Bedtime rituals

One of the tips that the National Sleep Foundation recommends for a good night sleep is to have a relaxing bedtime ritual. It’s meant to serve as a type of buffer to separate your sleep time from the rest of your busy day and to signal to your body that it’s time to relax and prepare for sleep.

I was thinking about my own bedtime rituals and how they’ve changed over the years. When I was very young, my bedtime ritual consisted of my parents coming to tuck me into bed and probably reading me a bedtime story. When I was a little older, I added a new piece to the ritual, my parents would kiss me goodnight and then kiss my stuffed animal too. These were simpler, pre-diabetes times.

When you think of everything you do before bed, some of it you do because you know it’s good for you and your health, some of it you do because you have to, and some because you want to. Brushing your teeth, flossing, washing your face, these are all ways to take care of your body and your health. Taking medication or checking your blood sugar before bed are important rituals that can’t be forgotten. Reading, listening to music, meditating, cuddling your partner or your pet, these are things that you enjoy doing. Taken together, all of these activities become your bedtime ritual, changing as you grow and age.

I started thinking about this topic right before bed because of my newest additions to my ritual. Every night after I check my blood sugar, I calibrate my sensor on my pump. The calibration lasts 12 hours at best, so I want to make sure that it lasts through the entire night. This is something that I didn’t have to do with my old pump, but I’ve gotten used to doing it. But then, I go into my settings and silence all my alarms for the next 10 hours. I had to add this piece to my ritual because while calibrations should last 12 hours, many nights it would last closer to 6, and I was getting tired of being woken up at 4 am to buzzing telling me to calibrate. And worse, you can only snooze that alarm for an hour before it will go off again. So your only option at that point is to go test your blood sugar and re-calibrate, or continue to snooze and be woken up every hour. (Even with alarms silenced, it will still buzz for low blood sugars, so I feel comfortable implementing this work around every night).

But what category does this activity fall into? It’s not something that’s good for my health since essentially I’m ignoring alarms that are going off for a reason like alerting me of high blood sugars (although it is good for my sleep), it’s not something that I have to do, or something that I enjoy doing. This work around for a flaw in the technology has made its way into my nightly bedtime routine, but every night as I silence the alarms so I can get undisturbed sleep, I think to myself how I shouldn’t have to be doing this extra step. The failure of the sensors lasting the full night has resulted in more time and effort being required from me. It’s a small addition, but small additions add up. And instead of feeling calm and relaxed before bed, the little step adds a bit of annoyance and frustration each night.

There are many features of this Medtronic 670G insulin pump that I find annoying, this being one of them. But I’m learning to focus on what is within my control right now. I can’t always control when my pump is going to require a calibration, but I can control the level of interference with my sleep. Instead of feeling annoyed but this extra step, I try to feel empowered by my ability to make this device fit my needs and lifestyle instead of having its buzzes and beeps negatively affect my quality of life and sleep.

Really, my bedtime routine is kind of a metaphor for life itself. It’s made up of a combination of activities I like to do, some that I don’t necessarily enjoy but I know are good for me, and frustrations or challenges that I do my best to control or overcome. And yes, it would be simpler or more enjoyable if my routine was only things I enjoyed doing, but it’s the mix of the “want to”, “have to”, “try to”, that best prepares me for sleep…and life.

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It’s truly amazing what our bodies can get used to. And for once, I’m not talking about diabetes…well not yet at least.

