How a Lack of Sleep Affects BGs + Stress Levels


This content was made possible with support from Medtronic Diabetes, an active partner of Beyond Type 1 at the time of publication.

Editor’s Note: This content has been verified by Marina Basina, MD, a clinical associate professor at Stanford University. She’s a clinical endocrinologist and researcher with a focus on diabetes management and diabetes technology. Dr. Basina is an active member of multiple medical advisory boards and community diabetes organizations, and she is on the Beyond Type 1 Science Advisory Council. 

Based on research supported by the University of Chicago, elevated blood sugar levels, carbohydrate and sugar cravings, insulin resistance… What do these things have in common? They are all the results of sleep deprivation.

What happens when you’re not sleeping

If you’re getting fewer hours of sleep than your body requires, not slipping into deep restorative sleep, or sleeping on an irregular schedule, a set of hormonal responses kick in. How many hours you need varies from person to person, but most adults need seven to nine hours of sleep.

These are your body’s attempt to ensure you have enough energy to function despite the lack of rejuvenating rest. But it’s like connecting to a weak Wi-Fi signal—you’re not going to be operating at optimum levels.

The unfortunate part about poor sleep and type 1 diabetes is that it’s cyclical. A day of out of range blood sugar levels, high or low, will lead to interrupted sleep. Needing to wake up for a blood glucose level check, to treat a low, or to go to the bathroom because elevated blood glucose numbers kicks us out of our sleep cycles.

Additionally, research done by the University of São Paulo suggests that when blood sugar levels are above an average of 8.6 mmol/L154 mg/dL, your body produces less melatonin, the hormone that regulates sleep.

Based on our bodies’ relationship to daylight (our circadian rhythm), our deepest sleep tends to be around two to four a.m., so even if we do get a proper number of sleep hours total, we are unlikely to have fallen into the most restful cycles of sleep with so many interruptions.


When our bodies try to function on less sleep, stress hormones, like cortisol, increase, and our systems start craving quick sources of high-carb, high-sugar fuel, even though they won’t keep us energized for long. Because of the shift in stress hormones, we are also likely to experience insulin resistance in the day, or days, following a bad night of sleep.

So, what happens next? More out of range blood sugars due to our cravings and insulin resistance, so the cycle begins again. And this is, of course, without any added issues of insomnia, anxiety, sleep apnea, restless leg syndrome and other sleep disorders and mental health disruptors that can impact people living with type 1 diabetes (T1D) more intensely.

While an off night here and there can be recovered from, chronic disrupted sleep can lead to poorer health outcomes. In a 2016 study, Sarah S. Farabi reported that adults with type 1 diabetes who slept less than six and a half  hours per night, or spent less time in slow-wave sleep (i.e. deep sleep), had higher A1C levels than those who experienced healthy sleep amounts and patterns. Understandably, this can lead to added stress and anxiety over our diabetes management and health, continuing the unhelpful cycle.

How to get better sleep

Overall, if you’re struggling with staying in range, experiencing insulin resistance, or fighting food cravings, it may be time to look at your sleep health. Here are a few tips you might not have thought to try to build a better sleep strategy:

    • Stop eating a few hours before bedtime so you have time to level out your blood sugar before you go to sleep. Being able to keep a steady level overnight will help your body slip into deep sleep cycles and lead to more restorative sleep.
    • Sleeping on a consistent schedule matters more than the actual hours you sleep. In other words, you don’t have to sleep from 10 p.m. to 6 a.m. to be a healthy sleeper, but it will help to keep consistent hours. If your schedule dictates sleep from 1 a.m. to 10 a.m., great! Just keep to a schedule.
    • Staring at screens before bed disrupts your brain’s signals to fall asleep. If you absolutely cannot give up Netflix, grab blue light blocking glasses. If you can, put away your computer and phone an hour or more before bedtime. Let your body know it’s time to sleep.
    • If you have a hard time falling asleep, consider what activities may be increasing your stress hormones in the evening, like challenging post-5 p.m. exercise. If you can, consider switching around your schedule to do strenuous activity earlier in the day.
    • The brain loves a routine. Make bedtime your favorite time of day by creating a ritual of stretching, meditation and caffeine-free tea before you turn in.

WRITTEN BY Marina Basina, POSTED 03/08/20, UPDATED 08/04/23

Dr. Basina is a clinical associate professor at Stanford University. She is a clinical endocrinologist and clinical researcher with a focus on diabetes management and diabetes technology. Her primary interests are in type 1 diabetes, diabetes technology and diabetes in pregnancy. She has a busy clinical practice at Stanford Hospital and Clinics, seeing patients in both inpatient and outpatient settings, and serves as medical director of inpatient diabetes service at Stanford. Dr Basina received numerous teaching awards and a Stanford Hospital award for excellence in patient care. She also has verified Beyond Type 1’s Alcohol and Diabetes content.