Difficulty Sleeping: Symptoms, Causes, and Treatment

From verywellhealth.com

Difficulty sleeping is a common problem that affects us all at one point or another. Having trouble falling or staying asleep, waking up feeling tired, and having challenges with your memory, decision-making, and irritability due to not getting good rest are all associated with sleep difficulties or even a sleep disorder. If the symptoms associated with your difficulty sleeping interfere with your quality of life and daily functioning, a healthcare provider can help you figure out what might be causing it and how it can be treated.

This article will provide an overview of sleep difficulties, common symptoms, causes, how to test for sleep disorders, and when to seek medical care.

Maria Korneeva / Getty Images

Symptoms of Difficulty Sleeping

Depending on the severity and cause, symptoms related to having trouble sleeping include:

• Daytime sleepiness, which may be excessive
• Needing to take naps during the daytime
• Having trouble getting to sleep or staying asleep
• Waking up especially early and being unable to go back to sleep
• Impairment of daily functioning, including thinking, retaining memories, and slower reaction times
• Changes in mood, which may also include irritability and depression

Causes of Difficulty Sleeping

Anyone can have difficulty getting the sleep they need from time to time. However, those who regularly experience sleep difficulties or significant impacts on their daily functioning and quality of life may have a sleep disorder.

In the United States, about 70 million people live with a sleep disorder. Common sleep disorders include:

Insomnia

Sleep apnoea

Restless leg syndrome (RLS)

Narcolepsy

Sleep difficulties arise from these types of causes because the disorders disrupt your body's sleep/wake cycle, which is also known as the circadian rhythm.

What Is the Circadian Rhythm?

Circadian rhythms are the body's natural processes for changes that occur physically, mentally, and behaviourally. These rhythms respond to exposure to light and darkness. For example, you are more likely to feel tired when you are exposed to darkness and more awake when you're exposed to light.

Your genes and cues from your environment can impact your body's circadian rhythm. Factors such as genetic mutations that change the way it functions, exposure to light when we typically don't have it (such as light emitted from mobile phones at night), and changes to the timing of when you're awake or asleep (like when you experience jet lag or work the night shift) can all alter your circadian rhythm.

There are physical, psychological, and environmental causes for various sleep disorders, ranging from work schedules, genetics, older age, and even some medications.

What Medications Can Cause Difficulty Sleeping?

In addition to other causes, several medications can impact sleep quality and your ability to get enough sleep. Some types of medications that can cause sleep problems include:

• Some beta-blockers, such as Lopressor (metoprolol) and Inderal (propranolol), may cause insomnia, nightmares, or waking up during the night.
• Over-the-counter (OTC) medications that contain alcohol or caffeine, such as cold and flu medications, pain relievers, and caffeine supplements, can disrupt sleep or delay sleepiness.
• Selective serotonin reuptake inhibitors (SSRIs), including Prozac (fluoxetine) and Zoloft (sertraline), can impact REM sleep and make you feel tired during the day.
• Diuretics may increase the need to pee at night or cause leg cramps that may keep you awake. 
• Certain antihistamines, such as those included in some OTC cold medicines and motion sickness tablets, may make you drowsy.
• Stimulant medications used to treat attention deficit-hyperactivity disorder (ADHD) such as Ritalin (methylphenidate) and Adderall (dextroamphetamine-amphetamine) can make falling asleep difficult and impact deeper stages of sleep.
• Nicotine replacement therapy products like Nicoderm and Nicorette may contribute to nightmares and insomnia.
• Medications that treat thyroid conditions, such as Levoxyl and Synthroid, can cause difficulty falling asleep, fragmented sleep, and insomnia. 
• Corticosteroids, such as prednisone, can make you feel jittery, reduce the amount of REM sleep you get, and cause insomnia.

How to Treat Sleep Difficulties

For occasional or mild sleep difficulties, there are a number of healthy sleep hygiene practices you can establish to get your sleep/wake cycle back on track. These include:

• Going to bed and waking up around the same time each day. Maintaining a regular sleep schedule can help your body naturally feel tired and awake at the same time on a daily basis.
• Keeping your sleep environment cool, dark, and quiet. Exposure to warm temperatures, light, and noise can keep you awake or make it hard to go to sleep.
• Limiting or avoiding the use of electronic devices where you sleep. Electronics such as tablets, laptops, televisions, and smartphones can emit blue light, which can trigger your body to feel more awake.
• Eating light before bed. Heavy meals and too many liquids can keep you up. Further, substances such as alcohol and caffeine can make it hard to get to sleep or disrupt your sleep cycle, so aim to limit or avoid those before bed.
• Getting active during the daytime. Getting physical activity during daylight hours can improve your sleep quality at night.

If you continue to experience sleep difficulties, or your symptoms are severely impacting your daily functioning, a healthcare provider can help you treat the symptoms. Treatment will vary depending on the specific cause, which can include medicine, counselling, and the use of devices such as a continuous positive airway pressure (CPAP) machine.

