there I forced myself to turn the television on and try to get distracted by a show so I wouldn’t fall back asleep until I knew that my blood sugars were stable again. Before too long, I was heading up, so I did my best to lull myself to sleep, though I tossed and turned for awhile before I finally did drift off.

All in all, I lost about an hour to an hour and a half of sleep because of this one instance! Not all of my lows are like that – sometimes I can fix them in 5 minute flat, other times they keep me up for upwards of two hours – but it doesn’t even really matter. It’s more so the principle of the thing.

Plus, think about how freakin’ ridiculous it is that people with diabetes have to eat something sugary to come up from a low – that in itself isn’t wild, but it IS grating to have to do in the middle of the night when you aren’t hungry and were enjoying a deep sleep. Also…ever try drinking orange juice after you’ve brushed your teeth? It’s unpleasant, to put it mildly.

So you have it: The middle of the night is the absolute worst time for a low blood sugar, in my semi-expert opinion.

When it Comes to Dexcom Alarms…Never Assume

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I may have had diabetes for more than three-quarters of my life, but that doesn’t mean that I don’t make silly mistakes with it from time to time.

But I must admit, I still surprise myself on the occasions that I make a slip-up that’s incredibly stupid…and incredibly avoidable.

When it Comes to Dexcom Alarms...Never Assume
In life with diabetes (and in general), mistakes are bound to happen…

For example, one morning my Dexcom started alarming, and I thought that I knew exactly why it was sounding off: It sounded like the signature triple buzz of a high alert, so I did what anyone else would do when it’s very early in the morning and not quite time to wake up yet…I ignored it and fell back asleep.

But true to typical Dexcom alarm nature, my sleep was interrupted again by continued buzzing. Rather than pick up my phone to dismiss the alarm, though, I decided to bolus for a couple of units without ever verifying that I was, indeed, high.

Yikes. Can you say rookie mistake?

Fortunately for me, I really did have to get up and start my day within a couple of hours of taking that bolus. Thank goodness I did, because when I got up, I immediately glanced at my Dexcom and was taken aback to see that my blood sugar had not ticked up past my high threshold in the last several hours…it had actually lost reception completely.

Ahh…so that’s what it was trying to tell me. Oops.

Furthermore, my blood sugar was inching below my low threshold – the two units I’d carelessly taken had kicked in, and all I could feel in that moment was relief that I hadn’t taken more insulin.

This story could’ve had a very different ending. I’m still kind of in disbelief that I didn’t just roll over to check my Dexcom and confirm the reason why it was alarming in the first place. I mean, that’s what I do any other time it goes off, regardless of the time of day. I suppose that I was just overly confident in what kind of alarm it was. Coupled with the fact that I was barely awake when this all went down, then it really isn’t all that crazy that this happened…but it doesn’t make me feel any less dumb.

Lesson learned. When it comes to Dexcom alarms, always check them, and never make assumptions.

 

4 Ways Diabetes Makes it Difficult to Sleep

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I’ll never forget the first time I saw my mother’s bio in her high school yearbook: She’d listed “sleep” as one of her favorite past times. I though it was hysterically funny then, and I still do now, but I also think it makes her incredibly relatable. Who doesn’t love catching some z’s?

I may not be unique to others when I say that I love a good night of sleep, but only people with diabetes know the real struggles that we, without functioning pancreases, face virtually every night at bedtime.

Because that’s right, diabetes doesn’t just make life hard for us when we’re awake, it also disrupts our precious slumbers. How dare you, diabetes!

Here’s four ways in which diabetes can make it difficult to sleep:

1 – Beeping and buzzing devices. Nobody actually likes waking up to a blaring alarm clock. Imagine not only having to contend with that, but also the possibility of low and/or high alarms going off at any hour of the night. The shrill alarms built into my Dexcom are very rude awakenings and definitely serve as an extra incentive to do everything possible to try to stay in range overnight, but we all know that diabetes can be unpredictable, so this isn’t always possible.

