Symptoms Of Night Time Hypoglycemia
Sometimes you may wake during an episode of nocturnal hypoglycemia.
However, if you dont, you may notice one or more of the following indications that hypoglycemia may have occurred whilst you were asleep.
- Waking with a headache
- Waking with damp bed clothes and sheets from sweating
Having a clammy neck can be a particular indication of night time hypoglycemia.
The Effects Of Low Blood Sugar On Your Body
Every cell in your body needs energy to function. The main source of energy might come as a surprise: Its sugar, also known as glucose. Blood sugar is essential to proper brain, heart, and digestive function. It even helps keep your skin and vision healthy.
When your blood sugar levels fall below the normal range, its called hypoglycemia. There are many identifiable symptoms of low blood sugar, but the only way to know if you have low blood sugar is by taking a blood glucose test.
Learn more about the symptoms of low blood sugar, as well as the long-term effects on the body.
most common reasons for low blood sugar are some medications used to treat diabetes, such as insulin.
In type 1 diabetes, the pancreas can no longer produce insulin. In type 2 diabetes, the pancreas doesnt make enough insulin, or your body cant use it properly. Too much insulin or oral diabetic medication can lower the blood sugar level, leading to hypoglycemia.
However, contrary to popular belief, low blood sugar isnt exclusive to diabetes, though it is rare. It can also happen if your body makes more insulin than it should.
Another possible cause of low blood sugar is drinking too much alcohol, especially over long periods of time. This can interfere with the livers ability to create a buildup of glucose and then release it into your bloodstream when you need it.
Other causes include:
Meal And Alcohol Timing And Glucose Levels
When you wake up after a long nights sleep, your body has been in a fasting state for quite a few hours. During this fasting period, your body expends circulating and stored glucose to perform all the usual physiologic processes. If you tend to stop eating earlier in the evening and do not snack at night, this fasting window will be greater, leading to lower glucose levels during that night.
Additionally, drinking alcohol in the evening could lead to low glucose values overnight. Its thought that drinking alcohol the livers ability to make new glucose via gluconeogenesis, leading to lower circulating glucose levels. To counter this decrease, alcohol stimulates the breakdown and release of stored glucose . This balance between impaired gluconeogenesis and increased glycogenolysis means that alcohol shouldnt significantly affect glucose levels for normal, healthy individuals eating a standard diet.
However, the situation is different for those whove been fasting or are in a ketogenic state because these individuals already have much less glucose stored as glycogen in the liver and muscles. Normally this state prompts the liver to produce new glucose via gluconeogenesis, but, as noted above, alcohol inhibits this process. The result is that glucose levels can fall to dangerously low levels, and in extreme cases, this hypoglycemic state can lead to seizures, coma, or death.
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How To Determine If Nocturnal Hypoglycemia Is A Concern For You
Test your blood sugar levels before bed and immediately when you wake up to get a clear picture of your overnight blood sugar level trend. If you dont have access to a glucometer or CGM, though, you should watch out for the following nocturnal hypoglycemia symptoms:
Having a headache or confusion upon waking up
Noticing damp bedsheets and clothes
Nightmares or sleep disturbances
A rapid increase in breathing
Feeling unusually tired the following day
Trembling or shaking
A clammy neck at night
Low Sugar Symptoms & Sleep
Nighttime hypoglycemia is caused by various factors, from exercising too close to bedtime to drinking alcohol in the evening. If untreated, low overnight blood sugar levels can lead to headaches and loss of sleep and in extreme cases, seizures or even death.
You may have these symptoms when your blood sugar has dropped below 70 milligrams per deciliter . When you have had diabetes for many years, you may not always develop symptoms of mild low blood sugar.
Some young children with diabetes cannot recognize symptoms of low blood sugar. Others can, but not every time. To be safe, the parents need to do a home blood sugar test whenever they suspect low blood sugar in a child.
Symptoms may include:
You may wake up with a headache in the morning if your blood sugar was low during the night.