For the past 6 weeks I’ve been struggling with insomnia. I know that in the scheme of life, there are much, much worse things to have to deal with- tragedies, deaths, fatal illnesses, etc. I’m grateful that it’s nothing of the sort, but putting aside these more horrific life events, insomnia is probably next on my list of things I hoped I would never have to deal with.
You see I love my sleep. And for the past 26 years, I’ve been an superb sleeper. Getting at least 8 hours of sleep has always been incredibly important to me. I often prioritize my sleep over fun. It was a running joke among my roommates back in undergrad that when I couldn’t remember a particular crazy story that they were recounting they would say, “Oh, you were probably sleeping.” And it was true. My sleep was and still is that important to me.
And when I didn’t get my 8 hours, I suffered. I would feel foggy, dizzy, sometimes even shaky. I would get headaches and just overall feel slow and out of it. And I would feel this way with 7 hours of sleep. I know it’s crazy since that’s more sleep than most people get normally. But I was just so used to getting high quality sleep that anything less was noticeable.
Six weeks ago, I had a string of a couple bad nights. I would wake up at 5 am and not be able to fall back asleep. I would become anxious that I wasn’t sleeping and worrying about how miserable I’d be the next day and my body would start to feel electric. Pretty soon I got caught in a vicious cycle where even thinking about sleeping made me anxious. My normal oasis of a bed became associated with restless sleep. Now it would sometimes take me hours to fall asleep, or I’d wake up at 3 and not be able to fall back asleep. My 8 hours of sleep became 4 hours of sleep, to sometimes no sleep at all.
I wish I could tell you that I’m better now, that things are back to normal, but they’re not. After talking with a sleep disorder expert who happens to be in my family and taking online sleep programs, I have a plan and have been making progress, but I still have nights that I just can’t sleep.
While my diabetes isn’t directly related to these sleep problems, it hasn’t been making it any easier. It’s truly awful to have finally calmed down enough to start to doze off only to be jarred awake by the buzzing of my CGM or by the symptoms of a low. And while I know this isn’t a good solution, I’ve been letting my blood sugars run on the higher side at night just to avoid an extra middle of the night wake up. However, this plan has backfired when I wake up having to go to the bathroom from the high blood sugars instead.
This insomnia experience, although probably one of the more exhausting things I’ve had to deal with (haha, get it?), has also reminded me a lot of when I was first diagnosed with diabetes. I remember this feeling of being so overwhelmed, of wondering how I’d get through each day. I remember being constantly anxious of the unknown and worrying if I would be able to handle the challenges of the new diagnosis. But I did it, I got through each day. And I’m doing it now. As the weeks have gone by, I know that I can get through my work day on minimal sleep. It’s not ideal, but my body can handle it. I can handle it.
I know my insomnia, unlike my diabetes, is temporary (although hopefully a cure changes that too). But my diabetes has shown me that I can handle life’s challenges. That a bad day of blood sugars doesn’t mean that tomorrow will be bad too. A bad night of sleep doesn’t mean that I won’t be functional tomorrow. Our bodies are made to be resilient. We must choose if our minds will follow the example.

Diabetes Blog Week- Day 2

“This year, Diabetes Blog Week and TuDiabetes are teaming up to bring out the poet in you! Write a poem, rhyme, ballad, haiku, or any other form of poetry about diabetes.”

CGM, Go To Bed

An ode to my continuous glucose monitor

10:30 pm:

I put you on my nightstand, I lay you down to rest,
In case I don’t feel well, my blood sugar you will test.

My blood sugar is steady, not too high and not too low,
That ice cream after dinner, I hope you will not show.

An undisturbed night of sleep is what I really need,
A steady line on your graph in the morning, I truly hope to read.

Slumber is upon me, I’m drifting off to sleep,
I beg you CGM, a quiet night without a peep.

1 am: Buzz buzz buzz

Double arrows pointing up I awaken with a start to find,
Of all the arrows, up and down, you’re my least favorite kind.

Not much I can do, laying here with insulin on its way,
Groggily back to sleep I go, and hoping this time to stay.

2 am: Buzz buzz buzz

My eyes spring open, you caught me quite off guard,
My bg’s now over 180, you just had to make this hard.

My number is too high now, but I’m hoping not for long,
It may start to drop too fast, but hopefully I’m wrong.

4:30 am: Beeeeeep Beeeeep Beeeeeep

From my nightstand I hear your sound, which can only mean one thing,
“You’ve dropped below 55, wake up, wake up!” your beeps eagerly sing.

I take my fruit snacks and into my mouth I dump them all,
For the last time tonight, please back to sleep I hope I fall.

4:45 am: Buzz buzz buzz

Now you say I’m under 80, well at least I’m on the rise,
Maybe giving insulin for that high wasn’t all too wise.

Please CGM, let this be all, I’m really very sleepy,
If you wake me up one more time I may get a little weepy!

7:30 Ringgg Ringgg Ringgg

You’ve got to be kidding me, what is it now? You haven’t had enough?
With all the ups and downs this night, my sleep has been quite rough.

It’s my alarm! Time to get up; to work I must get ready and go.
Oh what’s that on the graph? A perfect number NOW you decide to show!