2 – Rolling over on uncomfortable sites. I toss and turn throughout the night: Usually, I fall asleep on my back, then switch to my side, and roll over on my stomach…multiple times throughout the night. And I never seem to be able to do it without rubbing up on a site. It doesn’t matter where it is – my arms, legs, stomach, or back – any rockin’ and rollin’ I do in my sleep is almost always bound to push my CGM sensor or pod uncomfortably harder into my body, and it can be the reason why I wake up in the middle of the night to make yet another adjustment in how I’m sleeping.

4 Ways Diabetes Makes it Difficult to Sleep
At least my diabetes has zero impact on Clarence’s ability to sleep. Was this another excuse to use my adorable dog as a good photo for this post? I shall neither confirm nor deny.

3 – Waiting for a high to come down. There have been a handful of occasions in the last year of life with diabetes ALONE in which I’ve been so, very tired but too afraid to go to sleep until my blood sugar has come down to a “safe” level. It doesn’t matter if the high was caused by incorrect carb calculations or a site that I’m not sure is working properly – I just want to avoid sleeping knowing that I have a hyperglycemic blood sugar because waking up to one in the morning is bound to start my day off on the wrong foot. And it even resulted in a trip to the ER one time, which I don’t want to experience again.

4 – Waking up to a low. Just like high blood sugar, low blood sugar can also delay and/or interrupt sleep. Whether the low happens just after brushing my teeth and I’m forced to ruin my fresh breath with something sugary (just thinking about the orange juice and mint flavor combination makes me wanna yak) or if it wakes me up from a sound slumber and I proceed down the stairs to eat the entire kitchen because I’ve run out of low supplies on the nightstand next to my bed…you get the picture. It’s downright annoying and honestly I bet that I’ve had at least a couple hundred nights of sleep in my 22+ years of diabetes disrupted to a low.

So you see, as much as a person with diabetes like me enjoys a full night of sleep, I’m always aware of the fact that my diabetes doesn’t sleep…and instead keeps me on toes.

 

A Nightmare-Induced High Blood Sugar?

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I’d never tried competitive eating before, but there I was, tying a bib around my neck and preparing to eat as many pancakes as I could within a certain window of time.

Sounds like a T1D’s nightmare, right? Attempting to bolus for an unknown amount of high-carb food that will be consumed within a matter of minutes…

…well, that’s because it was this T1D’s nightmare!

Yes, I had an actual dream (but I’m calling it a nightmare because of what happened when I woke up) that I was in a pancake-eating competition. So bloody random, weird, and kind of funny. Unfortunately for me, I never found out how I fared in the competition, because just as it was about to begin I woke up to the sounds of my CGM (both my receiver and the app on my phone) buzz-buzz-buzzing.

Blearily, I rolled over in bed to silence both of them…but my eyes opened wide when I saw what was on the screen(s).

284 with an up arrow!

Look at the stars.
The more I think about it, the more it begins to make sense…nightmares COULD definitely cause high BGs. After all, just about anything else can make my BG go up or down!

Immediately, I grabbed my meter so I could confirm that I was, indeed, that high. One finger prick later, I discovered that yes, I WAS that high – just over 300, in fact.

I was absolutely bewildered. It made no sense that I was so high. I’d been 85 just before bed and had a small package of animal crackers (15 total grams of carbohydrates) to ensure stability throughout the night. That was hours before, at around 8 P.M., so they should’ve been through my system by the time I woke up to the high, at 2 A.M. Moreover, my high alarm on my CGM is set to 180, so I’d slept through numerous alarms. That was frustrating, but I’m relieved I did eventually wake up to correct the high…the alternative, staying in a deep sleep and waking up to a sky-high number to start my day, was definitely worse.

I was struggling to make sense of the high but I knew it was more important to treat it and stay awake until I knew I was coming back down. That way, I could rule out my pump as the problem. Sighing, I took my bolus, got up out of bed, grabbed a cold water bottle from the fridge, and trudged back up the stairs to prop myself up and watch some TV to make the next hour or so go by faster.

