People with diabetes certainly aren’t immune to issues with insomnia or other sleeping problems that occur with age, jet lag or seasonal affective disorder. When that happens, sometimes counting sheep just doesn’t cut it. But there has been concern discussed recently in the D-OC about using sleep aids with diabetes. A thread on TuDiabetes starts off with the notion that “any kind of sleep aid is taboo for an insulin-dependent diabetic.” So we decided to put on our Mythbusters hat and investigate whether this claim is true or false…
Although there aren’t any recommended sleep aids specifically for people with diabetes, Kelley Champ Crumpler, a diabetes nurse educator and the wife of an endocrinologist, primarily recommends melatonin to treat sleeping problems. Melatonin is a naturally occurring hormone in your system that helps to control your sleep and wake cycles. Unlike insulin, melatonin is a hormone that is synthetically made and can be ingested, so a natural supplement is available over-the-counter (usually found in the vitamin section of your grocery store).
“We have them start with a small, 1 mg tablet before bed, and can taper up as needed,” Kelley says. “Melatonin won’t render you useless like other sleep aid/hypnotics will. It’s even safe for children to use.”
If that doesn’t work, Kelley says that using an antihistamine that contains either diphenhydramine (found in Benadryl or nighttime pain relievers like Tylenol PM or Advil PM) or doxyalimine (found in the over-the-counter sleep-aid tablets Unisom).
Anecdotal evidence on some of the diabetes forums shows that melatonin and antihistamines are the most popular way of treating insomnia. These meds are also “light” enough that they won’t knock you out so much that you won’t wake up naturally in an emergency — or from a low blood sugar. Overnight hypoglycemia or hypoglycemia unawareness is the number one cause for concern, which is why Kelley encourages testing blood sugar at bedtime or even wearing a continuous glucose monitor if you have access to one.
In addition to treating with meds, investigate possible causes of insomnia, which include: consuming caffeine too close to bedtime (last cup should be four to six hours before), exercise before bed, stress, or other stimulants. Some prescription medications, called sedative hypnotic sleep aids (Lunesta, Ambien, etc.), can be used if the other options don’t work, but those should be used as a last resort and always start with the lowest dose and taper up, Kelley says.
Like any medication, sleep aids can also cause side effects and some can be particularly addictive, so talk to your doctor about the best med for you, and make sure to let him/her know if you notice any unwanted changes. Sleep aids are generally not safe if you’re pregnant or drinking alcohol. You also don’t want to take sleep aids for a long time period, so make sure to consult with your doctor if your insomnia doesn’t get better after a couple of weeks.
Of course, we’d love to hear about it if anyone out there has a useful, diabetes-friendly sleep aid suggestion: Grandma’s old-fashioned warm milk? Wait, no… too many carbs?
Sweet dreams!
I’ve had bouts with insomnia and didn’t want to take anything and not feel lows at night so I went by this thorough list of recommendations and found it fixed my sleeping issues. I’ve gone 5 years without any problems going to sleep:
http://articles.mercola.com/sites/articles/archive/2010/10/02/secrets-to-a-good-night-sleep.aspx
Word of caution regarding antihistamines in older adults over 60 years — Benadryl (diphenhydramine) should be used with caution in older adults as it can cause dizziness, low blood pressure, and too much sedation. Diphenhydramine is on the list of meds that are potentially inappropriate in older adults. In older adults this can lead to increased risk of falling, especially when combined with other medications. As a pharmacist I encourage anyone who is considering a sleep aid, even over the counter, to consult with a pharmacist to review all of your therapy and evaluate the risk vs the benefit.
I use Melatonin and I’ve found it works well for me. No after effects the next morning, and it’s just as easy to wake up to my Dexcom or my pump.
Which actually means I sleep through the alarms about 30% of time — when IS Dexcom going to give us configurable alarm sounds??
Actually turkey is supposed to contain an ingredient that’s sleep-inducing, but I haven’t tried it. Candied yams on the other hand don’t work
It’s interesting you wrote about this right now as I am on a week’s worth of insomnia. Terrible, I am following my same routine as always: get into bed at a reasonable hour, read to make me drowsy but I just can’t drop off, or I do and wake up an hour later, zing. Cause: unknown. So, I am trying melatonin. Taking 1 or 2 tablets of 3mg before going to bed, my doctor advised it and said it takes a few days to build up in your system. So far can’t really tell. Either it’s helping or pure exhaustion has let me sleep thru the past 2 nights.
