Why Is Diabetic Neuropathy Worse at Night?

Diabetic neuropathy symptoms can feel worse at night. Nerve pain in your feet may become more noticeable once you’re lying in bed and the distractions of the day are gone.

Nighttime pain is common with neuropathy. So, why is neuropathy worse at night? Part of the answer lies in how your body responds to rest and sleep.

Next, we’ll get into what can make nerve pain worse at night and what may help you sleep more comfortably. We’ll also cover signs that the pain may be coming from poor circulation.

What Makes Nerve Pain Flare at Night?

So, why is neuropathy worse at night? Several changes that happen around bedtime can make nerve pain more noticeable.

Fewer Distractions, Louder Signals

During the day, your mind has plenty to focus on. You’re up and moving, handling your usual routine. Once you lie down for the night, the pain may be more noticeable.

Temperature Changes While You Sleep

Your skin temperature changes throughout the night. Cooler feet can make damaged nerves more sensitive, which may make your symptoms worse.

Blood Sugar Swings Overnight

Diabetes is one of several causes of neuropathy. Blood sugar can go up or down while you sleep, which can make nerve pain worse during the night.

Keeping your blood sugar in the range your doctor recommends can help protect your nerves and keep the damage from getting worse. 

Slower Circulation When You Lie Still

Peripheral artery disease (PAD) reduces blood flow to your legs and feet. The problem is that the pain can feel a lot like neuropathy. Since the two can be difficult to tell apart, diagnosing neuropathy may include checking for other causes of your symptoms. Pain that gets worse when you lie down is one reason your doctor may check for poor circulation. 

How to Sleep With Diabetic Peripheral Neuropathy

Figuring out how to sleep with diabetic peripheral neuropathy often takes some trial and error. Along with neuropathy treatment from your doctor, changing your sleeping position, arranging your bedding, and caring for your feet before bed can help you get more comfortable. 

1. Keep your blood sugar routine consistent. Check your blood sugar and follow your doctor’s instructions for managing it before bed.
2. Keep your feet comfortably warm. Socks can help if cold feet make your symptoms worse. Be careful with heat if you have numbness in your feet. A heating pad or very hot water can burn your skin before you realize it.
3. Take pressure off sensitive feet. Even the weight of a sheet can hurt when your feet are sensitive to touch. Try loosening the bedding around your feet or arranging the sheets so they don’t rest directly on them.
4. Take a short walk before bed. If you’ve been sitting for much of the evening, a light walk can get you up and moving. Follow your doctor’s advice about physical activity. 
5. Check your feet every night. Look for cuts, blisters, sores, swelling, or changes in the skin. Moisturize dry skin, but avoid putting lotion between your toes.
6. Try a different pillow position. Move the pillow under or between your legs until you find a position that puts less pressure on painful areas.
7. Limit alcohol in the evening. If you drink, talk to your doctor about how alcohol fits into your diabetes and neuropathy care.
8. Talk to your doctor about your medication schedule. If prescribed medication isn’t controlling your pain through the night, ask whether the timing should be adjusted. Don’t change when or how you take it on your own.

When Night Pain Is a Sign of Something More: The Circulation Connection

Worse pain at night doesn’t necessarily mean your neuropathy is getting worse. Nighttime flares are common. Movement drops off once you’re in bed, the room may be colder, and your natural pain threshold is lower at night.

The bigger concern is nerve pain that regularly disrupts your sleep and doesn’t improve with changes such as keeping your feet warm, reducing pressure from bedding, or adjusting the timing of prescribed pain medication with your doctor. At that point, it’s worth looking at what’s driving the neuropathy rather than treating each bad night as an isolated flare.

Neuropathy has many underlying causes, and some are treatable. An evaluation can help connect persistent nighttime pain to its source and determine whether treatment needs to address more than pain relief.

Treatments That Can Calm Nighttime Neuropathy

Even when you’re managing your blood sugar, burning, tingling, or pain can still keep you awake at night. The best treatment depends on what’s causing your symptoms, how severe they are, and how much they’re interfering with your sleep. 

If poor circulation is adding to the pain, there are ways to improve blood flow to your legs and feet, which may also help ease your nighttime symptoms.

Frequently Asked Questions

Why do my feet burn at night?

Burning feet at night? Diabetes can be one reason. At night, there’s less going on to take your mind off nerve pain. Foot pain while you’re resting can also come from poor circulation. If it keeps coming back or starts getting worse, have it checked.

Why is neuropathy worse at night?

Neuropathy can feel worse at night because there are fewer distractions once you settle down to sleep. Changes in skin temperature, blood sugar, and circulation can also make nerve pain worse. 

Does elevating your legs help neuropathy at night?

It depends on what’s causing the pain. If raising your legs makes the pain worse but lowering them brings relief, contact your doctor promptly. This can be a sign of advanced PAD. 

What is the best sleeping position for neuropathy?

The most comfortable sleeping position will be different for each person. Try sleeping on your back or side with pillows positioned to take pressure off sensitive areas of your feet and legs.

When should I see a doctor for foot pain at night?

Talk to your doctor if foot pain keeps coming back, gets worse, or regularly keeps you from sleeping. Don’t wait to get checked if you have a sore that isn’t healing, changes in the color or temperature of your foot, or pain that gets better when you dangle your leg over the side of the bed.

Sleep Shouldn’t Hurt – Find Out What’s Behind Your Night Pain

If burning, tingling, or aching feet keep waking you up, reduced blood flow could be making your symptoms worse. American Endovascular & Amputation Prevention can determine whether you have diabetic neuropathy and offer you the right treatment option.  Schedule a consultation to get answers about your nighttime foot pain.