By 3:30 A.M., I’d watched three full episodes of Sex and the City (thank you, E! Network, for playing that show at such an odd hour) and my blood sugar had tumbled back down approximately 100 points. I felt like it was now safe for me to go back to sleep, so I drifted back off to dreamland…and continued having really weird freakin’ dreams for the rest of the night (one involving me auditioning to be the voice of Moana, the Disney princess, in the movie…I can’t even begin to fathom how or why I dreamt about that).

Days later, I still don’t know how the high happened. But I think I’m closer to a conclusion: It must’ve been all those damn pancakes that I ate in my dr- I mean, nightmare.

One Night with Diabetes

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You settle into bed, ready to fall asleep after another long day.

But first, you check your blood sugar, just like you do multiple times every day.

Your glucometer reads 201.

Suddenly,  you’re a little nervous to drift off to dreamland, because you just changed your insulin pod an hour earlier and you’re not quite sure if it’s the reason behind the high blood sugar.

You wonder: Could my blood sugar be high due to a miscalculation with insulin or carbs at dinner? Is it because of my stress levels? Is it because I’m dehydrated, or because I’m starting to get sick, or because my new pod’s site is on scar tissue, or because…?

Before long, you feel incredibly exhausted because you’re cycling through what seems like an endless list of reasons why you might have an elevated blood sugar and it has zapped you mentally.

You feel your eyelids grow heavy, and just before you go to sleep, you give yourself an insulin dose that should bring your blood sugar back down before long.

You experience a broken night of sleep.

One Night with Diabetes
When you read this, put yourself in the shoes of a person with diabetes…and this is just one night with the damn thing.

Since your Dexcom app is programmed to alert you when you’re over your high threshold for an extended period of time, it goes off, practically every hour, from 10 P.M. to 1 A.M.

Every time it happens, you wake up to the sound of your Dexcom alarm blaring in your ear.

You worry about waking up others in the household before you even begin to worry about your blood sugar.

You’re pretty sure it’s not a pod problem, since your blood sugar would probably be higher if that were the culprit, but you’re too damn tired to care about the cause at this time of night.

You bolus, go back to sleep, hear a high alarm, wake up, and repeat until finally your sleep stops getting interrupted by your Dexcom.

You get a few hours of broken rest.

You wake up at 6 A.M. and realize that, after all that, your blood sugar levels are still slightly elevated.

You’re pissed that your Dexcom was off by 40+ points, as confirmed by a fingerstick check.

You take more insulin, and force yourself to get up and out of bed because it’s time to start the day: Your diabetes is waiting for nothing, least of all you.

Just another night of not enough sleep and too much worry, thanks to diabetes.

That Time Low BG Made Me Mad at the Moon

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Low blood sugars in the middle of the night are far from pleasant. But they’re especially grating when you’re just trying to have a sleepover with your best friends and your CGM alarms loudly and urgently, rousing more than just me from a peaceful slumber.

Dammit, diabetes…you’ve done it again.

I don’t know how or why the low happened. I went to bed around 1 A.M. – we had stayed up late talking, drinking wine, and eating snacks – and at that time, my blood sugar was 156. You can’t get much better than that, and it felt even sweeter because we’d eaten pizza for dinner earlier in the evening.

I thought I’d be fine overnight. I might come down a smidgen due to the unit and a half I took to cover a slice of fabulous flour-less chocolate cake (utterly heavenly), but I made the assumption that I wouldn’t come crashing down.

I should know by now…never assume with diabetes.

So it happened at about a quarter of four in the morning – a witching hour, in my mind. I woke to the frantic buzz buzz buzzing of my CGM and quickly acknowledged it, then reached for my tube of glucose tablets. I did it as silently as I could, seeing as I was sharing the room space with my three gal pals. From what I could tell, my super slow glucose tablet chewing didn’t even cause my friends to stir. It seemed that I’d successfully managed to avoid waking anyone up, thank goodness.

I was just starting to fall back into a doze when the frantic low CGM alarm blared – BEEP beep BEEP beep BEEEEEEEEEEEP. Ugh! Upon hearing the first beep I snatched up my receiver, silenced the alarm, and scooped up my test kit and my phone. I tiptoed out of the bedroom from which we were all nesting to the living room, where I searched through my backpack for the Skittles I’d purchased earlier in the day…because that’s right, this 3:45 low blood sugar hadn’t been my first in the last twelve-hour window of time.

