Sleep

Waking Up With My Sleep Cycle

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The one problem that I have been trying to solve for the better part of last year is why I often find myself feeling so tired.

Despite getting a solid 7-9 hours of sleep each night, I was waking up most mornings feeling like I had gotten a lot less.

Part of me wondered whether it was just the relentless nature of managing diabetes, on top of everything else going on in life, that was taking its toll on me. This culminated a few months ago when I lost my appetite, and just sank onto the couch after work one afternoon feeling run down.

Of course, my subconscious jumped to all sorts of conclusions. Is it anaemia? Another autoimmune condition? I’m overdoing it. Or maybe it’s just the relentless nature of diabetes management on top of life. Stop being stupid – you’ve been managing your diabetes quite well and besides – you haven’t even had it for that long!

I did pay a visit to my doctor expressing my symptoms in a bid to put my mind at ease. He organised some bloodwork, which all came back fine.

After turning to Dr. Google, the words how to wake up feeling refreshed eventually led me to an app called Sleep Cycle.

No sooner than I had started using it, it truly changed my life.

The concept is pretty simple. During the night, the body goes through several cycles of roughly 90 minutes where it transitions from light sleep to deep sleep and vice versa. Case in point below.

While I’m in bed and the app is running, Sleep Cycle analyses my sleeping patterns using the microphone on my device. Sleep Cycle wakes me up within a 30-60 minute window set by me, when I’m in the lightest phase of my sleep.

I have used this app almost every morning for the past two months, and it has been a true game changer. Waking up is much, much, much easier than it once was. Sleep cycle is waking me up earlier than my alarm clock once did, and I’m feeling far more refreshed with less sleep than before.

One of the more surprising things I noticed almost instantly was an improvement in my mood. I don’t think I realised just how snappy I was getting until I wasn’t anymore. I also found I had far more concentration and focus during the day.

I’ve been running Sleep Cycle on my iPad so that I don’t drain my phone battery come morning. I’ve also been trying to get to bed at the same time each night, and trying not to sleep in longer than an hour on the weekends.

After two months, I feel that Sleep Cycle has definitely helped me to ‘re-calibrate’ my sleep. I often find myself waking up more naturally, anticipating Sleep Cycle’s gentle alarm. I’ve recently stopped using the app on weekends and I still find myself waking up fairly easily. Once I settle into a bit more of a consistent bedtime routine, I think I could make do without it for good.

It’s definitely easy to overlook sleep when my diabetes management feels far more important. I know that sometimes, my blood sugar levels have other ideas come bedtime. But when I’m managing a condition that demands a great deal from me, I need to be able to function at my best.

Combined with more substantial eating to match my energy expenditure and ongoing self care efforts, this is where my focus has been over much of the past year.

I can honestly say that I physically feel the best that I have in some time.

Diabetes at 3.14am

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I stirred in my sleep, registering the blaring red 3.14 on the clock radio beside my bed. Pulling my left arm out from under the covers, I fumbled around for the switch at the base of my bedside lamp. When my desk was finally illuminated in cosy warm white light, I heaved the remainder of my body up from the bed, reaching for my meter and test strips.

This certainly wasn’t the number that I was expecting to see, considering the full 2 unit correction that I had given prior to bedtime for a 10.7. (And in case you’re wondering, I’m only using the OneTouch Verio to deplete my final box of strips…)

I immediately ripped my pump away from it’s resting place inside my inner left pocket, and gave another full correction of 3.3 units for that very uncomfortable number. My frustration was only further fuelling my actions, as I set a 50% basal rate increase for the next two hours on my pump to ensure that this correction insulin did its job.

As I flicked off the lamp and rested my body back onto my bed, I couldn’t get back to sleep. I could feel the heat emulating from my pillow, and flipped it over to the cool side. My whole body felt stuffy, presumably a consequence of the higher blood sugar.

As I lay there, tossing and turning, my mind was quickly consumed with guilt.

