Sleep and Diabetes

Learn how to sleep better with these science-backed tips.

We will provide you with the knowledge needed to get the best night’s sleep you have had in a very long time. However, you must take this knowledge and create a plan for yourself to help you get the much-needed rest you deserve. If you find that you are still struggling with sleep afterward, you may want to see a professional as there may be something more concerning keeping you from getting the sleep you need. Let’s get started!

How Does Sleep Impact Diabetes?

Circadian Rhythm

Research shows that chronic lack of sleep contributes to the risk of developing pre-diabetes and type 2 diabetes. Lack of sleep also has adverse effects on people with type 1 diabetes. According to the Sleep Foundation, “Circadian rhythms are 24-hour cycles that are part of the body’s internal clock, running in the background to carry out essential functions and processes. One of the most important and well-known circadian rhythms is the sleep-wake cycle.”

Another part of your circadian rhythm includes your pancreas producing insulin. When you don’t get adequate sleep over an extended period of time, you are disrupting your circadian rhythm. If you already have diabetes and aren’t getting enough sleep, your blood sugar will likely be high.


Hormones are chemical substances that affect the activity of your entire body. Almost everything you do has some effect on your hormones. Sleep is arguably the most important process we undergo on a daily basis. Its restorative process is critical to both our mind and our body, as well as glucose homeostasis. Glucose homeostasis is the balance of insulin and glucagon to maintain blood glucose.

Part of your circadian rhythm during sleep is your glucose metabolism becomes slower. This happens during the first part of the night’s sleep when slow-wave sleep dominates the sleep process. These effects are reversed during the latter part of the sleep cycle when REM sleep is more dominant. When you don’t get enough sleep, you don’t experience the second part of this process, affecting glucose homeostasis. As a result, your blood sugar is higher and less stable. 

Lack of sleep also causes the hormone ghrelin to increase while the hormone leptin decreases, which leads to increased cravings and hunger. In response, people often overeat, particularly unhealthy foods, which leads to weight gain. Weight gain and obesity are also strongly correlated with pre-diabetes and type 2 diabetes. As you can see, sleep quality has a significant impact on developing pre-diabetes and type 2 diabetes.

How Diabetes Affects Sleep

As many as 50% of people with diabetes report sleep problems. When you have high blood sugar, you urinate more frequently. If your blood sugar is high overnight, it will likely cause extra trips to the bathroom during the night, disrupting your sleep. Additionally, high blood sugar can make you feel dehydrated and lead to waking up to drink water during the night.

Many people with diabetes find they feel incredibly lethargic when their blood sugar is high. When this occurs during the day, you may find yourself taking naps. As we will discuss below, napping can disrupt your circadian rhythm and make it difficult to fall asleep at night.

Alternatively, having low blood sugar can also affect sleep. Symptoms include shakiness, dizziness, confusion, sweating, and nightmares. Low blood sugar often causes insomnia and can lead to feeling irritated or confused when you wake up.

How Do I Find My Circadian Rhythm?

Image with a man inside a clock illustrating sleep circadian rhythmScientists have found that disrupting your circadian rhythm has a causative relationship to developing type 2 diabetes. This disruption is most commonly caused by varying work schedules, particular night shift work, exposure to artificial lights, jet lag, obesity, and sleep disorders. The result of disrupting your circadian rhythm is your pancreas’ production of insulin becomes damaged, increasing your vulnerability to developing type 2 diabetes.

It is important to know that your circadian rhythm can change as you age. It is also important to know that people have different circadian rhythms. Although there isn’t anything you can do to determine exactly when your circadian rhythm starts and ends, you can determine approximations to help get started. You can then take action to help regulate and foster your circadian rhythm.

We suggest taking this 8 question quiz to determine your individual circadian rhythm. (This quiz is free to take and doesn’t require your email or signing up for anything.)  “Night owl or early bird? Take this quiz to discover how your chronotype affects your job”.  About midway down the article, click the “TAKE THE QUIZ” button shown below:

The quiz will provide you with your chronotype or personal circadian rhythm. A chronotype refers to “a person’s natural inclination with regard to the times of day when they prefer to sleep or when they are most alert or energetic.” You will also receive some helpful information about healthy habits to help support your chronotype. This is a good first step when thinking about a healthy sleep schedule for yourself.

