Two vigilance errors through lack of sleep

@Chris just started an interesting thread about vigilance error.

Something happened to us two nights ago that I also wanted to share, interestingly also about vigilance but for another reason.

Two nights ago my son had a series of peaks rapidly followed by treatment drops then by more peaks (all puberty based). The last few nights had been rough on us, as this had happened almost non-stop for a week now, so I was quite tired.

Around 2:00 am, from a beautifully steady 125 that I had just treated to bring down below 100, he started to dip strongly on the CGM. It looked like one more developing deep low and I decided to give him 8 carbs right away. Within a minute of treatment, I realized that it could well have been a Dexcom pressure low. I had not wanted to test him because he wakes up when I test him – but, when I did, I found out it was a pressure low :frowning:

So, of course, I had to follow up and inject more insulin just to cancel out the sugar I had just given him: error #1.

I stayed up to verify he would come down eventually. Well, he did not, and, at 4:00 am I gave him a sizable insulin injection to finally overcome his mild but steady high (by now around 150), clearly hormone driven. I set a wake-up alarm to 5:20, to make sure that he would not go low (or stay high), and forestall a possible low if necessary.

I did not wake up until 9:00am: I slept through 2 streams of low alarms, in two consecutive cycles. It turned out he went down to 72, below my low alarm, went back up for an hour, then went back down to 75 (alarms again), then went back up to wake up around 90. My wife’s alarm was set to 70 so she never had to wake up – but I blew all my wake up alarms – error #2.

I never sleep through these alarms. But this time I did.

When I look back at the night, I realize that both errors were likely caused by my ongoing, accumulated lack of sleep. The first one was not so bad, but, of course, could also have been a wrong call the other way. The second one could have been much worse, in particular if my wife had not been home.

Bottom line: lack of sleep can be the cause of very bad mistakes, both for a diabetic and for the caregivers of a diabetic. I can see how mine could have had terrible consequences. I am adding lack of sleep as something we need to manage, both for the boy and for ourselves.


If you figure out the solution let me know! We see the fact that both of us tend to wake up to the others’ alarms as a feature, not a bug…but when there are two or three rough nights in a row, having no one on deck who has had a restful night’s sleep gets tricky.

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I’m glad I’m around because Erin doesn’t hear anything…she could sleep through WWIII. I hear pins drop so I wake up to everything. Lately, every night we’ve been going low toward the early AM hours (between 5 - 8AM). At this point, I’m even embarrassed to show images of our CGM. :frowning: Liams body is behaving erratically and we’re just hanging on for dear life and trying not to fall off of the roller coaster. If one were to look at his receiver, they’d think he hits low 8 or 10 times per day (seriously…like low 50 or less)…but he doesn’t hit that level but about 1/4 of the time. 60’s and 70’s a lot, but 40’s and 50’s not so often. Even when the receiver is reading 45, when we do a finger stick, he’s usually in the 60’s or 70’s…still not good, but not AS bad.

I know 1/4 of the time is bad, but his body is doing crazy things right now. Dropping from a cool 130 to 50 in a single tick.

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This must be SO stressful for you two.

I think we all get used to the increased level of stress that this disease carries with it. The hardest part is learning how to positively deal with it, for me.

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Positively on the outside, and positively on the inside. Both are hard.

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Yes…most of the positivity that I have to remember to have are for my own voices in my head.

“Yes, you’re doing OK.”
“Yes, he’ll grow up healthy.”
“No, I’m NOT going to kill him by accident.”

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