I wasn’t happy that it had taken me this long into the night to finally stir in my sleep and check my damn blood sugar. I felt terrible for the fact that I had been sitting there, at that very uncomfortable level, for the better part of five hours. I felt frustration, because a mere two weeks ago I was super insulin sensitive and today I feel like I’m not getting enough.

Second guessing my prior decision in the darkness, I reached for my pump and lowered that 50% temporary basal rate to 30% before clipping it back inside my pants pocket.

Trying to purge those thoughts from my mind, I began thinking about all of the positive things that I am doing in managing my diabetes, reminding myself that numbers like those are isolated occurences nowadays.

If this had happened in the middle of the day, I’d have corrected the high without giving it a second thought. But laying there in the middle of the night with nothing else on my mind to worry about, was a completely different story.

By the time I woke up on a grey Sunday morning, last night’s occurrences felt like nothing more than a dream.

Defeated In The Darkness

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I could feel the sweat dripping from my forehead. My favourite red checkered cotton pyjama pants were stuck to my thighs, drenched in sweat. My entire upper body was trembling. I felt like I’d woken up from a bad dream that still felt very real in the dark of my bedroom. I pulled off my blankets, which I usually hid underneath to stop myself from freezing in the air conditioning.

The red numbers 12.40 were glowing back at me in the dark of my bedroom early on this Thursday morning. I reached over to flick on the lamp beside my bed. I pulled back the cap on my tube of test strips, grabbed one and feverishly stuck it into my meter. I pricked my finger and navigated it over to the test strip. 2.1 mmol/L. Just the number I wanted to see at 12.40am on a Thursday morning.

I heaved myself up to reach for the bag of marshmallows on the bed head behind me. Too weak to support this upright state, I leant over to one side. My elbow rested on my pillow, supporting my upper body weight. Marshmallows were in hand.

I opened the zip lock bag and pulled the marshmallows, stuck together from the heat, apart. One, two, three, four, five. I mentally counted to myself as I placed them into my hand, knowing my hypo-muddled brain would lose count of how many I’d eaten midway through.

By the time I was down to that last one, I couldn’t even remember eating the other four. I collapsed back onto the bed, relieved as my head sank back onto the pillow. I felt absolutely exhausted, and too weak to move. I reached over for the remote to the air-con, dialling the temperature down a few degrees. I so badly wanted to close my eyes, but knew I had to stay awake and see this hypo through. I turned and faced my bedside lamp, hoping the bright light would keep my weary eyes distracted.

I’ve always felt very in control of my diabetes. Throughout the day, I’ll test as often as I want. Those tests produce numbers. Numbers that give me a sense of security. Numbers that keep me in the know while I’m riding the wave of an unpredictable disease.

But when night comes and my body switches off, I’m forced to give up all control.

Laying there in that moment, paralysed in front of the lamp, I couldn’t help but feel a little defeated by my diabetes.

I roused again at 2.24am, having dozed off in front of the lamp. I switched it off, rolled over and closed my eyes with a sigh of relief.

(And I’m only now realising why my shoulders were aching the following day!)

Three Hypos in One Night

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It was a cool, breezy Summer evening. That perfect kind of early Summer weather that never seems to last long enough.

We’d had a barbecue lunch that day. Steak, sausages, eggs, onion, salad and cherries. The kind of lunch that left me feeling like it was Christmas Day – stuffed, sleepy and happy.

I wasn’t particularly hungry by dinner time. I wanted to make sure that my blood sugar levels had stabilised before bedtime after that barbecue, and I didn’t want to spoil my appetite for breakfast the next morning. I had some leftover salad and cherries, and gave myself a small correction dose.

14 units of Lantus is what had been keeping me stable those past few nights. 14 units. I figured with that big barbecue lunch, 14 units would do the trick once again.

I sat down outside with my laptop after dinner, catching up on some of my dBlog reading. I started browsing for Christmas gift ideas a little later on, but somehow ended up comparing prices of items on my own Christmas want list.