Your provider will likely give you a physical exam and ask about any medications or other medical conditions you have that could be contributing to your symptoms. If an undiagnosed condition or issue is suspected, you may also undergo tests to rule those out. If your provider suspects you may have a sleep disorder, they may refer you to a sleep specialist for further testing.

Are There Tests to Diagnose the Cause of Sleep Difficulties?

There are several tests that can help determine the root cause of sleep difficulties and disorders. A healthcare provider may want to test you for any underlying conditions, particularly chronic issues such as heartburn, diabetes, thyroid problems, depression, anxiety, and arthritis. Keeping a sleep diary in which you take notes on your sleep patterns for a period of a few weeks can help further inform what may be causing your difficulties.

To test for sleep disorders, there are a number of options that are typically available in a clinical sleep centre setting:

• Polysomnogram: This test requires you to go to a sleep centre to be observed while you sleep. While you sleep, your brain waves, heartbeat, oxygen levels, and eye movements are monitored.
• Multiple sleep latency test: This test measures how sleepy you are during the daylight hours and is often used to assess for narcolepsy. It's also conducted in a sleep centre. During the testing period, how quickly you're able to fall asleep and the stage of sleep you reach during a series of 20-minute nap periods are measured.
• Maintenance of wakefulness test: This test measures how alert you are in a quiet environment. Instead of measuring your ability to fall asleep in a series of time periods, your sleep specialist will measure alertness in several trials over the course of a day in a sleep centre.
• Titration: During a stay at a sleep centre, your specialist will fit you with a CPAP machine to observe how well the device helps you breathe while you sleep during this test. This can help determine the most appropriate settings for the machine for home use to help with sleep apnoea and obstructed breathing during your sleep.

You may be able to conduct some studies and tests for assessing possible sleep disorders at home, where you often can get a better night's sleep than in a clinical setting. Your sleep specialist will give you certain devices to use while you sleep to take the necessary measurements.

When to See a Healthcare Provider

If you have a poor quality of life because of sleep difficulties, speaking with a healthcare provider can help you investigate and treat what may be the cause of:

• Having a hard time getting to sleep or staying asleep
• Feeling overly tired during the day
• Needing to take naps during the day
• Experiencing challenges with day-to-day functioning, including while driving, at work, or at school

Summary

Many people have sleep difficulties occasionally. Regularly experiencing them may indicate chronic sleep difficulties or a sleep disorder. Common sleep disorders include insomnia, sleep apnoea, restless leg syndrome, and narcolepsy. These disorders are caused by a number of factors, such as certain medications, genes, work schedules, and health conditions.

Speaking with a healthcare provider can help you investigate the cause and appropriate treatment for sleep difficulty symptoms. If a sleep disorder is suspected, you may get a referral to a sleep specialist and further testing in a sleep centre. Treatment can range from adopting healthy sleep hygiene habits to certain medications, counselling, or devices to help you breathe at night.

A Word From Verywell

Sleep is critical to your overall well-being and daily functioning. It's not just about the ability to get to sleep and stay asleep; the quality of your sleep matters as well. Not addressing chronic sleep difficulties can lead to other health issues. Reaching out to a healthcare provider can help you work towards getting high-quality sleep and reduce the risk for longer-term health issues.

https://www.verywellhealth.com/difficulty-sleeping-5667211 

I Had Insomnia For a Decade—These 5 Products Helped Me Overcome It

From verywellhealth.com

By Loren Brutsch 

Drift off to sleep faster with five products our writer personally uses

We all know the feeling of struggling to sleep. You turn the lights out, find a comfortable position, close your eyes—and wait. And wait. And wait. The next thing you know it’s 2:00 a.m. and you’re more alert than you were before lying down. The panic sets in, and you know tomorrow is going to be painful. 

This was my nightly routine from early high school through my late twenties. And even on the nights when I was finally able to drift off, I’d wake up at least four or five times without explanation. When talking to friends and family about it, they’d viciously nod in agreement saying they experienced something similar. But no one had a real solution. The sad truth is insomnia is incredibly common, with one out of every three people reporting experiencing it in 2019 alone.

While many people suffer from the pain of sleepless nights, it’s important to know when to see a specialist. “If you have multiple nights a week (3+) or feel that you routinely have trouble with the quality or quantity of your sleep multiple nights a week, talk with your doctor or a sleep specialist. There are a lot of effective treatments out there, such as Cognitive Behaviour Therapy for Insomnia,” says Shelby Harris, PsyD, Director of Sleep Health at Sleepopolis and licensed clinical psychologist who specializes in behavioural sleep medicine (BSM).

Insomnia is commonly linked to mental disorders such as stress, anxiety, depression, and PTSD. As someone with generalized anxiety disorder (GAD), I had no idea whether my anxiety was the cause or the symptom of my insomnia. But I knew the two together created a ruthless cycle of stressful days and sleepless nights that was feeding itself like an ugly two-headed monster living under my bed. 

After more than a decade of trial and error, I finally have my sleep under control and average eight hours of restorative slumber per night. A lot of it came down to creating a strict routine that includes putting away my phone by 9:00 p.m. and meditating in bed (which isn’t recommended but works for me). But I also owe my blissful nights to a few products that I now can’t live without such as bamboo sheets, a cooling mattress, and a contour face mask. 

