Sleeping With an Insulin Pump

Insulin pumps are some of the greatest inventions that make life easier for people with Type 1 diabetes and some with Type 2 diabetes. They are small, portable, and just about the size of a smartphone, but they are highly effective in managing blood glucose levels. They are designed to deliver insulin doses through a tin tube under the skin.

The best part of an insulin pump is that it mimics your body's natural pattern in releasing insulin gradually throughout the day (basal insulin) and an extra dose during meals (bolus) to stabilize your blood sugar even after eating. This process eliminates the need to take insulin injections at intervals, giving you something close to everyday life.

But despite the enormous benefits of insulin pumps, it's always a scary thought for most people, considering that the device must stay connected to their bodies 24/7. The trickiest part is sleeping with an insulin pump attached to the body! I shared the same concerns when I got my first pump, as many awkward questions crept into my head! Will I damage my pump if I roll on it? What if I unknowingly disconnect it? What if I block the infusion tube from delivering insulin?

This Diabetic & Me article will answer these crucial questions and show practical examples of safe ways to sleep with an insulin pump.

Who Should Use Insulin Pumps?

Although insulin pumps are generally recommended for people with diabetes, using them is a matter of choice. But your doctor will most likely recommend one if you fall into any of the following categories:

1. Your body delays food absorption

One major complication of diabetes is gastroparesis — a digestive disorder that causes poor nutrition, problems managing blood glucose, and low quality of life. People with diabetes with gastroparesis also experience a slower food absorption rate, making it necessary to use an insulin pump in such situations to deliver the correct dose at the right time.

2. You have extreme symptoms of low blood sugar

Different people with diabetes react differently to low blood sugar. Your doctor will likely recommend an insulin pump if your high blood sugar symptoms are usually severe. Insulin pumps are far more flexible and help you manage your blood sugars better than insulin pens or injections.

3. You are a sportsman

You may also need an insulin pump if you often exercise since exercising can increase or decrease blood sugar. An insulin pump allows you to regulate insulin delivery during exercises, depending on your sugar levels. All you need do is press a few buttons, and everything is under control.

4. You are/want to get pregnant with diabetes

Insulin pumps are also great for pregnant women with insulin-related diabetes. This is mainly for those who can't control blood glucose using MDI without experiencing disabling hypoglycemia.

Potential Problems of Sleeping With an Insulin Pump

Sleeping with an insulin pump or a similar medical device attached to your body can raise many concerns. Fortunately, most of these worries are about comfort and not safety. So if you ever ask, "Do I have to pump at night?" Here are a few potential issues if you must sleep with an insulin pump:

1. Pressing the button accidentally

One of the first concerns I had with an insulin pump the first night was, "would I accidentally press my buttons while sleeping? But that is not the case since the pump controls are designed in a way that you can't push the buttons unintentionally. Setting up a bolus requires more than a click, so the chances of delivering a bolus in your sleep are minimal. Besides, some pumps have a lock feature to prevent unintended responses if you accidentally press a button.

2. Pulling the infusion set

Another issue most starters have about insulin pumps is if they'd mistakenly pull out the infusion set while sleeping. Well, the design of the average pump makes such an outcome highly improbable. Most pumps have alarm systems to notify you once you mistakenly pull the infusion from the site - but that is quite rare. Reconnecting my pump in the middle of the night is one thing I never enjoyed, but since I always have a spare infusion set near my bed, the whole process is much easier.

3. Rolling on your insulin pump

If you have thought, "what if I roll onto my insulin pump while asleep," you are not alone. Most diabetic people share this concern: I did at first, too. But then, as I said earlier, the possibility of pressing the buttons is rare if they are in lock mode. Damaging your pump clip if you roll on it is also rare. However, you may feel a bit uncomfortable around the infusion site. But it's usually not enough to wake you up.

4. Blocking insulin delivery

Although it seems possible, it's very unlikely to obstruct the insulin delivery tube when you roll on it, thanks to the springy mattress on your bed. Even the most restless sleepers rarely block their insulin pump, no matter how often they turn from side to side.

5. Tangling up in the pump tubing

As a diabetic using an insulin pump, you can expect to wake up some days with the pump tubing wrapped around you. But this is usually not an issue as the tubing is thick enough not to allow any obstruction even when tangled. So you can be sure your blood sugar level isn't at stake.

At first, I was concerned about my tubing each time I woke up to see it around my body. I feared it could block the flow and affect my blood sugar levels, but that never happened. However, I have resorted to either having the insulin pump in my pajama pocket or wearing an insulin pump belt to keep it stable.

Five Ways to Sleep With an Insulin Pump

We can all agree that having diabetes technology devices like insulin pumps and continuous glucose monitors (CGMs) attached to your body can be discomforting during sleep! However, there is no one-size-fits-all approach to comfortably sleeping with an insulin pump. It depends on your lifestyle, habits, concerns, and what works for you.

In case you haven't figured out how, I have tried out a few techniques that I find interesting and easy, and I will be sharing them with you right away.

