The Night I Ended Up On an Insulin Drip
There was a period where I genuinely didn’t want to fall asleep. Not because I had insomnia in the conventional sense — but because sleep felt dangerous. What if I had a hypo and didn’t wake up? What if I spiked through the night and woke up with ketones?
So I stayed awake. Checking. Monitoring. Hypervigilant. Night after night of broken, shallow, anxious non-sleep.
The irony — brutal and predictable in hindsight — is that the sleep deprivation itself was wrecking my blood sugar. Lack of sleep raises cortisol, increases insulin resistance, and makes glucose management erratic. My levels became more unpredictable the less I slept, which made me more anxious, which made me sleep less.
It ended with me in hospital with tons of ketones. An insulin drip, and the thing I’d been trying to avoid by staying awake, happened anyway — accelerated by the very vigilance meant to prevent it.
After that, something shifted. I told myself I was never going through that again. And I found ways to actually sleep.
Why T1D And Insomnia Are Such a Difficult Combination
T1D disrupts sleep in multiple directions. Nocturnal hypos wake you with a pounding heart and soaking sheets. Hyperglycemia causes frequent urination and restlessness. CGM alarms interrupt sleep even when levels are fine. And then there’s the anxiety — the mental hypervigilance that keeps you half-awake even when your body is exhausted.
Meanwhile, poor sleep makes all of it worse. Insulin resistance increases. Glucose variability increases. Appetite hormones shift, making you crave high-carb foods. It is one of the more vicious feedback loops in T1D management.
What Most People Get Wrong
Standard sleep hygiene advice — no screens before bed, keep a consistent schedule, avoid caffeine — is fine as far as it goes. But it doesn’t address the core issue for many T1Ds: the fear. The hypervigilance. The sense that sleeping is a risk you’re taking.
Until you address that, no amount of lavender pillow spray is going to fix T1D insomnia.
The 7 Weird Ways That Actually Worked
- Making peace with my CGM alarms rather than fearing them
I reframed my alarms from “threat warnings” to “safety net.” The alarm is there so I don’t have to stay vigilant. It does the watching so I don’t have to. That cognitive shift — trusting the technology — was the single biggest change I made. - Setting a “safe to sleep” range and only checking when alarms trigger
I stopped checking my level every hour “just in case” and only responded to actual alarms. Checking constantly was feeding the anxiety, not resolving it. - Accepting that some nights will be disrupted — and that’s okay
Fighting the possibility of a bad night made every night worse. When I accepted that some nights would be interrupted and that I could handle it, the anticipatory anxiety reduced significantly. - A deliberate wind-down that addressed the diabetes anxiety specifically
Not just general relaxation, but a specific mental check-in before bed: levels are okay, CGM is on and alarming, I have glucose on the nightstand. Ritualistic reassurance that gave my hypervigilant brain permission to stand down. - Talking to my diabetes team about overnight targets
Adjusting my overnight basal and alert thresholds made the nights less eventful. Fewer real alarms meant I could trust the quiet more. This is a clinical solution worth pursuing if you’re having frequent overnight disruptions. - Remembering what happened when I didn’t sleep
The hospital stay with ketones was, in a grim way, useful. It gave me a concrete, visceral reminder that not sleeping was more dangerous than sleeping. When the anxiety about sleeping crept in, I reminded myself of that night. Sometimes fear of the known is more motivating than fear of the unknown. - Processing the underlying fear rather than just managing the symptoms
The hypervigilance was rooted in a deeper fear: that my diabetes would kill me in my sleep. Until I addressed that fear directly — sat with it, examined it, worked through it — no practical tip made much difference. The emotional work was the real work.
When to Involve Your Team
If chronic sleep disruption is significantly affecting your diabetes management or your mental health, please raise it with your GP and diabetes team. There are clinical interventions — CGM optimisation, basal adjustments, and in some cases sleep-specific support — that can make a real difference.
Sleep Is Not a Luxury – It’s Part Of Your T1D Management
I sleep well now. Not perfectly — T1D doesn’t really allow for that — but well. And the difference it makes to my blood sugar, my mood, and my capacity to manage the condition is immeasurable.
If you’re in the hypervigilant, exhausted loop right now, please know it doesn’t have to stay that way. The fear can be worked through. The sleep can come back.
Let’s talk if this resonates with you – because you’re not alone in this.
You also might like:
Beyond Type 1: Anxiety and Diabetes
P.S. Insomnia isn’t something that you need to just “get through” on your own, and it’s something that we’re not warned about. So if this is resonating with you, and you’re experiencing it yourself; then feel free to reach out to see if we’d be a good fit to work together. I look forward to having a talk with you soon.
Yours,
Pete
T1D Mindset Coach