Otherwise, ambien is my drug of choice, always works and I wake up clear-headed. And while I am always slightly nervous about taking a sleeping pill for fear I won’t wake up should I have a low, I find if I need to wake up, I do. That said, as in everything diabetes, it may be different for everyone.
Parents of CWD struggle with this too… Our sleep cycles get knocked way out of balance, but it’s scary to take something that will put you too far under to hear your child’s cry or a dexcom alarm. I usually lie awake for almost 2 hours before I can fall asleep, then I pretty much wake up every other hour out of habit.
@Riva – actually, turkey is supposed to contain Melatonin! I never ambien personally, but lots of friends swear by it. I might take the leap on my next cross-country trip. Travel always messes with my sleep!
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I have used melatonin on and off for years to aid in sleep.
Depending on the time I wake up I adjust the dose.
If it is before 2 a.m. I will take about 1.5 mg and if 2 p.m. I take half of that dose. I have a tendency to be groggy in the morning if I take it after 2:30. Otherwise, it works very well for me.
Another trick is to not drink caffeine after mid afternoon and to create a sleeping ritual, like a relaxing tea and read something that is not too exciting before bedtime.
Meditation helps with sleeping, among other benefits such as immune system enhancement, less fatigue and a sense of calm.
Many think is it tryptophan an amio acid in turkey that causes sleepiness. Here is a link to a nice article explaining the process; small carb snacks help the tryptophan get into the body and also the idea of eating larger amounts, relaxing with friends and add some wine in and the combo helps us to be drowsy.
http://www.webmd.com/food-recipes/features/the-truth-about-tryptophan
DiabeticLiz
I’ve been diabetic for over 25 years, and have been taking sleeping pills for the last 10+ years. The drug I take is not a sedative; it’s an old school antidepressant that just knocks everyone out. It used to take me hours to fall asleep, and then I couldn’t stay asleep for more than 45 minutes or so at a time.
The drug is like a miracle to me; I’m healthier and happier. And the best part? It’s never ever prevented me from waking from a low. Yes, I sleep through my pump’s vibrations until it audibly alarms, but I would do that regardless. And when I get sweaty low, even without the cgm, I awake.
Oddly I can’t fall asleep if I am below 70 even with the drug. If I am lying in bed for more than an hour, I always get up and test and 99% of the time I am hovering just below 70.
Don’t be afraid or demonize sleep aids; for me, they truly made me a better person. The drug I take is trazodone. In theory it’s non habit-forming, but I’ve been taking it for so long I’m sure it would be a rough transition if I had to stop.
I get the opportunity to work with a great deal of people with type 2 diabetes that are having trouble sleeping. More often than not it’s a problem with their circadian rhythm and their adrenal gland. This is a problem that requires a saliva test done most often by quest diagnostics. If the test shows an abnormal circadian rhythm it’s important to support the connection between the brain and the adrenal gland which will help sleep.
The second and more common problem is that the adrenal gland is broken down to a point where it can no longer produce enough cortisol. Cortisol is a stress hormone, but it also helps to regulate blood sugar at night when you’re not eating. If your blood sugar drops at night and you can’t produce enough cortisol, your body will produce adrenalin instead. This will wake you up and cause your blood sugar levels to spike.
Try to eat some lean protein before bed and find a practitioner that understands the adrenal gland. Hope this info helps someone.
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This is exactly what I was looking for . thanks.
Great post, very inspiring.
[...] 5-Hydroxytryptophan, Diphenhydromine, Doxylamine Know better? Leave your own answer in the comments! Question by SaveOne: What are some of the names of the OTC sleeping aids that work the best? Best a… Know better? Leave your own answer in the comments!WordPress › [...]
[...] Melatonin, 5-Hydroxytryptophan, Diphenhydromine, Doxylamine Add your own answer in the comments! Question by SaveOne: What are some of the names of the OTC sleeping aids that work the best? Best a…ine, Doxylamine Add your own answer in the comments!WordPress › [...]
I would also strongly recommend everyone to consult with doctor before taking any sleep aids. You must be aware of their usage and side effects to avoid overdoes. Anyway, thanks for the great tips and information Allison!