My blood sugar levels were looking good during the course of that night, clocking in at 7.1 and 6.2. I had the best of intentions to settle in for an early night before the start of another working week. Little did I know, however, that my diabetes had other intentions.

I was 3.8 at 9.18pm. I figured that the majority of my rapid acting insulin had worn off. I thought 3 marshmallows would do the trick, but I gave 4 just to be safe. 20g of carbs, because I was about to go to sleep. I laid in bed, surfing on my phone for a while longer, until it was nearing 10pm. I was a perfect 7.6, but I was convinced that I’d given myself too much for that hypo. I set the alarm for midnight, ready to catch a rebound high in it’s tracks.

That was hypo number one.

I woke up a while later, and my pyjama pants were sticking to the sweat on my thighs. I knew that I didn’t need to test, but I needed to know how low I was. 3.2. I reached for the bag of Marshmallows beside my bed, carefully counting them out in my hand so my hypo induced brain wouldn’t forget how many I’d eaten. One, two, three, four, five. I shoved the 25g of carbs into my mouth and rested my head back on the pillow, feeling instant relief.

I finally noticed that it was 11.53pm, and switched off the midnight alarm on my phone. By this point, I figured that I’d given myself more Lantus than I needed. By this point, I knew that there wouldn’t be any rebound highs to catch that night. By this point, I realised that these hypos were a consequence of skipping dinner. I switched out the light, and went to sleep.

That was hypo number two.

By 4.30am, I was startled awake by my favourite sound in the world. I felt shaky once again. I wasn’t sure if it was another hypo, or if I didn’t have enough blankets on the bed. My meter confirmed that it was the former, clocking in at a very hypo 3.4.

I shuffled into the kitchen, my mouth tasting of dry sugar, and prepared myself the most refreshing thing I could think of. A bowl of Weet Bix, a sliced banana and lots of cold milk.

As I sat there relishing the cold, refreshing milk on my dry throat, I thought about what a great start to a Monday morning it had been.

That was hypo number three.

Nightly 1am Blood Glucose Checks

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I’ve always based my decision to check my glucose levels overnight on how confident I am that they will remain stable. There have been good stretches where I have enjoyed several weeks of stable numbers through the night. And some wonderfully uninterrupted nights of sleep. Then there have also been some terrible stretches, where I have had absolutely no confidence in my glucose levels whatsoever. Which pretty much sums up the past couple of weeks for me.

I’ve been stuck in a bit of a rut these past couple of weeks. It probably started with a few days of less than perfect food choices. It would have been followed by a couple of days of less than ideal, and even harder to control, numbers. It has resulted in a lack of energy, and some unhealthy habits on my part. Like some late nights, and some extremely long weekend sleep ins. And the longer I’ve let this go on, the harder it has been for me to pick myself up and begin to climb out of this rut.

There is one thing I have done differently during this rut, however. I have taken ownership for the consequences of my unhealthy behaviour these past couple of weeks. That consequence is getting up at 1am every night to test my glucose levels. I’ve dialled up my Lantus dose to cover the added stress, fat and carbs consumed. But I’ve never really felt certain whether my glucose levels will settle, or spike again after I go to bed (mostly the latter).

There’s no worse feeling than waking up to something like 15. Or even worse, 20. It puts a huge damper on the quality of my day, and the people I interact with. I hate thinking about the fact that my glucose levels have been sitting at those crazy high levels for the better part of 8 hours. I am ridden with guilt when I think about how irresponsible I’ve been, and of all the damage that I’ve done to my body.

During this rut, I’ve managed to catch a lot of those highs at 1am and bring them back down within range by morning. I’m quite proud of that. Having control over those night time numbers has slowly restored some of my diabetes motivation. Gradually I’m getting back into my healthier habits, and my insulin requirements seem to be getting back to normal once again.

By the time I went to bed on Sunday night, I finally felt confident that my glucose levels would not rise through the night. What I did not anticipate, however, was going hypo at 1.30am. But I will still take it as a win. I just need to drop my Lantus dose a tad more, and I should be good to go once again.

Hopefully ready for the start of another good stretch.