A useful first step towards preventing hypoglycemia is to test your blood glucose levels before bed. For people on two or more insulin injections per day can help prevent hypos overnight keeping blood glucose levels above 6.5 mm before going to bed.
If overnight hypos are suspected, carry out a test at 3 am. Together with a before bed and first thing in the morning test, this can help to understand how your sugar levels are behaving overnight.
If sugar levels are dropping too low overnight, you may need to adjust your insulin doses. Speak to your doctor if you need help with correctly adjusting your insulin.
Hypos can also be prevented by:
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Treating Low Blood Sugar At Night
There are two ranges of blood sugars to treat if your child is low because they need more carbohydrates if their blood sugar is less than 50.
Nighttime Low Blood Sugar Treatment For Children UNDER 5 Years Old:
|Blood Sugar 50 or less||Blood Sugar 51-100|
- Any 15 gram carbohydrate item
- 14 cup = 2 ounces
- 12 cup = 4 ounces
Do you still have questions about managing your childs blood sugar levels during the day or at night? Contact the diabetes team at Childrens Diabetes Center, Childrens Hospital & Medical Center at for more information about how to treat your childs blood sugar levels to keep them safe.
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What Happens To Blood Sugar While You Sleep
Itâs tied to whether the hormone insulin, which removes glucose from the blood, is working the way itâs supposed to. Blood sugar levels surge while youâre sleeping, usually around 4 to 8 a.m. for someone with a normal sleep schedule. In a healthy person, insulin can handle the surge by telling muscle, fat, and liver cells to absorb the glucose from the blood, which keeps your levels stable.
For people who have diabetes or who are likely to get it, insulin canât do that job very well, so blood sugar levels will rise higher.
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A Low Blood Sugar Level Without Diabetes
A low blood sugar level is uncommon in people who do not have diabetes.
Possible causes include:
- a gastric bypass
- other medical conditions, such as problems with your hormone levels, pancreas, liver, kidneys, adrenal glands or heart
- some medicines, including quinine
See a GP if you think you keep getting symptoms of a low blood sugar level. They can arrange some simple tests to check if your blood sugar level is low and try to find out what’s causing it.
Preventing Nocturnal Hypoglycemia: Low Blood Sugar Attacks At Night
Preventing Nocturnal Hypoglycemia: Low blood sugar attacks at night, how to prevent low blood sugar overnight, What happens if blood sugar gets too low while sleeping?
What is nocturnal hypoglycemia?
This is HYPOGLYCEMIA WHILE ASLEEP. People may not even be aware that they experience night time hypos. It is GOOD to be able to spot the SIGNS and SYMPTOMS.
It is most common in insulin users but can also happen to people who take oral antidiabetic drugs.
The symptoms include:
waking up with a headache seemingly unprovoked sleep disturbance waking up to a damp bed clothes and sheets from sweating sudden nervousness trouble thinking clearly or concentrating loss of consciousness
too high level of basal insulin alcohol consumption physical activity during the day that increases insulin sensitivity following a period of illness if basal insulin was increased absence of night time snack when one is usually taken
Other causes of low blood sugar attacks at night: certain medications, such as quinine some medical conditions, such as hepatitis or kidney disorders a tumor that produces excess insulin endocrine disorders, such as adrenal gland deficiency
To manage night time hypos, take 10-15g of a quick acting sugary food.
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Your Diabetes Devices And Hypoglycemia
Several insulin pumps are now available that make managing blood sugar levels easier, particularly when connected to a glucose meter or a CGM.
Some of the most important advantages of CGM devices are the improved insulin control and the ability to detect trends and lows early. With improved technology, it is now possible for parents to track blood sugar trends in their kids even when they are hundreds of miles apart .
In addition, automated insulin delivery systems, also known an artificial pancreas or a hybrid closed-loop system, will automatically adjust insulin to match your bodys need to help you spend more time in your target range.