How Many Hours of Sleep Do I Need?

How much sleep do we need? Although we are all different and our bodies have different needs, research shows that adults need at least 7 hours of sleep. The optimal window of sleep for adults is between 7 and 9 hours of sleep. We recommend you create a sleep schedule that aims for this amount of sleep. Children and teenagers require more sleep. This article is written for adults and uses research based on recommendations for adults.

It makes sense why sleeping less than 7 hours can start to harm your body. Intuitively, we can understand that our body needs time to rest and restore. However, too much sleep (more than 9 hours) also harms your body and overall health. Too much sleep can increase the risk of diabetes, heart disease, stroke, and even death.

We all know the importance of sleep, but many of us aren’t familiar with many of the details we should know about sleep. At Total Diabetes Wellness, we believe sleep is one of the first behaviors you should self-assess and address to help reverse type 2 diabetes.

Create a Restful Environment

Long before you think about getting into bed for a good night’s sleep, you can do things that will help you get a good night of sleep. It is important to avoid alcohol and caffeine for 4 hours before going to bed to help your body be ready to sleep. Avoid taking naps, as this disrupts your body’s circadian rhythm. Exercise during the day has many health benefits, but it can also negatively impact if done too late in the day, just like caffeine and alcohol.

According to Johns Hopkins Medicine, “we do know that moderate aerobic exercise increases the amount of slow-wave sleep you get. Slow-wave sleep refers to deep sleep, where the brain and body have a chance to rejuvenate. Exercise can also help to stabilize your mood and decompress the mind, “a cognitive process that is important for naturally transitioning to sleep.”

A Restful and Relaxing Environment

Relaxing bedroom to promote sleep and a restful environment.It is important to create a restful and relaxing environment to help get a good night’s rest. Part of your rest environment is the physical space in your room. Keeping your room clean helps reduce distractions and stress from the clutter, which helps create the right mood for getting more sleep.

Blackout curtains, turning lights off, and having your devices turned off can improve the darkness in your room. Devices include phones, watches, clocks, etc. Another physical aspect of your bedroom is the temperature. Make sure that the heat is an ideal setting for you. It may be helpful to incorporate smells or music to help set the mood for sleeping.

Another physical area to make improvements in your room is your bed. When you consider that you spend around one-third of your life in your bed, it should be evident that spending some money on your bed makes sense. Determining which style of mattress is best for you depends on how you sleep. It’s also important to know when it is time to replace your current mattress. We also recommend finding a comfortable and supportive pillow and soft sheets. If it’s not cost-prohibitive, consider spending a little more on higher quality sheets that will last longer and be more comfortable.

Establish a Sleeping Routine

A sleeping routine will help your body to unwind from the day and help you relax. If you struggle going to bed at a consistent time, it may be helpful to set some alarm reminders. For example, you might have an alarm to turn off your devices and start getting ready for bed or an alarm to stop what you are doing to lay down to go to bed. Establishing a consistent schedule for sleep will help ensure that you are getting adequate sleep each night. This includes determining what time you need to wake up. When the alarm goes off in the morning, avoid hitting snooze and be ready to wake up for the day. 

We recommend keeping the same sleep schedule throughout the entire week. Be careful getting into the habit of staying up late on weekend nights and sleeping in the following day. This pattern can be difficult on your body, and you may notice more swings in your blood sugar as a result.

Watch What You Eat, Drink, and Do Before Going to Bed

As you might imagine, some foods have a negative impact on sleep. There are also foods that promote sleep and help regulate the sleep cycle. The nutrients, amino acids, enzymes, chemicals, and hormones work together in these foods. These ‘sleep beneficial’ foods should be consumed during the day, not right before bedtime. It is usually best to avoid eating within a couple of hours of when you plan to sleep.

Foods rich in promoting sleep and hormones melatonin

Here are some suggested foods to consider throughout the day. Almonds or walnuts in food or as a snack later in the day have melatonin, which helps regulate sleep. Turkey is an excellent source of protein and contains the amino acid tryptophan, which increases melatonin production. Eating fatty fish can help you fall asleep more quickly and has health benefits to your cardiovascular system. 

