Dr. Ahmed “My father is unable to sleep whenever we give him insulin. Can you please guide me if there’s something wrong with the insulin or if it could be something else? He can’t sleep even when his blood sugar is normal after taking insulin.”
This is the first time someone asked me this question. I was unaware of how to answer this patient’s question.
But one logical answer was if insulin was causing hypoglycemia resulting in adrenaline release – adrenergic symptoms of hypoglycemia.
Adrenaline is a stimulant drug and hypoglycemia could be triggering adrenaline release which then causes insomnia.
However, whether insulin directly disrupts your sleep or not is not known.
1. Hypoglycemia and Adrenaline Release:
One plausible explanation is hypoglycemia (low blood sugar) caused by insulin. When blood sugar drops too low, the body reacts by releasing adrenaline (epinephrine) to mobilize glucose from stores.
Adrenaline, being a stimulant, can cause symptoms like:
- Rapid heartbeat
- Tremors
- Sweating
- Anxiety or nervousness
- Difficulty sleeping or insomnia
If hypoglycemia occurs during the night, it might wake the person up or prevent them from falling asleep in the first place.
Even if blood sugar levels appear normal, fluctuations or near-hypoglycemic episodes might still trigger adrenaline release.
2. Cortisol Dysregulation
Insulin injections can affect cortisol levels indirectly. Hypoglycemia is a known stressor, prompting the release of cortisol, another stress hormone.
Elevated cortisol levels at night can interfere with the natural circadian rhythm, leading to difficulties in falling asleep or staying asleep.
3. Anxiety or Stress Related to Injections
For some individuals, the act of injecting insulin itself can be anxiety-inducing, especially for those new to insulin therapy.
Anticipation of potential side effects like hypoglycemia might also contribute to stress, making it harder to relax and fall asleep.
4. Discomfort from the Injection Site
Pain or discomfort at the injection site could be another factor affecting sleep. If the injection causes irritation or inflammation, the discomfort may be enough to disturb sleep, especially for light sleepers.
5. Individual Sensitivity to Insulin
Some patients report feeling restless or unusually energized after taking insulin. Although this is not a common side effect, individual differences in how the body responds to insulin could play a role.
It’s worth noting that insulin itself is not a stimulant, but its impact on glucose metabolism and energy levels might vary from person to person.
Practical Tips to Address Insomnia After Insulin
If you or a loved one is experiencing insomnia potentially linked to insulin injections, here are some steps to consider:
- Monitor Blood Sugar Levels:
- Check blood glucose levels frequently, especially before bedtime, to rule out hypoglycemia as a cause.
- Adjust Insulin Timing:
- Talk to a healthcare provider about adjusting the timing of insulin doses. Sometimes, changing the injection schedule can minimize disruptions.
- Maintain a Consistent Routine:
- Develop a relaxing bedtime routine to help signal the body that it’s time to wind down, countering the effects of adrenaline or cortisol.
- Address Anxiety:
- If injection-related anxiety is a factor, techniques like deep breathing or mindfulness can help. A healthcare provider might also suggest using insulin pens for convenience and comfort.
- Evaluate Insulin Dosage:
- Ensure the dosage is appropriate and not leading to frequent hypoglycemia. Work with your doctor or diabetes educator to optimize insulin therapy.
- Consider a CGM (Continuous Glucose Monitor):
- A CGM can provide insights into nighttime glucose trends, helping identify and address any blood sugar fluctuations contributing to insomnia.
When to Seek Medical Advice
If sleep disturbances persist despite trying these strategies, consult a healthcare provider. They may consider other factors, such as coexisting sleep disorders, medications, or stress, that might contribute to insomnia.
Additionally, exploring alternative diabetes management options, like longer-acting insulin or oral medications, could be beneficial.
Conclusion
While insulin itself may not directly cause insomnia, the physiological and emotional responses to insulin therapy, such as hypoglycemia and adrenaline release, can interfere with sleep.
By identifying and addressing these underlying issues, it’s possible to improve sleep quality while maintaining effective diabetes management.