1. Keep your pump near your bed

If you worry that you may roll onto your insulin pump and damage it, your healthcare provider can recommend longer tubing. With this long, flexible tubing, you can safely keep the pump near your bed or on the floor. If you are usually restless during sleep, this approach is also a proactive measure to ensure you don't push your pump off the bed.

2. Keep the insulin pump by your side

This is the easiest method I've used, and it worked for me since I rarely move while sleeping. If you are not a fan of the PJ clip method, I suggest keeping your pump by your side on the bed. Make sure you don't keep it closer to the edge of your bed to reduce the chances of your pump slipping off the mattress.

If you share a bed with a partner who moves a lot, warn them about your insulin pump, or better still, keep the pump on your (own) side. Trust me, I had it before that my partner slept on my pump.

3. Get the insulin pump clipped to your underwear or pajama

One of the most common ways to have a decent sleep with an insulin pump is by clipping it to your nightwear or undies. Some prefer to attach it to their pajama's waistband or breast pocket. But if your nightwear has no pocket or strap, clip the pump to your undies. Or fasten it to your V-neck collars if you like wearing nightgowns.

4. Place the pump under your pillow

I also like the idea of placing my insulin pump under my pillows. Although I don't usually move during sleep, having my pump under the body pillow by my side provides cushion and restriction, so it doesn't fall off or damage should I mistakenly roll on it.

5. Attach the pump to your insulin pump belt

You can wear these belts around your waist to keep your insulin pump intact. It is a comfy and reliable solution for people's common questions about sleeping with pumps! I love the side pockets because they are pretty protective: I don't have to worry about my pump slipping out during my daily activities or sleep.

How Can Lack of Sleep Affect People With Diabetes?

Sleeping disorder is a common issue that is not necessarily caused by severe underlying health conditions. Lifestyle (like sleeping a lot during the day), anxiety, and stress, for instance, can cause sleepless nights. However, diabetes can also cause it because studies have shown that diabetes and sleep are closely related, and many people with type 2 diabetes experience poor sleep quality (insomnia).

According to this research published in PubMed.gov, about half (one out of two) of those with Type 2 diabetes also have sleeping issues. Sleeping disorders in diabetic people are primarily a result of blood sugar instability. Diabetes-related symptoms, including high blood sugar (hyperglycemia) and low blood sugar (hypoglycemia), can lead to insomnia at night and tiredness the following day. Psychological factors like depression or anxiety about your health can also trigger insomnia.

How diabetes affects sleep

Once your blood sugar levels spike, your kidneys are forced to work overtime to deal with the excess glucose. This overcompensation by the kidney forces you to urinate more often at night, ultimately affecting your sleep! High blood sugar is also linked to persistent headaches and increased thirst, which compounds your sleeping issues.

People with diabetes may also have low blood sugar at night when they don't eat enough or take their medication correctly. This may lead to nightmares, profuse sweating, and waking up spontaneously in confusion.

How poor sleep affects sugar levels

While diabetes affects sleep quality, your quality of sleep goes a long way in determining your sugar levels. According to the National Library of Medicine (National Center for Biotech Information), having low-quality or less restorative slow-wave sleep strongly links to high blood sugar levels in diabetic and prediabetic people. However, the pattern of these links hasn't been established as researchers are yet to figure out whether one causes the other or whether other variables constitute the disorder. The hypothesis is that since poor sleep affects insulin, cortisol, and oxidative stress, it can also affect blood sugar levels.

Nonetheless, about 25% of people with diabetes reportedly sleep below and above average (less than 6 hours and more than 8 hours), putting them at a higher risk of blood sugar spikes — the causes of this sleep disorder range from biological to physical factors such as lifestyle.

For instance, sleeping with an insulin pump wrongly attached to your body can interfere with your sleep and ultimately spike your blood sugar. Buying a pump that doesn't fit properly can also have a similar effect. I recommend user-friendly products like the T-slim pump, Omnipod, Tandem, or Medtronic (MiniMed™) for an improved sleeping experience and stable blood sugar.

Tips for Improving Sleep

Some ideas to improve your sleep if you have diabetes-related insomnia:

• Maintain an optimal blood glucose level by sticking to your doctor's instructions.
• If insulin injections mean you must wake up at midnight for a dose, try insulin pump therapy.
• Stay away from caffeinated drinks during evening hours.
• Carry out at least 30 minutes of physical activities during the day (not at night or shortly before bedtime).
• Get your daily proteins from quality sources like chicken, eggs, and seafood.
• Be consistent with your bedtime.
• Avoid taking a nap during the day to fall asleep easily at night.
• Create an environment that promotes sleep
• Adopt a few bedtime routines.

Frequently Asked Questions

Conclusion

Getting enough sleep is a crucial lifestyle improvement you must make to manage diabetes effectively. Lack of sleep has been linked to many complications in diabetic people, such as increased insulin resistance, difficulty losing weight, high blood pressure, heart disease, impaired immune system, and more. Hence, you must take every necessary step discussed in this article to ensure your insulin pump improves your sleep - not interfere with it.