Here are the 5 (mostly inexpensive) products that helped me overcome insomnia.

This Sleep Mask Blocks Light and Doesn’t Smoosh My Lashes

Amazon

Slip Silk Contour Sleep Mask, $55; amazon.com

Light has always bothered me when trying to sleep so I decided to give sleep masks a try. I went through a few pairs that were comfortable enough, but unfortunately crinkled and flattened my eyelashes. No mascara was strong enough to keep me from looking like Mr. Snuffleupagus from Sesame Street during the day. Eventually, I found Slip Silk Contour Sleep Mask. 

This sleep mask leaves enough room for your lashes to lay undisturbed by providing a cushy raised ring of padding around your eyes. The silk fabric is smooth on your skin and won’t cause breakouts. I’ve also found it’s easy to wash—I just throw it in on a cold load with my other clothes and hang it dry. It’s perfect for anyone who has longer lashes and feels like they need complete darkness to drift off.

Cooling Bamboo Sheets that Feel Weighted and Soft

Amazon

Bedsure Bamboo Sheets, $60; amazon.com

Remember how I said insomnia is often tied to mental disorders such as anxiety? A great way to reduce stress is through weighted blankets or sheets as the weight calms your autonomic nervous system (which is the part of your nervous system that controls things like your heart rate, blood pressure, breathing, and digestion). The Bedsure Bamboo Sheets feel heavier than most and are silky soft to the touch, which provides a calming effect. 

They also feature a serious cooling sensation, which helps with sleep as elevated body temperatures have been associated with wakefulness throughout the night. “Body temperature drops slowly while you’re sleeping and rises again in the morning. This happens in sync with your circadian rhythm and is an essential part of falling and staying asleep. If your body temperature is too warm, it can interfere with your deep sleep and cause you to wake up more frequently throughout the night, affecting your sleep quality and quantity,” Dr. Harris explains. 

I love these Bedsure sheets because they keep my body temperature regulated and cool so it’s easier to both fall asleep and stay asleep—sweat-free. If you’re someone who wakes up from night sweats or struggles to sleep because your body is roasting, these sheets are for you.

A Foam Mattress with Cooling Effects and Lumbar Support

Puffy

Puffy Mattress, $700 with discount code (was $1450); puffy.com

Just as cooling sheets were a game changer for me, a cooling mattress made a huge difference in my ability to fall asleep faster and stay asleep longer. The Puffy Mattress is a foam mattress with multiple layers—two of which provide a cooling sensation that keeps you from overheating at night. 

I usually prefer softer, plush mattresses, so when I found that I loved the firmness of the Puffy I was pretty surprised. Unlike other firm mattresses, it doesn’t feel like I’m sleeping on a block of cement. What’s more, I suffer from severe allergies, and this mattress is hypoallergenic so I don’t wake up sneezing in the middle of the night. It also comes in a compressed box for easy delivery and offers a 101-night sleep trial so if your insomnia doesn’t ease up you’re not locked in.

Ear Plugs That Reduce Noise and Let Me Sleep On My Side

Amazon

Tiliwame Reusable Earplugs, $17; amazon.com

Even the slightest noise in the middle of the night would have me shoot up like a rocket, but earplugs never seemed like an option for me. For side sleepers like me, earplugs can feel like a sharp jab to your eardrums—making it impossible to doze off. 

I love the Tiliwame Earplugs because their base lays flush with my inner ear. They’re not completely noise-cancelling, but more noise-reducing. But this is great for people who worry about not hearing their alarm in the morning, or who have kids that may need help in the middle of the night. These earplugs are also great because they’re reusable, which is better for the environment. 

It’s worth noting that I’ve found foam headphones to be more noise-cancelling than the Tiliwame Earplugs. But foam can be a bad option for people with allergies, and are prone to growing bacteria so they need to be thrown out after a few uses. That means reusable plugs are the way to go if you’re worried about the environment.

Melatonin That Works and Tastes Great

Amazon

Natrol Melatonin, $10; amazon.com

Melatonin has always worked well for me. While it’s by no means the cure for insomnia, it’s a natural remedy that can occasionally help ease you to sleep. “People think that melatonin is a natural cure for insomnia but there’s not a lot of data in support of this, and they also tend to take way too much,” Dr. Harris explains. “While it can help a few people with insomnia, it isn’t the panacea most people think it is,” she adds. So while we don’t recommend you run out to buy melatonin thinking it’s the be-all and end-all to your sleep struggles, it can be an occasional boost into slumber for some.

I’ve tried plenty of melatonin products that get the job done for me personally, but I love Natrol Melatonin because I believe chewable options hit me with sleepiness a little faster and harder. Plus, they taste great. Melatonin isn’t a sleeping pill—it won’t keep you asleep all night. But it takes the edge off by signalling to your body that it’s time to fall asleep.

https://www.verywellhealth.com/products-help-insomnia-sleep-better-6828435