Anyone who reads my posts on the regular knows that I tend to bitch about Diabetes complications a lot. And with good reason; Type-1 Diabetes affects just about every system and every organ in the body, to one extent or another. Sleep is no different, with fluctuating blood sugars causing insomnia, nightmares or restless leg syndrome. There’s plenty that can go wrong during a Diabetic night’s sleep, including being woken from a drop in blood sugar. Believe me when I say that I’m grateful that I DO wake up. But for the most part, I haven’t had a full, uninterrupted eight hours of sleep in a very long time.
The focus of today’s post isn’t exactly a symptom, per se. But rather an unfortunate side effect of the current Diabetes therapy I use. I’m referring to trying to get a full night’s sleep while wearing an insulin pump and/or CGM. It stands to reason that as I sleep, I need to carefully consider how I position myself in order to avoid kinking my cannula (say THAT three times fast) or applying consistent pressure to the CGM sensor, which may cause it to fail.
There are all sorts of websites that provide some interesting (if not altogether accurate) explanations regarding different sleep positions, what they mean and apparently describe your personality. I’m not a big believer of that last one, but to each their own. My point is that for the longest time, I’ve slept on my stomach. I have no other explanation for this other than it’s always felt the most comfortable. But over the past year or so, I’ve slowly adjusted myself to remain on my back while sleeping, due in part to the pump set sitting on my abdomen and the CGM sensor embedded in my tricep.
There have been a number of times where I’ve rolled over during the night, since the average person can’t necessarily control their movements while asleep. This has caused a score of issues including but not limited to, my pump slipping out of my pocket, my infusion set being pulled out and even my pump slipping off the bed and yanking at the injection site. Wanna talk about rude awakening? That’ll do it for ya! I’ve rectified this with a silicone sleeve, which makes the pump less slippery and less prone to slipping out of my pyjama pockets. There are also neoprene belts you can purchase, if you don’t mind paying a fortune.
CGM sensors are a different bastard, since any sustained pressure against their injection site will cause them to fail. This means that if I roll to my side and my tricep is pushed against my mattress, it prevents the sensor from reading the interstitial fluid in a way that’s required for consistent CGM readings. And since the Medtronic 670G absolutely LOVES chirping at me in the middle of the night, it only takes a few minutes before the pump wakes me with an alarm to tell me that something’s wrong. Two times out of three, if I’ve kinked or blocked the sensor in this way, it won’t right itself and I find myself disposing of a sensor long before I was due for a change.
I’m likely making it sound worse than it actually is. In reality, the sensors aren’t AS delicate as the previous paragraph makes them out to be. But it’s a very real concern. The biggest concern, which has happened before, is having the pump’s infusion set pulled out of my injection site. The problem with this one is that it can take a long time before my CGM acknowledges that my blood sugars are starting to rise. And even as they do, the Auto Mode will start pumping out more insulin to compensate, which will do nothing but soak into the bedsheets.
After a long enough period of time, an alarm will start beeping on the pump to warn me that my intervention is required since the insulin isn’t working. But by then, my blood sugar level can have potentially gotten high enough to require multiple boluses, monitoring for hours and plenty of fluid intake. Something everyone LOVES to spend the overnight hours doing. Luckily, this has only happened to me a few times, and the sting from the adhesive being pulled usually wakes me anyway.
When we talk about Diabetes complications, most people associate the term with vision problems, organ failures, amputations or Ketoacidosis. But we often forget that the technology we use, although helpful in many respects, can be a hindrance in others. This is what’s led me to sleep like a poorly posed Egyptian mummy. If you’re on pump therapy, try and train yourself to sleep in a position that will prevent issues with your equipment. Store your pump in a protective silicone sleeve in case it tumbles out of bed or consider using pyjamas that have zippered pockets. It makes the sleep process more complicated, but it’s a small price to pay for decent blood sugar control. Now if you’ll excuse me, I need a nap… ☯