How to Adjust CGM Alarm Thresholds for Better Sleep with Type 1 Diabetes

The One Sleep Habit That Improves T1D Time in Range

SHOW NOTES: Eight weeks. Twenty-four episodes. The dawn phenomenon, cortisol, alarm fatigue, sleep stages, Fear of Hypoglycemia, CGM as a proactive tool. If Neil had to give you one thing to keep from all of it -- just one habit -- here it is: go to bed at the same time every night. This is not a joke, and it's not oversimplified. It's the finding from the 2023 T1D sleep study with 76 participants that Neil has been referencing throughout this challenge. Bedtime consistency was the dominant sleep variable associated with time in range -- not total hours, not sleep efficiency, not how many times you woke up. Consistent bedtime. Every extra hour of bedtime variability was associated with roughly 10% less time in range. And the effect runs both directions: more consistency, better glucose outcomes. We're in Week 8 of the While You Were Sleeping Challenge. Three days from the finish line. In this episode: * Why consistent bedtime is the single most impactful sleep habit for T1D time in range * What the 2023 research actually says -- and why it's the clearest finding in the whole challenge * Why your body doesn't know it's Saturday (and what that costs you weekly) * The Jerry Seinfeld productivity method applied to your bedtime * How to pick your time, commit to the 60-minute window, and start the streak This Week's Challenge: Pick your bedtime. Say it out loud. Write it down. Commit to it through the end of the challenge -- including this weekend. Helpful resources and newsletter: https://yourbestt1dyear.com [https://yourbestt1dyear.com] Connect with Neil: TikTok: https://tiktok.com/@the.betes [https://tiktok.com/@the.betes] Instagram: https://instagram.com/thebetes [https://instagram.com/thebetes] Facebook: https://facebook.com/neilgreathouse [https://facebook.com/neilgreathouse] LinkedIn: https://linkedin.com/in/neil-greathouse-a607b912 [https://linkedin.com/in/neil-greathouse-a607b912] Website: https://yourbestt1dyear.com [https://yourbestt1dyear.com] Books on Amazon: Type 1 Diabetes – One Day at a Time: https://a.co/d/6UHooWJ [https://a.co/d/6UHooWJ] Type 1 Diabetes – True Stories: https://a.co/d/dfIlyI1 [https://a.co/d/dfIlyI1]

What "Good Enough" Sleep Actually Looks Like When You Have Type 1 Diabetes

SHOW NOTES: Perfect is not the goal. This episode takes a stand on something that doesn't get said enough in health content of any kind -- and especially not in T1D content. If you've been measuring your sleep quality against general population benchmarks (the 8-hour standard, the 90% sleep efficiency score, the deeply uninterrupted ideal), Neil is here to tell you, with genuine care, that you've been holding yourself to the wrong ruler. T1D "good enough" sleep is its own category. You're managing a disease overnight. Your liver is running its 3am shift. Your cortisol is cycling. Your CGM is monitoring. Comparing your sleep to non-T1D benchmarks is not a useful exercise. And chasing perfect while managing T1D is a fast road to frustration. Meaningfully better is the goal. This is Week 8 of the While You Were Sleeping Challenge. We're almost at the finish line -- and this episode matters. In this episode: * Why comparing T1D sleep to non-T1D population benchmarks doesn't serve you * What "meaningfully better" looks like for someone managing overnight glucose * The batting average analogy: what winning looks like when you're playing with T1D physics * How to define your own version of sleep success -- one that accounts for what you're actually managing * Why "fewer interruptions than last month" counts as a real win This Week's Challenge: Write one sentence: what would "better" sleep look like for you? Not perfect. Your version. One sentence. Helpful resources and newsletter: https://yourbestt1dyear.com [https://yourbestt1dyear.com] Connect with Neil: TikTok: https://tiktok.com/@the.betes [https://tiktok.com/@the.betes] Instagram: https://instagram.com/thebetes [https://instagram.com/thebetes] Facebook: https://facebook.com/neilgreathouse [https://facebook.com/neilgreathouse] LinkedIn: https://linkedin.com/in/neil-greathouse-a607b912 [https://linkedin.com/in/neil-greathouse-a607b912] Website: https://yourbestt1dyear.com [https://yourbestt1dyear.com] Books on Amazon: Type 1 Diabetes – One Day at a Time: https://a.co/d/6UHooWJ [https://a.co/d/6UHooWJ] Type 1 Diabetes – True Stories: https://a.co/d/dfIlyI1 [https://a.co/d/dfIlyI1]

