Optimal BG level for sleeping

Great questions and very interesting to see the various responses. My preferred range for sleeping is 85-95.

I wake up more frequently when my BG is lower than 80 and I only remember my dreams when I’ve woken up off & on in the night.

I sleep soundly when my BG is 150+

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I guess it’s definitely a YDMV sort of thing. I don’t have much new to add, but maybe it will resonate with someone.

If my blood sugar is trending low, I sleep great. If it’s trending upwards, I don’t sleep as well. If it’s stable, then I sleep just fine… :sleeping: :sunflower:

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That was a lot of interesting responses! Good point by @LarissaW about non-diabetic BG numbers. It makes sense that it should be best to target the lower end of the range. I also agree with @Chris about the body getting used to a particular range. Personally, I would like to teach my body to prefer a “normal” level.

Those of you with pumps, do you find that you require more basal overnight? I’m on MDI and it’s mostly okay. Meals and exercise will cause some highs and lows, but when I’m still and fasting, I end up between 4 and 8. The slightly annoying part is that I’m often closer to 8 when sleeping and sometimes get low when awake. Right now I’m not sure if I should just be happy than I’m in range and accept it, or if it’s worthwhile to tweak it further.

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totally anecdotal, but I notice that Samson wakes up most refreshed if he’s running above 80 and below about 110 for most of the night. That said, he doesn’t have a perfectly normal blood sugar profile all day, so it could be that someone who’s running tighter would prefer to be even lower?

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Yes! That’s what I’ve heard from a decent amount of people. @Chris put it well above:

I by no means think targeting 70 at night is right or preferable for everyone! That’s just where I feel best (again probably partly mental there.)

Nights that I don’t have a CGM on I tend to aim for a higher target just for peace of mind. But if I can maximize my time in my preferred range overnight, then I try to! (not always successfully!)

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There was an old thread on this here:

It seems like it varies by person and like you were saying on activity level and if/how much they have eaten.

Are you going low while asleep? Is it a consistent pattern?

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I by no means think targeting 70 at night is right or preferable for everyone! That’s just where I feel best (again probably partly mental there.)

We still treat 70 as “low” for Samson – anything below 80. So basically I suspect he’s been calibrated to feel optimal in this slightly higher range.

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I rarely go low during the night, unless I’ve messed up a bolus late in the evening. The pattern I’m seeing right now is higher values while sleeping and lower ones during the day. It’s still in range though, unless there’s eating or exercise involved.

For now I think I’ll just keep an eye on it, but if I eventually consider a pump, then a higher nighttime basal would definitely be something to consider.

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I am so glad to have read this topic. it is a true testament to how YDMV kind of thing.
I need significantly LESS basal during the night than I do during the daytime. it makes little sense to me, bc during the day is when I am most active; at night I’m just lying on my side for 8 - 10 hours. my only activity during the night takes place in my dreams :rofl:

my preferred, most comfortable overnight BGs are 75-95. I sleep soundly and comfortably. I try and keep my BGs between 80-95 throughout the day. But, I am also hypo-unaware. I could be in my 60s for hours and not notice it at all. I don’t really notice I am low until I am around 50ish; then I start having trouble seeing, I can see stars and spotting bright lights, and I get a metallic taste in my mouth. in my 40s I start to shake.

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Thank you all for this topic as I’ve been trying to figure this sleep issue out as well. I’ve found both highs and lows make for restless sleep followed by the next day or two with numbers all over the place. If it’s been a low night I tend to rebound the next day with harder to control highs, and visa versa. The other night I went down into the 50’s per blood, (FreeStyle Libre CGM in the 40’s). Took gluc tabs and came up but the rest of the night was restless. The next day I didn’t feel good at all, headache, no energy, spacey… much more then just a bad night’s sleep. BS stayed on the lower side the next day - 90 to 114. Before bed I was up to 139. Got up to 152 at 5am, adjusted with 1 unit ( I use Novolog pen) which would usually bring me down nicely but it didn’t. I spent the day with high numbers (for me) getting up to the 170’s. I shot up more then my usual amount, was extra careful with what I ate and made sure to have a good workout. I had more energy but still had the headache. Sleep was better that night and the next day I was pretty much back to my “normal”.
Could it be that the body is trying balance in some way…? As I’m only 31/2 years into this world of LADA the learning curve is still big, but am feeling I’d rather be a little higher through the night then lower. I think I sleep better when I’m on the high side of my normal rather than my acceptable low side.
Thank you again,
Cheers

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@SFLADA - from my experience, if I wake up in range, I tend to have a better day of BGs. If I wake up high or low and I’m trying to get my day started and am rushing (as per usual) to workout/work/school then that makes it harder to “stick the landing” and end up at a decent number, and then I’ll end up chasing an in-range number for what feels like all day.
I know that there was a clinical trial being conducted to see if overnight in range BGs are associated with a better TIR the next day. Not sure if they’ve released the data, but should be interesting!

As far as a high rebound following a night of lows - it could be due to stress hormones peaking more than they usually do, causing more insulin resistance and a harder time to get the BG to come down. But it could be lots of factors!! Keeping a nice BG overnight is so tough, and it definitely affects me the next day as well if I’m out of range all night or waking up to correct a low or high.

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Thank you for the insight LarissaW it was helpful
Cheers

That’s an interesting possibility. I suppose the 24-hour duration isn’t quite 24 hours, right? In my case, though, I’m already taking all of it in the evening and would still like a little more during the night. So far it’s not a dealbreaker, so I think I’ll just stick with the current solution a while longer.

Thanks for your input anyway!

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It would be interesting to see a study on that, though I wonder how it would be designed. I’m thinking it would be hard to tell whether the overnight BG has a direct effect on the following day or if they simply have another common cause.

I am using a Tandem T-slim pump. Since I upgraded the software to their Control-IQ the pump takes over at 10pm and stays in Sleep Mode until 7am the next morning. It regulates my blood glucose with a target range somewhere around 110. On occasion it has failed to bring me down from a 10pm high, I think because of insulin resistance. And twice I have had to treat a low, because it had cranked down my basal to 0 and I still went low. But it has taken all the worry out of going to bed (how much and when did I eat, how much of that is still digesting, what is my insulin on board, is any of that still being absorbed because of a site problem, how much exercise did I have today, do I have a cold, am I dehydrated, etc). I am so pleased to wake up every morning between 100 and 130! It makes constant adjustments as if I were staying up all night and doing it myself, and it does it better than I do. It has let me relax every night and just not worry. So of course I sleep better.

My experience, might not be yours.

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That matches our experience with Control IQ, we actually use sleep mode to great effect for 23.9 hours per day. It really takes a lot of the work out of things, much more autopilot.

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Thanks @Chris. I searched and found your other comments on sleep mode in various threads. Very helpful. We should probably have a thread on 24-hour sleep mode.

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Me too. If I’m about 150-300, I sleep like a rock. Over 300, the need to pee/drink starts to interfere, but before that, it seems to be somewhat sedating to me. Which is not a good reason to run high and not something I ever do intentionally, but as someone who sometimes has difficultly sleeping through the night, not going to lie, there have been some nights where it happened and I then ended up feeling it was kinda worth the trade-off.

That said, my aim is to be somewhere around 80-110. I agree with the people who find it easier to stay in range during the day if you start there.

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Good Idea Randy!

I sure hope my tslim pump will do the same when I get it. I have 263 days left. I am tired of having to get up in the night and fix a low.:rofl::weary::triumph:

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