Chamomile tea has many health benefits; one is the antioxidant apigenin. Apigenin binds to receptors in your brain and promotes sleepiness, and reduces insomnia. Lettuce can help increase sleep duration as well as decrease how long it takes to fall asleep. Kiwifruit eaten with dinner can improve sleep duration and the efficiency of that sleep time.

Foods that Disrupt Sleep

Avoid caffeine and alcohol for 6 hours before bedtime. Sources of caffeine include coffee, chocolate, sodas, tea, and even some medications. Although alcohol may help you fall asleep faster, its effect on the quality of your sleep is disruptive. If you are going to consume alcohol, having a glass of water for each alcoholic drink is helpful. 

Smoking has nicotine, which is a stimulant, and is counterproductive for sleep if consumed before bed. Since smoking also has a harmful impact on sleep and your overall health, if you’re trying to find reasons to quit, this would be a reason you can add to your list.

Make sure you pay attention to when you eat as well. Even if you eat a healthy meal at night, eating too close to bedtime is not recommended and can negatively impact sleep. Your stomach will be full and your body will spend a lot of resources digesting the food, which can disrupt your sleep cycles.

Find a Comfortable Sleeping Position

Finding the right sleeping position depends on each individual. Factors such as injuries, arthritis, sleep disorders, snoring, or pregnancy can all change which sleeping position may be best for you. It is important to research all sleeping positions and consider any specific health concerns to find the best sleeping position. Keep in mind that trying a new sleep position may take some time, as changing your sleep routine doesn’t typically happen instantly.

Some commonly recommended sleep positions include the fetal position, on your side, on your stomach, and on your back. If you are in the market for a new mattress, we suggest determining your sleeping position first. The position you sleep in significantly impacts which style and firmness of mattress will be ideal for you. It would be unfortunate to spend a lot of money on a comfortable mattress for a current sleeping position, but the mattress becomes less comfortable after changing your sleeping position.

Although less than 10% of the population sleeps on their back, sleep experts agree that back sleeping is the best overall sleeping position. Laying on your back allows you to rest in a fully neutral position, which helps blood flow and systems operate at an optimal level. One issue some people will have sleeping on their back is snoring, which can disrupt sleep. Keep in mind that each person is different, and although the back position may be the best overall, it may not be the best for you specifically. If your sleep is disrupted at night, then you are better off finding a different sleeping position.Woman asleep on a bed illustrating different common sleep positions

Daily Physical Activity

There is substantial evidence that exercise helps you fall asleep faster and improves the quality of your sleep. Although there are several ideas as to why this is true, ultimately, exercise increases the amount of deep sleep you get. This deep sleep is responsible for your brain and body recovery. Exercise helps stabilize your mood. It also improves blood flow throughout the body, which is helpful for all of your body’s organs and vital systems.

Recall from earlier that doing something shortly before bed typically disrupts the effectiveness and efficiency of your sleep. Exercise is no different. For most people, exercising a couple of hours before bedtime keeps them awake. This happens because of the endorphins that are released and the fact that your core body temperature increases. Your body needs to reach a normal state to fall asleep and get a comfortable night’s rest.

Types of Exercise: Aerobic and Anaerobic

Two women smiling while enjoying exercising outsideEngaging in at least 30 minutes of moderate aerobic exercise is beneficial for getting a better night’s sleep. There are two main types of exercise: aerobic and anaerobic. Aerobic exercise is light exercise that you can maintain for long periods, such as walking, jogging, or biking. Anaerobic exercises are typically short bursts of activity that cannot be sustained, such as sprinting, plyometrics, or lifting heavy weights. A moderate level of exercise is also important. Straining yourself too much can cause injury and stress that disrupts sleep, and exercising too lightly would have little to no effect as well.

The statement, “Engage in at least 30 minutes of moderate aerobic exercise,” means to exercise for at least 30 minutes doing something that can be maintained for long periods at a moderate level. Going for a brisk walk, rollerblading, riding a bike, using an elliptical machine, or swimming are great examples of aerobic exercise.

Total Diabetes Wellness believes exercise programs should be implemented safely and at a moderate level. Unless you are an elite athlete, there is no need to push your body to limits and risk injury. The amount of time you lose due to an injury or soreness has a worse impact on overall health than exercising at a safe and moderate level for those not engaged in elite competitions.

