Ever woken up sweaty, shaky, or confused in the middle of the night?
That midnight disruption might be more than just a bad dream,  it could be nighttime hypoglycemia, or low blood sugar during sleep.

In this blog, we'll break down why it happens, why it's dangerous, and how you can stay safe and steady overnight.

Introduction: What Is Nighttime Hypoglycemia?

Nighttime hypoglycemia is a drop in blood glucose levels during sleep. It's particularly common in people managing diabetes with insulin or certain medications. The real risk? You’re asleep when it happens, which means you might not notice the warning signs or respond in time.

Common Overnight Symptoms:

• Sweating
  
  

• Restlessness or nightmares
  
  

• Jerky body movements
  
  

• Waking up disoriented or with a headache
  
  

• Fatigue or confusion in the morning

If you frequently feel off upon waking, it could be your body's silent alarm trying to tell you something important.

Why Nighttime Hypoglycemia Happens

Your body continues using glucose while you sleep, primarily to fuel your brain, breathing, and repair processes. If your blood sugar drops too low during this time, and there’s nothing to balance it out, hypoglycemia can occur.

Table: Common Causes of Nighttime Hypoglycemia

The Dangers of Nighttime Hypoglycemia

Credits: BETTER

Because you’re less likely to wake up or act quickly, nighttime hypoglycemia can be more severe than daytime episodes. In extreme cases, it can lead to seizures or a life-threatening condition known as “dead-in-bed” syndrome, though this is rare.

A 2007 study in Diabetes Care reported that up to 50% of severe hypoglycemic episodes in people with type 1 diabetes occur at night, often without recognition until morning.

Preventing Nighttime Hypoglycemia: Simple, Practical Steps

The good news? You can significantly reduce the risk with a few intentional habits.

Prevention Checklist:

• Eat a well-balanced dinner with protein and complex carbs
  
  

• Avoid intense workouts too close to bedtime
  
  

• Limit alcohol, especially in the evening
  
  

• Review your insulin or medication doses with your healthcare provider
  
  

• Keep fast-acting carbs by your bedside
  
  

• Use a CGM (Continuous Glucose Monitor) if available

According to a study published in JAMA (2017), people using CGMs experienced 50% less time spent in hypoglycemia overnight compared to those using standard monitoring methods.

Managing Blood Sugar at Night: Routine for Stability