7 Ways to Get Better Sleep With an Insulin Pump

I’m the Community Manager at Diabetes Daily and have been on an insulin pump for over 20 years. I started on a Minimed 508 way back in the day and am currently using a Tandem t:slim X2 Basal-IQ pump. Why I’m not using Control-IQ is for another article.

I’ve taken a few much-needed pump breaks over the years. For my long-term pumper friends, you KNOW what I’m talking about! We can get burnt out from all of the data and constant vigilance. Sometimes you need a break from the constant attachment, the devices stuck on you, and the BEEP BEEP BEEP that interrupts your precious sleep!

So, when I’m really exhausted and need more rest, how do I get a better night’s sleep on an insulin pump? Here are my top seven tips!

1. Wear clothing that makes pump wearing and access easy. 
   • I sleep on my side, so I clip my pump to the waist of my pants/shorts in the middle, and when I roll over it’s not affected. It also gives easy access to the screen if an alarm goes off.
     

     My pump clipped to my waistband.

   • I also love cozy hoodies and pajamas with pockets: I can put the pump in the pocket. Plus, it’s fun to shop for something new to wear to sleep! My pump does move around more in a pocket, so I prefer clipping to my waistband.
     

     My pump in the pocket of my hoodie.

   • Naked sleeper? Just let your pump lay on the bed beside you on the side in which the tubing is pointing, or opt for longer tubing. Omnipod gives you the option with no tubes at all.
2. Strategically place your sites to not interfere with how you sleep.
   • We know this can be tricky having to consider all the other variables (exercise, clothing choices, lipohypertrophy), but try to find what works best for you. Stomach sleeper? Put the infusion site on your love handles. Side sleeper? DON’T put the site on your love handles.
3. Adjust your high alert.
   • Turn off your high alarm or set it higher than normal for the night. I don’t always want a warning at 180 mg/dL. Who else knows the fun nighttime dance of your pump sounding alarms as it bounces back and forth between 179 and 181 mg/dL most of the night?!? UGH! On most nights I feel fine to set my alarm for 250 mg/dL (14 mmol).
   • However, if I’ve eaten pizza or a higher-fat meal at dinner, I know I’m at risk for a sticky overnight blood sugar high. I may want to keep my alarms on, so I can catch it before it goes too high.
   • Better yet, eating lower carb at dinner or in the evening helps reduce the risk of nighttime highs. If you exercised that day, please consider meals/snacks and boluses before making pump setting changes.
4. Change alerts to vibrate mode and reduce extraneous alarms. 
   • Change nighttime alarms to vibrate mode or to a less intrusive sound. The hard-set hypoglycemia alarm will still be loud and wake you up, but do you really need the double-up or double-down arrow alert?
   • There may be other alarms that you can switch off, like the “change your site” reminder or “Auto Off,” the one that sounds when you haven’t touched your pump in a certain amount of time.
5. Turn off other CGM tracking devices. 
   • Your iPhone, iWatch, and insulin pump all have alarms on them. I turn them off or set them to vibrate. Use one, and not all of them, for nights. It can be a HUGE pain for multiple alarms to go off at the same time. For lows, it’s good to have a loud alarm, but I don’t want my CGM to wake me up just because the arrow changed directions.
6. Calibrate BEFORE bedtime.
   • Gotta love when Auto Mode wakes you up at 3 am and demands that you check your blood sugar. WHY Medtronic, WHY?!? 
   • Too sleepy to calibrate? You can just input a value that’s close to the BG reading. Say your sensor reads 109 mg/dL, you can put in 110 mg/dL or 108 mg/dL to satisfy it. I have only done this when I’m really confident that my blood sugar will stay steady. Please know that we recommend that you actually check your blood sugar, particularly if you are feeling different from what your CGM is saying. Annoying as it is, there is a good reason the system wants you to double-check your blood sugar measurements.
7. Charge your pump BEFORE bed (or check/change the battery). 
   • Who hasn’t gone to bed with a 30 percent battery life only to be woken up by the low battery alarm? It’s my own fault.

Please keep in mind that what I do may not work or be safe for you, especially when it comes to changing alarm targets. Ask your healthcare provider whether these strategies are safe for you and your family, and come up with a sleeping plan that is best for your health and diabetes management goals. 

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