How to Use Your Overnight CGM Data to Improve Sleep and Blood Sugar

SHOW NOTES: You've been sleeping next to one of the most detailed health monitoring devices that exists. Every single night. For however many years you've had your CGM. It has been logging everything -- every rise, every drop, every 3am event, every overnight pattern. It has been very patient about all of this. Most T1D people use their CGM reactively at night. The alarm fires, you check, you respond or silence, you go back to sleep. What almost no one does is look at the full overnight graph proactively -- not to respond to a single moment, but to read the shape of the whole night. Your CGM shows you the dawn phenomenon, the post-exercise glucose drop, the cortisol spike, the active insulin tail. It has been a map this whole time. We've been treating it like a fire alarm. This is Week 7 of the While You Were Sleeping Challenge. This is the episode that changes how you use the device you already wear. In this episode: * The difference between reactive and proactive overnight CGM use * How to read the shape of an overnight graph -- not just the morning number * What the dawn phenomenon, exercise drops, and cortisol spikes look like in your data * Why your CGM graph is a map, not a report card * How one minute of overnight data review can improve the next night This Week's Challenge: Tonight, look at last night's full overnight CGM graph. The whole shape. Not to judge it. Not to fix it. Just to see what was there. Helpful resources and newsletter: https://yourbestt1dyear.com [https://yourbestt1dyear.com] Connect with Neil: TikTok: https://tiktok.com/@the.betes [https://tiktok.com/@the.betes] Instagram: https://instagram.com/thebetes [https://instagram.com/thebetes] Facebook: https://facebook.com/neilgreathouse [https://facebook.com/neilgreathouse] LinkedIn: https://linkedin.com/in/neil-greathouse-a607b912 [https://linkedin.com/in/neil-greathouse-a607b912] Website: https://yourbestt1dyear.com [https://yourbestt1dyear.com] Books on Amazon: Type 1 Diabetes – One Day at a Time: https://a.co/d/6UHooWJ [https://a.co/d/6UHooWJ] Type 1 Diabetes – True Stories: https://a.co/d/dfIlyI1 [https://a.co/d/dfIlyI1]

T1D Sleep Hygiene: The One Pre-Sleep Habit That Actually Makes a Difference

SHOW NOTES: "Sleep hygiene" sounds like you're brushing your sleep's teeth. Nobody has ever said that phrase in a natural conversation. And this episode is not about a 12-step pre-sleep protocol that you'll implement on Monday and abandon by Wednesday when life gets in the way. It's about one thing. Just one. Because T1D brains are very good at building complicated systems -- we've been doing it since diagnosis -- and when we hear "build a routine," we design a fourteen-point optimization plan that fails by Wednesday, raises our cortisol, and disrupts our blood sugar. One anchor behavior, repeated consistently, is how habits actually form. You already have a pre-sleep T1D routine. We're extending it by about thirty minutes, in one direction. We're in Week 7 of the While You Were Sleeping Challenge. In this episode: * Why multi-step sleep protocols fail and what actually sticks long-term * The three pre-sleep candidate behaviors that research supports for T1D people * Why "the one that feels manageable" beats "the one that seems most impactful" * How to use your existing T1D bedtime routine as an anchor for one new behavior * What five nights of one habit actually tells you about whether it's working This Week's Challenge: Pick one of the three pre-sleep behaviors from this episode. Commit to it for five nights. Write down what you notice. Helpful resources and newsletter: https://yourbestt1dyear.com [https://yourbestt1dyear.com] Connect with Neil: TikTok: https://tiktok.com/@the.betes [https://tiktok.com/@the.betes] Instagram: https://instagram.com/thebetes [https://instagram.com/thebetes] Facebook: https://facebook.com/neilgreathouse [https://facebook.com/neilgreathouse] LinkedIn: https://linkedin.com/in/neil-greathouse-a607b912 [https://linkedin.com/in/neil-greathouse-a607b912] Website: https://yourbestt1dyear.com [https://yourbestt1dyear.com] Books on Amazon: Type 1 Diabetes – One Day at a Time: https://a.co/d/6UHooWJ [https://a.co/d/6UHooWJ] Type 1 Diabetes – True Stories: https://a.co/d/dfIlyI1 [https://a.co/d/dfIlyI1]

Late-Night Exercise and Blood Sugar: What Your Evening Workout Does to Your T1D Overnight

SHOW NOTES: Your Tuesday 8pm HIIT class has opinions about your 3am blood sugar. The data is pretty clear on this. Neil is giving you fair warning before the episode starts. This episode covers the timing of exercise and its downstream effects on both sleep quality and overnight glucose in type 1 diabetes. Afternoon and evening exercise produce very different results -- not because exercise is bad for T1D management (it isn't), but because your core body temperature, cortisol rhythm, and post-exercise glucose patterns interact with your sleep in ways that depend heavily on when you moved. The 8pm workout can raise core temperature, spike cortisol, and set up a 2am glucose drop that fires an alarm -- all without any other mistake being made. We're in Week 7 of the While You Were Sleeping Challenge. In this episode: * Why afternoon exercise (roughly noon to 6pm) supports better sleep and overnight glucose stability * What high-intensity evening exercise does to core body temperature and cortisol levels * How post-exercise glucose drops in T1D can create 2-3am lows and trigger alarms * What to look for in your overnight CGM data on workout days vs. rest days * How even a modest timing shift can meaningfully change the overnight picture This Week's Challenge: What time was your last workout? Pull up your overnight CGM from that night. Did anything look different than your non-workout nights? Helpful resources and newsletter: https://yourbestt1dyear.com [https://yourbestt1dyear.com] Connect with Neil: TikTok: https://tiktok.com/@the.betes [https://tiktok.com/@the.betes] Instagram: https://instagram.com/thebetes [https://instagram.com/thebetes] Facebook: https://facebook.com/neilgreathouse [https://facebook.com/neilgreathouse] LinkedIn: https://linkedin.com/in/neil-greathouse-a607b912 [https://linkedin.com/in/neil-greathouse-a607b912] Website: https://yourbestt1dyear.com [https://yourbestt1dyear.com] Books on Amazon: Type 1 Diabetes – One Day at a Time: https://a.co/d/6UHooWJ [https://a.co/d/6UHooWJ] Type 1 Diabetes – True Stories: https://a.co/d/dfIlyI1 [https://a.co/d/dfIlyI1]