Why can’t I wake up when my blood sugar is low?
Low blood sugar is scary; sleeping through the constant beeping of your phone when your blood sugar is low is a complete nightmare. For people with diabetes, it is common to sleep through these dangerous events despite the physical warning signs and technological alarms set in place.
Nocturnal hypoglycemia occurs when blood sugar levels drop below 70 mg/dL as an individual is sleeping. Research has unsurprisingly found that the condition is “common in aggressively treated type one diabetes.” Nocturnal hypoglycemia has many of the same symptoms as a daytime low blood sugar: shaking, increased heart rate, and changes in breathing. But there are some unique quirks, such as restless sleep and nightmares, that decrease one’s quality of sleep. Despite the severity of these symptoms, it is still common to sleep through a hypoglycemic episode. While this is not too concerning for someone who is able to balance their hormones, this is extremely alarming for diabetics whose body is unable to auto-regulate their blood sugar.
One factor that makes managing nocturnal hypoglycemia so difficult is how a human’s sleep cycle is dynamic; our bodies and brains have varying levels of activity throughout the night. To better understand nocturnal hypoglycemia we should get a better understanding of sleep, specifically the different stages of sleep, as outlined by the sleepfoundation.org:
· Stage one is the transitional phase where you drift between conscious and unconscious.
· Stage two is where 50% of our sleep occurs. It is still a lighter phase of sleep where heart rate and brain waves slow.
· Stage three, or deep sleep, is crucial to our bodies’ recovery and growth.
· The final stage is REM sleep, which stands for rapid eye movement. It takes around 90 minutes of sleep to reach this stage, which is characterized by an increase in brain activity. This stage makes up about 25% of the sleep cycle.
During REM sleep, blood sugar drops about 5%, increasing the risk of hypoglycemia. This is concerning because research suggests it is more difficult to wake up from REM sleep than it is to wake up from the lighter stages of sleep.
How can we reduce the risk of nocturnal hypoglycemia?
Fortunately, many technological advancements have made managing blood sugar, even at night, easier and smarter than ever. Continuous glucose monitors allow diabetics to see their sugar levels throughout the night, and mobile apps now let users and their followers get real-time notifications about their numbers. Unfortunately, these alarms are often not enough during periods of heavy sleep. This has caused some diabetics to turn to physical innovations, such as Sugar Pixel, which will shake your pillow when a low blood sugar is detected.
Tracking your sleep is now simple and popular through the rise of fitness hardware, such as Fitbits, Garmin Fitness Watches, and Oura Rings. Even without this hardware, there are many apps, such as SleepScore, Pillow, and Sleep Cycle, which can identify what stage of sleep you are in, and you can sync the data with your Apple Health or Google Fit account.
Nocturnal hypoglycemia is a complex and multifaceted issue that is impacted by both your blood sugar trends and your sleep cycle. Right now, current methods to help detect low blood sugar levels at night target only one aspect of the problem. To truly understand the problem and to better address dropping levels before they become dangerous, you need to look at the whole picture and connect your blood sugar data with your sleep cycle.
Considering the fact that many people are already tracking these two data sets, there is an opportunity to bring them together to create customizable and smart notifications to better alert users about the chance of hypoglycemia. Daia is looking to connect your Google Fit sleep data with your continuous glucose monitor to create the whole picture and prevent nocturnal hypoglycemia.
Getting a good night’s sleep is crucial, and as technology continues to improve, diabetics can dream of sleeping soundly without the fear of nocturnal hypoglycemia.
