April 18, 2001
Question from Scottsdale, Arizona, USA:
My 15 year old son, who was diagnosed one and a half years ago with type 1 diabetes, has trouble staying asleep at night. He doesn’t seem to get enough restful sleep during the school week. He goes to bed around 9:00-10:00 pm and gets up at 6:00 am for school. We always make sure his blood sugar is in range before he goes to sleep even if we have to increase his carbs, and we make sure he gets 5 grams of protein in his bedtime snack. He doesn’t wake up with any lows, just wakes up. He isn’t overly active before bed so it isn’t caused by too much exercise. Does diabetes have anything to do with his sleep pattern?
Several thoughts come to mind:
This appears to be pretty standard for teenagers. My teenager gets up at the same time, but goes to bed later. She seems to sleep fine.
Maybe he is getting low and spontaneously raising the blood glucose with cortisol and other adrenal hormones. These are same hormones that wake us in the morning. It might be worth checking some sugars at a time a little earlier than he wakes up. If that fails, The Continuous Glucose Monitoring System might be worth the trouble as hypoglycemia at night is more common than most think.
Sleep problems are a big part of stress and/or depression. This is certainly worth investigating. Diabetes in a teenager is stressful enough and being a teenager is not easy either.