10 Hacks That Make It Virtually Impossible to Ignore (or sleep through) Diabetes Device Alerts

While no solution is 100% foolproof, these innovative solutions from device users and health care professionals can help.

For people with diabetes and their caregivers, concerns over accidentally sleeping through diabetes technology device alarms and alerts can be stressful. Despite improved and customizable sound options and vibrating devices, some people still have trouble waking up. Deep sleep and alarm fatigue can cause a person’s senses to stop recognizing these sounds over time making it even harder to wake up. 

While no solution is foolproof (we can't stress this enough!), we’ve found some innovative solutions that are sure to wake even the heaviest sleeper. There are options for a college student away at school, pre-teen off at summer camp, a child spending the night at a friend’s house or an elderly parent who lives alone. And some are good choices for people with different disabilities who may benefit from back-up options. So, here we go.

Our top 10 solutions starting with low-tech to high-tech DIY that can help awaken (almost) anybody.

1. Device Alarms: Turn the device volume to high and change the alarm options periodically. Hearing the same sound can contribute to alarm fatigue over time. We recommend changing specific alerts to a new sound every month or so. This can increase the likelihood that the user will hear it and wake up. 
2. Device in a Bowl: Put a glass or hard plastic bowl next to the bed, and place the device/phone in the bowl before going to bed. Be sure it’s set on vibrate. The rattling next to your bed can wake up even sound sleepers.
3. The Bed Shaker: There are a number of specialized alarms that can be installed next to your bed with vibrating pads and flashing lights. Some can be configured through third-party apps to respond to CGM alerts.
4. Sugar Pixel: This is a secondary glucose display alert system and “dedicated CGM hardware.” It looks like a retro clock that displays blood glucose in large numbers - easy to see across a room and comes with multiple alert options, including vibration and dual audio-vibration for heavy sleepers. Sugar Pixel runs around $99.00 retail. 
5. Phone Calls: The Sugarmate App, compatible with CGM devices, can send urgent alerts via phone call to people with diabetes and caregivers letting them know when blood sugar is low. The app also includes customizable alerts, such as when blood sugar is dropping or consistently high. 
6. Bellman & Symfon Phone Sensor Home Alerting System: This separate device is designed to wake people with hearing impairments. The device features a very loud alarm that increases in sound, bed shaker and flashing lights. It connects directly to a phone that can wake a person when phone calls or alerts come in. It can also be paired with the Sugarmate app to send waking alerts when blood glucose is low. 
7. Make it Louder: Bluetooth speakers can often be paired with a CGM device allowing more volume options when setting alerts for your device.
8. Multi-Sensory: Amazon Alexa can be integrated with Sugarmate and other apps. Multiple functions allow a caregiver to send commands to wake a person with diabetes such as playing loud music or turning on lights when using smart bulbs. This may require a bit more advanced programming.
9. Find My Phone: Some caregivers find that the “find my phone” alert on their phone or Apple Watch is very effective in waking a loved one. It's very loud and hard to ignore. Other users found that the watches vibrating alert on the inside of the wrist wakes them without additional sounds. If you are calling your loved one with diabetes, be sure your phone number is programmed to ring even when using the “do not disturb” function.
10. Nightscout: This is a DIY option that allows you to connect your CGM or pump to the app allowing alerts to the person with diabetes and other users. Some have found these alerts may be more effective. It’s important to enable the Lock Screen to keep the app running throughout the night. Visit Nightscout.

Additional Considerations for Effective CGM Alerts

• Caregivers should review and update CGM alert settings regularly, ensuring proper alert thresholds and volume settings are maintained. 
• Set a specific "Night" profile where available to minimize non-critical alerts during sleep, reducing disturbances while ensuring critical alerts are still received
• Check your CGM for audio and vibration alerts that are available through the app or through smartphone accessibility settings, this will help reduce missed alarms.
• Preprogram emergency contacts in smart devices to ensure that caregivers can always reach their loved ones to alert them of any issue.
• Encourage Smartphone users to deactivate automatic software updates until they have learned from the CGM device company how (if at all) the update will impact their personal CGM settings.
• Confirm that the addition of a new app, extension, or accessory does not interfere with alarms or alert delivery.
• Review that features like "Do Not Disturb", "Focus Mode" and app notification permissions do not interfere with alarms or alert delivery. 

• Deep sleep, alarm fatigue, and the body's adaptation to frequent alerts can reduce responsiveness. This is why changing alarm tones and integrating multi-sensory alerts can improve wakefulness.

• The ADA recommends real-time CGM (rtCGM) alerts for individuals at risk for hypoglycemia, particularly those with hypoglycemia unawareness, asymptomatic hypoglycemia, Type 1 Diabetes, and insulin-treated Type 2 Diabetes.
  

• Many low-cost options can improve alert effectiveness, such as placing a phone in a bowl, using vibrating alarms, or setting up phone call alerts via the Sugarmate app.

• Caregivers can remotely monitor CGM alerts using apps like Nightscout and Sugarmate, set up smart home wake-up solutions, and use Find My Phone alerts in case of emergency.

• Yes! Amazon Alexa, Google Home, and smart bulbs can be programmed to flash lights, play music, or trigger voice alerts when a CGM alarm is activated.