Reduce Your Stress

Stress can have serious health consequences, one of which keeps you from getting the sleep you need. There are some basic principles to follow to help create the best opportunity to get a good night’s rest. For more help dealing with stress and coping strategies, please refer to our main article and sub-articles that directly address stress.


Exercise is one of the most natural and healthy activities you can do to help reduce stress. By increases dopamine levels in the brain, exercise makes you feel happier, improves blood flow, digestion, memory and focus, moods and emotions, sleep, stress, pancreatic function (insulin regulation), heart and kidney function. Other hormones, such as serotonin and adrenaline, are released during exercise. It is important not to exercise soon before bedtime. Your body should be back to a normal state when lying down to sleep. Usually this is 1-3 hours, depending on exercise intensity and how your body responds to exercise. Walking, yoga, Tai Chi, meditation, swimming, biking, and rollerblading are great exercises to help reduce stress and help you sleep at night.

Healthy Relationships

Happy family playing a card game around a tableHealthy relationships also help reduce stress aiding in your sleep efforts. Spending quality time with family and friends or with your pet helps reduce stress. A by-product of this time is laughter and smiling, which also helps reduce stress. Cuddling with a loved one also helps reduce stress. Other healthy relationships might include relationships you cultivate through your church, work, or fitness center. Be conscientious of unhealthy or toxic relationships as well. Reducing or eliminating time spent with these individuals will also help reduce your stress.

Healthy Environments

Healthy environments both during the day and before bed can help reduce stress levels. Examples include a scented candle or another form of aromatherapy, listening to soothing or relaxing music or noises, reading a good book or article, watching a motivational or self-help video, deep breathing, and journaling. All of these activities help your body and mind to relax and create a deep sense of purpose. It is important to develop healthy habits to increase your productivity, efficiency at completing tasks, and a healthy schedule of habits.

Avoiding unhealthy habits shortly before bedtime can also help reduce stress. This could be drugs, alcohol, food, caffeine, exercise (if too close to sleep), electronic devices, social media, and anything else that might get you to start thinking or worrying about something shortly before going to bed. It is equally important to avoid unhealthy habits throughout the day. Some examples of unhealthy habits include: procrastination, overcommitting yourself, and putting yourself in situations that cause stress.

Limit Daytime Naps

It is important to understand how the sleep cycle impacts napping. If you take an afternoon nap, it is best to aim for a short 20-minute nap or a longer 90-minute nap. By taking a nap somewhere in the middle of this window (30-60 minutes), you wake up in the deep stage of sleep. You feel groggy when waking up, and it can also keep you from falling asleep at night. Waking up after 20 minutes keeps you from starting the deep sleep stage, and waking up at 90 minutes allows you to get through the deep sleep cycle and wake up when your body is naturally ready to wake up.

There are countries where naps are part of the daily schedule. If you run across this information, it is also important to note that they also stay up later. Some countries that take naps see negative effects on health. Greece experiences the most positive influence from naps. It is believed that this positive effect helps reduce stress during the day. It is important to know how your culture is structured. For example, in the United States, the traditional 9 to 5 work schedule is not helpful for people taking naps. Whereas in many areas of Greece, stores and businesses close in the afternoon for “mesimeri,” and many people nap or have other forms of quiet time.

Overall, the best advice for naps is to be proactive in your sleep schedule. By going to bed at a decent time, receiving between 7 to 9 hours of comfortable sleep, and following the tips outlined in this article, you should begin to experience getting a better night’s sleep.

Take Supplements (if needed)

Most people will significantly improve their sleep duration and quality by following the steps listed in this article.

If you’ve already implemented the changes mentioned above and are still struggling with sleep, we recommend scheduling an appointment with your doctor. Consider asking them to run a complete blood panel to ensure you don’t have any health issues that could affect your sleep.

If your bloodwork is normal and you don’t have any other health issues, you may want to consider the following supplements to help you sleep.

Always discuss supplements with your doctor BEFORE beginning use. This is especially important if you are on medications. Full disclaimer here.


Foods rich in magnesium that also help sleep, nuts, fish, bananas, salmon, eggsCommonly found in food, magnesium is a mineral essential for human health and is used in over 600 cellular reactions throughout your body. Magnesium helps quiet and calm your nervous system, relaxing your body and mind. Research has found that magnesium deficiency is linked to trouble sleeping and insomnia. People with diabetes have a higher rate of magnesium deficiency, as insulin resistance is linked to magnesium loss.

The Institute of Medicine recommends a daily dietary intake of 310-360mg of magnesium for adult women and 400-420mg for adult men. It’s important to not ‘overdose’ and take too much magnesium, as that can lead to unpleasant side effects and dangerous complications. If you find you’re not getting enough magnesium through your existing diet, we recommend incorporating some of the following foods to boost your magnesium intake:

      • Spinach, dark leafy greens
      • Avocados
      • Almonds
      • Flaxseeds

Alternatively, you may want to consider taking a magnesium supplement. Magnesium citrate is a popular pill form. The recommended dosage will vary depending on your diet. Another popular pill or powder form is magnesium carbonate. Magnesium calm is a powder that can be dissolved in warm or cold water and taken before sleep.


Melatonin is a hormone your body produces naturally that tells your brain when it’s time to sleep. Working together with your body’s circadian rhythm, melatonin levels rise when it’s dark outside and lower when the sun rises.

Melatonin supplements have become increasingly popular in recent years and work to reduce the amount of time it takes to fall asleep and help you stay asleep longer. Generally considered safe, there are risks of mild side effects as with any supplement. If supplementing with melatonin, it’s recommended to start with the lowest dose and slowly increase as needed. The goal should be to take the smallest amount required.


Lavender to promote sleep, lavender flowers, lavender oil and lavender bath saltsThis purple flower’s soothing fragrance is believed to enhance sleep. Studies have shown that smelling lavender shortly before bed can improve the overall quality of your sleep.

We don’t recommend ingesting lavender oil. Ingesting oils can be dangerous and has serious side effects in some situations. Instead, try running an essential oil diffuser or put a couple of drops of lavender oil on your pillowcase.

Recognize Sleep Disorders

Several sleep disorders can have a detrimental effect on sleep. Some questions you should ask yourself to help assess if you may have a sleep disorder include:

  1. Does it take you more than 30 minutes to fall asleep?
  2. Are you exhausted and irritable during the day, even after 7-9 hours of sleep?
  3. Do you wake up several times during the night?
  4. When you wake up at night, does it take you more than an hour to fall back asleep?
  5. Do you take a lot of naps during the day?
  6. Do you find it difficult to concentrate during the day (school, work, etc.)
  7. Do you fall asleep during the day while engaged in an activity (conversation, tv, reading, etc.)
  8. Do you often wake up too early?
  9. Do you snore or breathe loudly when you sleep?
  10. Do you want to move your legs or have a tingling sensation in your legs?
  11. Do you require stimulates to help you stay awake during the day?

Man sleeping while wearing mask for sleep apneaKeep in mind that many disorders and health concerns have the same or similar side effects. If you answered yes to several of these questions, we suggest that you talk to a health professional about the possibility of having a sleep disorder. However, these symptoms might be caused by something else. Either way, it is important to talk to a doctor as there is a good possibility that something needs to be addressed.

Types of Sleep Disorders

There are several types of sleep disorders. The most common include insomnia, sleep apnea, narcolepsy, restless leg syndrome, and REM sleep behavior disorder. Insomnia is when a person has trouble falling or staying asleep. Sleep apnea is when the airway becomes blocked, and you stop breathing. Narcolepsy causes you to fall asleep suddenly. Restless Leg Syndrome (RLS) causes you to have an uncontrollable urge to move your legs while resting. REM sleep behavior disorder is when you act out your dreams while asleep.

If you want to explore more information on sleep disorders, read our article on sleep disorders.

The Bottom Line

In summary, sleep is probably the most important, yet often overlooked, part of our life that has an incredible impact on our health and productivity. Creating an optimal routine for yourself and sticking to it will prove to have long-lasting health benefits. Sleep is one area that many people can have significant gains in a short amount of time. To improve overall health, Total Diabetes Wellness believes that everyone can benefit from looking at their current sleep routines and schedule to optimize their sleep.