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What Causes Excessive Sleepiness While On Metformin For Diabetes?

Posted on Thu, 13 Nov 2014

Question: I have been told I have type 2 diabetes and am presently taking metformin, 750 mg., once a day. I always get sleepy after I eat, whether it is a regular meal, or a bowl of soup, or a sandwich. No matter what it is, I always get sleepy and usually end up laying down and I actually do fall asleep. I stay asleep for sometimes two hours and sometimes more. What causes this and what can I do to prevent it?

Answered by Dr. Binu Parameswaran Pillai (1 hour later)

Brief Answer:
Metformin is nor responsible

Detailed Answer:
Good day,

Noted your concern.
Apologies for the delay in reply.

Could I ask him few questions?

Metformin is not responsible for the excessive sleep. May I know your weight and height?
Do you snore when you sleep? Do you feel fresh in the mornings when you wake up?
Are you on any other medications apart from Metformin?

I would appreciate a reply

Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (15 minutes later)

I am 62" tall and weigh 203 lbs. In addition to metformin I am taking armour thyroid once a day, felodipene once a day, Losartan + hctz once a day, plus I take a multi vitamin/mineral once a day, and one magnesium, one potassium 3 times a week, and 1 mg melatonin before bed. I do not snore and once I get awake in the morning I feel refreshed. I do not wake up tired I just get sleepy during the day. I do not believe I have sleep apnea. I usually don't wake up during the night except once in a while if I have to go to the bathroom. But not often.

Answered by Dr. Binu Parameswaran Pillai (19 minutes later)

Brief Answer:
Possible reasons

Detailed Answer:
Thank you for the reply.

Hypothyroidism itself can make you tired and sleepy. Have you done a recent thyroid blood test?
Another possibe cause of your syptoms is electrolyte imbalance. Low potassium and low sodium can make you tired and sleepy. This is especially so when you take hydrochlorothiazide(hctz). It is surely worth checking serum sodium, potassium and Magnesum levels.

Another possibility is Adrenal fatigue.

Uncontrolled diabetes is another possible cause. I hope it is well controlled on Metformin.

Since you take Melatonin now, i presume that you had sleep problems in the past. Please clarify.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (29 minutes later)

My last employment was a 24/7 call center with rotating shifts. It was difficult to sleep sometimes and I learned that melatonin could help. I tried it and it did. It works for me and I do not take it religiously but if it is getting to be bed time and I am not sleepy, I take one so that I can keep my circadian rhythms balanced.

I have an appointment next week with my GP and will ask for re-checks on my thyroid and also ask him to check my potassium, magnesium and sodium levels. Is there also a test that can be taken for Adrenal fatigue? I can have that checked as well. I am really tired of being sleepy a lot of the times.

Answered by Dr. Binu Parameswaran Pillai (50 minutes later)

Brief Answer:
Tests

Detailed Answer:
yes, an 8 AM serum cortisol and serum electrolytes may give clues towards adrenal fatigue. Other clues are Blood pressure fall on getting up from sitting position (it can be checked by measuring sitting and standing BP)
Regards
Binu

Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar