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Can I Die from Low Blood Sugar During Sleep?

Living with type 1 diabetes (T1D) poses various challenges, including the risk of low blood sugar or hypoglycemia. This article aims to address the concerns of curious individuals, healthy people, and those directly affected by T1D or supporting someone with the condition.

We will explore the normal blood sugar rhythm cycle during sleep, the impact of sleep on glucose levels, the potential risks of low blood sugar during sleep for individuals with T1D, tips to improve diabetic nocturnal hypoglycemia, frequently asked questions, and when to seek medical advice.

Normal Blood Sugar Rhythm Cycle During Sleep

A 2011 study brought forth intriguing findings that shed light on the potential relationship between late-night eating and obesity. The research revealed that individuals who consume high-calorie foods after 8 p.m. are more prone to obesity. [1] However, the exact causative factor remains uncertain: is it the timing of food intake or the sleep patterns of these individuals, commonly referred to as “owls,” who tend to sleep less than their early-bird counterparts, known as “larks”?

To comprehend this phenomenon, it is vital to explore the controlled functions of our circadian rhythm. One crucial aspect regulated by this internal body clock is hormonal cycles. Hormones like leptin, ghrelin, insulin, and growth hormones, as well as those responsible for activating metabolism and utilizing macronutrients, are under the influence of our circadian rhythm throughout the day. [2]

Under normal circumstances, as evening approaches, our cells become less sensitive to insulin, resulting in decreased efficiency in managing blood glucose levels. Moreover, the body’s utilization of fat for fuel is stimulated at night through increased secretion of growth hormones. This metabolic switch makes the body less efficient at using carbohydrates or glucose during this period. Interestingly, cortisol, known as the stress hormone and a key player in carbohydrate utilization, exhibits a decline in the evening and peaks upon waking. [3]

Notably, observations have indicated that individuals who prioritize sufficient sleep can experience improvements in weight management and metabolism. Recent studies involving participants embarking on week-long hikes, exposed solely to natural light cycles and a comforting fire, have reinstated the importance of a natural biological rhythm.

Aiming for an adequate amount of sleep, typically ranging from 7 to 9 hours each night for adults, emerges as one of the most influential habits in maintaining a healthy and optimal metabolism. [4]

Understanding the natural blood sugar rhythm during sleep further adds to the significance of comprehending the implications of low blood sugar for individuals with Type 1 Diabetes (T1D). Research has demonstrated that blood sugar levels typically exhibit a circadian rhythm during sleep, with the lowest levels occurring in the early morning hours. This knowledge underscores the importance of managing blood sugar levels throughout the night for individuals with T1D. [5]

In summary, the intricate interplay between late-night eating, circadian rhythm, and metabolic processes unveils compelling insights into obesity and overall health. Emphasizing the synchronization of our biological clock through sufficient sleep and mindful eating habits can significantly contribute to a healthier metabolism and improved well-being.

Can Sleep Raise or Lower Glucose Levels? (and Warning Signs)

Sleep can affect blood sugar levels, and fluctuations during the night are normal. However, disruptions in sleep or other factors can lead to imbalances in glucose levels. For individuals with T1D, both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) can occur during sleep, but we will primarily focus on the risks associated with low blood sugar. [6]

It’s essential to recognize the warning signs of low blood sugar, such as restless, irritable sleep, sweaty skin, trembling or shaking, changes in breathing, nightmares, and a racing heartbeat. [7]

Can I Die from Low Blood Sugar During Sleep with Diabetes?

While it is rare, severe untreated hypoglycemia during sleep can potentially be life-threatening for individuals with T1D. When blood sugar levels drop significantly and remain untreated, it can lead to loss of consciousness, seizures, and even death.

However, it’s crucial to note that with proper diabetes management and proactive measures, the risk of such severe outcomes can be minimized. [8]

Tips to Improve Diabetic Nocturnal Hypoglycemia

Managing nocturnal hypoglycemia requires a proactive approach to diabetes care.

Here are some tips recommended to help improve diabetic nocturnal hypoglycemia: [7]

Regular Monitoring. Check your blood sugar levels before sleep to ensure they are within the target range;

Adjust Insulin Dosage. Consult with your healthcare provider to determine the appropriate insulin dosage and timing to prevent nocturnal hypoglycemia;

Bedtime Snacks. Consuming a balanced snack containing complex carbohydrates and protein before bed can help stabilize blood sugar levels throughout the night;

Continuous Glucose Monitoring. Consider using continuous glucose monitoring technology to monitor glucose levels continuously during sleep and receive alerts for any significant fluctuations;



This section will tackle common questions related to low blood sugar during sleep and T1D, such as the possibility of hypoglycemia without diabetes, the relationship between low blood sugar and sleepiness, and when to seek medical assistance.

Can I get Hypoglycemia at Night without Diabetes?