Digital Imaging Specialist
Low blood sugar in the middle of the night can make you feel weird things…such as anger towards the moon.

I plopped myself on the couch and started furiously chewing Skittles. I remember looking out to the sliding glass doors and to the balcony and to the parking lot and then finally up to the sky to see the moon shining brightly at me. It was positively dazzling, yet infuriating with its cheerful gleam. I wanted to yell at it to stop looking so happy. I muttered to myself, “this sucks,” and reclined a bit on the couch while I waited to come up from the low.

Everything was fine within 15 minutes. I was on my way up and could safely go back to bed. And again, I congratulated myself for not waking anyone up.

Or so I thought.

“Did anyone hear my CGM go off in the middle of the night?” I asked my girlfriends, approximately six hours after the incident when we were all awake and about to head out to breakfast.

“Yes! I was wondering what that loud, aggressive noise was,” said one. I cringed, an apology lingering on the tip of my tongue, when she continued with an “are you okay? Don’t worry about the noise, I fell back asleep soon after.”

I was grateful for her reassurance, but also for her concern. It felt good to know that ultimately, she didn’t give (apologies for language) two shits about the actual sound that my low blood sugar caused, she was just worried that I recovered from it okay and could get back to sleep soon after.

I smiled to myself. Hours before, I’d been cursing the moon for merely existing and dealing with an annoying, random low blood sugar. But now, I was cruising at a great morning BG and I was on my way to get a delicious breakfast with my gal pals. Diabetes has its moments, but I sure as heck appreciate it when it cooperates during the ones that matter most. So in hindsight, the 3:45 A.M. low was nothing more than a temporary annoyance, and I was just glad that the worst thing it did was interrupt my sleep (and mine alone) for 10 minutes rather than ruin actual precious time spent with my friends.

Favorite Things Friday: Lavender Sleep Balm

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One Friday per month, I’ll write about my favorite things that make life with diabetes a little easier for me.

Diabetes and sleep can be mortal enemies. Some nights, I can sleep soundly for a full eight hours. Other nights, my sleep is interrupted three or four times by my CGM, buzzing and beeping to alert me to low or high blood sugar. It’s just as annoying as it sounds, and it’s even worse when I can’t fall back asleep after correcting accordingly. And even though I only experience interrupted sleep like this on a sporadic basis, that doesn’t make getting a sound night of sleep any less important to me.

And luckily, I’ve found something that helps me accomplish just that: lavender sleep balm.

8B4318E1-EFAC-49C4-B73F-832CD06F850E

I stumbled across it in a Target store a few months ago. I’d always known about aromatherapy and its alleged benefits, but I was definitely skeptical about it. How was I supposed to believe that sniffing essence of, well, anything would boost my mood, erase stress, or lull me to sleep?

I brushed my doubts aside and decided to give the balm a try. The instructions were simple: Massage a bit of it onto my pulse points, jump into bed, and let the soothing scents of lavender and bergamot calm me down into a blissful sleep.

The first time I tried it, I applied it to each side of my neck and on my wrists, dabbing it into my skin like a perfume. I breathed it in deeply – even if this stuff didn’t do what it promised, at least it smelled really nice. I’ve always liked the smell of lavender.

And then I don’t remember what happened next, because soon after I got into bed, I fell asleep. It…worked? And it has seemingly continued to work every night that I’ve remembered to apply it…

Don’t get me wrong here – I don’t think this balm is equivalent to a magical sleeping tonic or anything like that. But I do think that it’s a nice, relaxing thing to incorporate into my bedtime routine. I strongly suspect that the self-care aspect of it is what truly calms my mind and body down. Who knows, though? Maybe I should do a little more research into aromatherapy and learn the science behind it.

In addition to helping me sleep peacefully in spite of my diabetes, maybe it could even help me deal with the stress that it can sometimes inflict on me, as well.