Diabetic neuropathy can develop into a nagging intrusiveness that will undermine you ability to enjoy a good night’s sleep. And lack of sleep will exacerbate the painful symptoms of neuropathy. What can you do about it?
Peripheral neuropathy is damage to the nerves in the feet, legs, hands and arms. When it is caused by long-term diabetes it is called diabetic neuropathy.
This nerve damage can cause a loss of feeling in the feet or symptoms such as tingling, numbness, burning, and pain. These symptoms come and go and can be quite intensive and disturbing from time to time.
It is permanent, so once it’s happened you cannot improve it by controlling your diabetes better. However, you can allay the symptoms (and prevent the damage getting worse) through a change in diet and exercise.
As it can be very intrusive, neuropathy can disturb your sleep in a number of ways.
The pain and weird sensations (especially in the legs) of neuropathy can make it hard to fall asleep.
Many people find themselves focusing on their pain during the evening when daytime distractions are at a minimum which makes it more difficult to get to asleep. The pain can also kick in during the night and wake you up.
Neuropathy has been linked with sleep apnoea syndrome, ie pauses in breathing during sleep.
A meta-analysis published online in late 2013 by three Japanese researchers indicates that patients with diabetic neuropathy are twice as likely to have apnoea compared to diabetic patients who do not have neuropathy. This, however, does not mean that neuropathy is a cause of sleep apnoea.
The relationship between neuropathy and sleep is a two-way street. While neuropathy can cause your sleep to be disturbed, sleep that is disturbed (for other reasons) can make the symptoms of neuropathy worse.
In addition, being deprived of sleep can lower your pain threshold and your ability to tolerate pain, which makes your neuropathic pain feel worse.
How to overcome the effects of neuropathy on sleep
There are several things you can do to overcome the intrusiveness of neuropathy:
 You can use medicines, both over-the-counter and prescription medications. However these can cause drowsiness during the day, as well as other side affects and can cause dependency.
 You can try non-pharmacological treatments such as cognitive behavioural therapy, relaxation techniques, stress management, and acupuncture.
 You can follow the tips below for getting a good night’s sleep. This is probably the best thing you can do.
How to get a good night’s sleep despite your neuropathy
There are several things you can do to get a good night’s sleep. You may find some or all of the following useful:
- Keep your blood glucose under control using diet and, if necessary, medications.
- Get some exercise every day.
- Go to bed at about the same time each night so you adhere to a regular sleep/wake schedule.
- Make sure your bed is large and comfortable with a good mattress and supportive pillows.
- Elevate the bed sheets so that they are not in direct contact with your legs and feet. You can do this using wire frames to create a tunnel for your feet under the blankets.
- Ensure your room is cool (18 degrees Centigrade) and well ventilated.
- Sleep in the dark in a noise free room (or use a blindfold and/or ear plugs).
- Develop a bedtime ritual (eg, taking a warm bath, reading light material).
- Limit or eliminate caffeine four to six hours before bed and minimize daytime use.
- Avoid smoking, especially near bedtime or if you awake in the middle of the night.
- Avoid alcohol and heavy meals before going to bed.
- Turn off your TV, smartphone, iPad, and computer a few hours before your bedtime.
- Adopt relaxation techniques to help induce sleep such as setting an hour aside before bedtime to relax and unwind. Try meditation or deep breathing exercise.