Yes, it is possible to experience hypoglycemia at night without having diabetes. Hypoglycemia, or low blood sugar levels, can occur in people without diabetes as well. This condition can be caused by various factors such as alcohol use, certain medications, severe infections, and serious organ issues. [9][10]

Nocturnal hypoglycemia, which refers to low blood glucose levels during sleep, is also a common occurrence and can be potentially dangerous. Factors that increase the risk of nocturnal hypoglycemia include skipping meals, exercising before bedtime, drinking alcohol before bedtime, having infections, and taking certain types of insulin at dinner. [7][11]

If you experience symptoms such as restless or irritable sleep, hot or sweaty skin, trembling or shaking, changes in breathing, nightmares, or a racing heartbeat at night, it is recommended to consult a doctor. [7]

Does Low Blood Sugar Make Me Sleepy?

Yes, low blood sugar can make you feel sleepy. When your blood sugar levels drop too low, it affects the brain’s energy supply, leading to symptoms such as dizziness, difficulty focusing or concentrating, headache, and sleepiness. [12][13]

Sleepiness is actually one of the common signs of hypoglycemia. [10] It is essential to address low blood sugar levels promptly by consuming a high-sugar food or drink or taking appropriate medication to restore blood sugar levels to the normal range. [10]

When to See a Doctor?

If you experience symptoms of hypoglycemia, such as low blood sugar levels, it is recommended to see a doctor for evaluation and appropriate management.

The specific signs and symptoms of hypoglycemia may vary from person to person but commonly include: [10]

  • Shakiness
  • Sweating
  • Headache
  • Irregular or Fast Heartbeat
  • Nausea
  • Irritability, Anxiety
  • Difficulty Concentrating
  • Dizziness
  • Numbness
  • Hunger

Final Thoughts

To sum up, understanding the relationship between low blood sugar and T1D during sleep is important for individuals with diabetes and their loved ones. This article has explored the normal blood sugar rhythm cycle during sleep, the impact of sleep on glucose levels, and the potential risks associated with low blood sugar during sleep.

The problem with misdiagnosing hyperglycemia is not easy to spot. Too many times, people do not turn to the doctor in time because they describe their condition as a common ailment. Symptoms of hypoglycemia seem very common and not connected. Therefore, red flags are easily overlooked and can even lead to extreme cases, like death in sleep.

But, without side effects, such seemingly innocent symptoms can even lead to the development of a coma. It’s very important to connect the dots and act on them.

By following the provided tips and seeking appropriate medical guidance, individuals with T1D can take proactive steps to manage their blood sugar levels and minimize the risk of complications.

Remember, if you have any concerns or experience persistent issues, consult with a healthcare professional for personalized advice and support.


  1. Timing of food intake predicts weight loss effectiveness – PubMed. Accessed July 6, 2023.
  2. Arble DM, Bass J, Laposky AD, Vitaterna MH, Turek FW. Circadian timing of food intake contributes to weight gain. Obesity (Silver Spring). 2009;17(11):2100-2102. doi:10.1038/oby.2009.264
  3. Holmbäck U, Forslund A, Lowden A, et al. Endocrine responses to nocturnal eating–possible implications for night work. Eur J Nutr. 2003;42(2):75-83. doi:10.1007/s00394-003-0386-6
  4. Markwald RR, Melanson EL, Smith MR, et al. Impact of insufficient sleep on total daily energy expenditure, food intake, and weight gain. Proc Natl Acad Sci U S A. 2013;110(14):5695-5700. doi:10.1073/pnas.1216951110
  5. Golem DL, Martin-Biggers JT, Koenings MM, Davis KF, Byrd-Bredbenner C. An integrative review of sleep for nutrition professionals. Adv Nutr. 2014;5(6):742-759. doi:10.3945/an.114.006809
  6. Sleep & Glucose: How Blood Sugar Can Affect Rest. Sleep Foundation. Published December 4, 2020. Accessed July 5, 2023.
  7. Hypoglycemia: Nocturnal. Published August 8, 2021. Accessed July 5, 2023.
  8. Zhu B, Abu Irsheed GM, Martyn-Nemeth P, Reutrakul S. Type 1 Diabetes, Sleep, and Hypoglycemia. Curr Diab Rep. 2021;21(12):55. doi:10.1007/s11892-021-01424-1
  9. Hypoglycemia Without Diabetes: What Does It Mean? Healthline. Published April 25, 2016. Accessed July 5, 2023.
  10. Hypoglycemia – Symptoms and causes. Mayo Clinic. Accessed July 5, 2023.
  11. MD CI. Low Blood Sugar at Night: Nocturnal Hypoglycemia. University Health News. Published June 30, 2020. Accessed July 5, 2023.
  12. Understanding Nocturnal Hypoglycemia. Verywell Health. Accessed July 5, 2023.
  13. What Is Non-Diabetic Hypoglycemia? Verywell Health. Accessed July 5, 2023.

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