Resources that provide people with T1D and their families with more detailed information about pumps and CGM devices are available through JDRF here. For people looking for a deeper understanding of technology that helps people with T1D better manage their blood sugar, JDRF resources are available here.
Eat Regular Meals And Snacks
Eating enough carbohydrates throughout the day can help keep your blood sugar levels more stable. If you skip meals or snacks, you might develop low blood sugar later in the day.
This is especially important if youre taking insulin or another diabetes medication that can cause hypoglycemia, such as sulfonylureas.
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Why Is It Important To Recognize A Low Blood Sugar Level
Low blood sugar levels can happen with Type 1 and Type 2 diabetes. Low levels are more likely to happen if you use insulin. Hypoglycemia can cause you to have falls, accidents, and injuries. A blood sugar level that gets too low can lead to seizures, coma, and death. Learn to recognize the symptoms early so you can get treatment quickly.
How Do You Treat Hypoglycemia
Treatment for hypoglycemia involves both the immediate steps needed to raise your blood sugar level in addition with the later treatment or medication dose adjustment to prevent recurrence.
To immediately raise your blood sugar level, Dr. Shah advocates the rule of 15eating 15 grams of carbohydrates and then checking your blood sugar level 15 minutes later. Fast-acting carbohydrates include:
- 4 glucose tablets
- 4 ounces of fruit juices
Keep repeating these steps every 15 minutes until your blood sugar reaches above 70 mg/dL, he explains. Once your level has stabilized, its important to then eat a snack or even a full meal to maintain that balance, Dr. Shah adds.
If your symptoms are more severe and/or a person is unable to swallow, you may need an injection of glucagon, he says.
To prevent episodes of hypoglycemia in the future, Dr. Shah says that treatment may involve the changing of prescribed regimens and dosages or adjusting your meal plans.
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What Is Nocturnal Hypoglycemia
Hypoglycemia is the term for low blood sugar, which occurs in people with type 1 and type 2 diabetes. It is defined as a blood glucose level below 70 mg/dL. Hypoglycemia is considered severe when blood sugar drops below 54 mg/dL.
People without diabetes can also develop low blood sugar, but it isnt as common as in people with diabetes.
Nocturnal hypoglycemiais when your blood sugar level drops at night, usually when youre sleeping . Nocturnal hypoglycemia can be more dangerous than hypoglycemia during the day because you might not be awake or aware of the symptoms.
What Causes A Low Blood Sugar Level
In people with diabetes, the main causes of a low blood sugar level are:
- the effects of medicine especially taking too much insulin, medicines called sulfonylureas , medicines called glinides , or some antiviral medicines to treat hepatitis C
- skipping or delaying a meal
- not eating enough carbohydrate foods in your last meal, such as bread, cereals, pasta, potatoes and fruit
- exercise, especially if it’s intense or unplanned
- drinking alcohol
Sometimes there’s no obvious reason why a low blood sugar level happens.
Very occasionally, it can happen in people who do not have diabetes.
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Wellness: What Does Sleep Have To Do With Diabetes
- Kam AtwalDoctor of Osteopathic MedicinePulmonary / Critical Care / Sleep Medicine at Adventist Health Tillamook
Diabetes is a chronic health condition that affects more than 30 million Americans and is the 7th leading cause of death in the United States. Most of us know how important weight control, exercise, and nutrition are in controlling blood sugars. What impact does sleep have?
Sleep is extremely important in maintaining our bodys performance, not only physically and mentally, but also down to the bodys chemical balances. Diabetes, whether type 1 or 2, comes down to an imbalance of the insulin and blood sugar relationship.
The right amount of sleep is needed to keep the endocrine system working well so insulin and blood sugar stays balanced. Studies have shown that too little sleep or too much sleep can increase the risk for developing diabetes and make pre-existing diabetes more difficult to control. Some research suggests a 40% increase in the risk of developing diabetes if sleeping less than four hours per night. The human body is very complicated, and it needs just the right amount of sleep to work properly. The recommendation of about 7-8 hours a night comes from years of research to evaluate the amount sleep needed for our bodies to function at their best.
Some steps to
1. Have a regular sleep and wake time
2. Bedtime routine: wind down, read, no TV, keep bedroom dark, cool, quiet
3. Avoid eating 2-3 hours before bed
How Can I Treat Low Blood Sugar Quickly
If you feel symptoms of low blood sugar, test your levels with a blood glucose monitor as soon as possible. If your sugar levels are low , you can follow the 15-15-15 Rule:
Eat 15 g of a fast-acting carbohydrate . Common examples of 15 g include: a half cup of fruit juice, 6 to 8 hard candies, or 3 to 4 glucose tablets.
After 15 minutes, retest your sugar levels.
If they are still low, eat 15 g more.
If you are having a severe hypoglycemic attack or are unable to treat yourself, you may need a trained person to administer an emergency injection from your glucagon kit or a nasal spray of Baqsimi. If needed, you can eat 15 g of a fast-acting carbohydrate right after. If, after 15 minutes, you are still feeling confused or unconscious, have someone call 9-1-1.
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Does Everyone Have Symptoms From Hypoglycemia
Some people dont have symptoms or dont notice them. Healthcare providers call that situation hypoglycemia unawareness. People with such a challenge arent aware when they need to do something about their blood sugar. Theyre then more likely to have severe episodes and need medical help. People with hypoglycemia unawareness should check their blood sugar more often.
How Does Lack Of Sleep Raise Your Risk
Itâs hard to know for certain. Many studies have suggested that short sleepers have irregular eating habits, snack more, and are more likely to eat unhealthy foods.
Other research has found that shortchanging sleep can directly affect how the body makes other hormones, which in turn affect blood sugar. For example, when you stay up late, your body makes more of the hormone cortisol, which affects how insulin works.
Also, growing evidence shows that disrupting your bodyâs biological clock by being awake at night can make your cells more resistant to insulin. In one study, researchers altered the circadian rhythms of 16 healthy volunteers by allowing only 5 hours of sleep each night for 5 nights, much like a sleep-deprived workweek. When those volunteers ate food at night — a time when the body isnât biologically prepared for a spike in blood sugar — their bodies didnât use insulin normally.
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Questions Caregivers Should Ask
As a family member, friend, or caregiver, you want to do your best to keep your loved one, friend, or patient safe from severe hypoglycemia. But knowing whats best can be overwhelming. Here are some questions to help you get started.
- What are my loved ones/friends/patients chances for severe hypoglycemia?
- How often should my loved one/friend/patient check their blood glucose?
- What should I do if there is no change after giving the glucagon?
- What would be the best food or drink to give my loved one/friend/patient once they wake up?
- Should I talk with a diabetes educator?
- How can I help treat their hypoglycemia?
Sleep Helps To Regulate Body Fat
Sleep helps to maintain your body weight in many different ways, including regulating hunger hormones and insulin levels, as discussed earlier.
Research published in the journal âDiabetologiaâ shows that lack of sleep increases levels of free fatty acids in your blood. Those high fatty acid levels lead to a reduction in insulin sensitivity and hamper your bodyâs ability to metabolize fat.
Controlling glucocorticoid levels is another body fat regulator. Glucocorticoids are hormones that control several processes such as metabolism, inflammatory response, and brain function. One of the principal glucocorticoids is cortisol .
Studies show that when weâre sleep-deprived, cortisol levels increase both during that night of disrupted sleep and the following dayâs long period of wakefulness. When cortisol levels increase, it can lead to insulin resistance. This can lead to an increase in blood sugar, weight gain, and potentially Type 2 Diabetes.
So, a lack of sleep negatively impacts your glucose levels in many ways. But what typically happens to your blood sugar levels when you get a good nightâs sleep? Do you know what your normal blood sugar levels should be overnight?
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