Sleep problems

What do we mean by sleep problems?

We all need to ‘recharge our batteries’ overnight so that we can be energetic and alert during the day. Most of us spend a third of our lives asleep. But at least half of us experience sleep problems at some time in our lives. Some people don’t get enough sleep, others are too restless, and others may feel that they are sleeping too much. Perhaps you have difficulty getting to sleep, or problems staying asleep through the night, or you wake too early in the morning? You may think you’re getting enough sleep but if you wake up feeling tired or feel very sleepy during the day, then you might have a sleep problem. Too little sleep can make you feel tired and irritable, and less able to concentrate the next day. But it isn’t just how much sleep you get that matters; quality of sleep is important too.

The most common kinds of sleep problem are:

• insomnia – having difficulty falling asleep or staying asleep
• sleep apnoea – due to breathing interruptions during sleep
• restless legs syndrome – uncomfortable sensations that make you feel you have to move your legs.

There are treatments for most sleep disorders. Sometimes just having regular sleep habits can help.

How much sleep is enough?

Most adults seem to need seven to eight hours. But a few people thrive on less, and feel worse if they sleep more. Others need ten hours or more to feel right. Older people will often only have one period of deep sleep during the night, usually in the first three or four hours. After that, they wake more easily. The short periods of being awake can feel much longer than they really are, so it is easy to think you are sleeping less than you actually are.

What causes insomnia?

Insomnia can take many different forms. It can mean taking a long time (more than 30 to 45 minutes) to get to sleep, or waking a lot in the night, or waking early and finding you can’t get back to sleep.

Going through a stressful time can trigger short-term sleep problems. For instance, a big life event (like a house or job move, going into hospital or exams), a personal crisis (such as bereavement, conflict in a close relationship or worries about money or a job loss), or minor illness, pain or injury can all cause periods of insomnia. In the same way, the stress of long-haul air travel will disturb sleep rhythms until the body-clock catches up. A noisy neighbourhood and shift-working can make sleep difficult in the long term. But if none of these things is the cause, then there could be a medical reason.

Sleep Apnoea

Lots of people snore. But loud snorers who feel sleepy during the day may be having sleep apnoea (pronounced AP-ne-ah) attacks. Sleep apnoea means having long pauses in breathing during sleep. The pauses can last from ten seconds or much longer, and can happen between 5 and 30 times or more an hour. Then breathing starts again, often with a loud snorting or choking noise. Because sleep apnoea keeps jolting you out of deep sleep and into light sleep it is one of the leading causes of long-term daytime tiredness.

The most common type is called obstructive sleep apnoea because the airway gets blocked during sleep. It mainly affects men and is more common in people who are overweight. Most people won’t know they have sleep apnoea unless a family member and/or bed partner notices the signs: loud and irregular snoring, excessive body movements or gasping for breath while you are asleep, and of course persistent daytime tiredness. Alcohol and sleeping pills relax the tongue and throat muscles, which block the airway and so make the problem worse.

If you have a fairly mild case of obstructive sleep apnoea, sleeping on your side may stop your tongue and palate from falling backwards and blocking your airway. And losing weight usually helps reduce the problem in overweight middle-aged men. More serious obstructive sleep apnoea needs medical attention.

Restless Leg Syndrome (RLS)

RLS causes unpleasant sensations in the legs and an irresistible urge to move them when you lie down or relax. It usually gets worse at night, so it can cause sleep problems. Mild RLS can often be helped by the following lifestyle changes:

• Have a regular sleep schedule and follow our sleep hygiene rules.
• Exercise moderately. Daily activity significantly reduces RLS symptoms. But excessive exercise can actually make it worse.
• Reduce your caffeine intake because too much caffeine makes RLS worse.
• Cut out alcohol or tobacco because reducing your intake tends to improve RLS.
• Consider taking vitamin supplements. Being low on iron, vitamin B, folic acid or magnesium can bring on RLS.
• Lose weight because this often reduces RLS symptoms.
• Try yoga and meditation (see the ‘See Someone’ section) because they can boost relaxation and so may ease RLS.

Further information and advice

• Are you feeling more nervous than usual or having worrying thoughts that are keeping you awake? If so, you might find our section on STRESS AND ANXIETY helpful. If anxiety or poor sleep are making your life difficult, you should see your doctor.
• Are tiredness or fatigue during the day more of a problem than poor sleep? If so, you might find our section on FATIGUE useful.
• Pain makes it hard to sleep and means that sleep may be less refreshing. Poor sleep makes pain feel worse, so the result is a vicious circle. If you are getting long-term pain, you may find it helpful to look at our section on MUSCLE ACHE. If you are experiencing joint pain that is preventing you sleeping, you may find our section on OSTEOARTHRITIS helpful. But you should also see your doctor if persistent pain is giving you poor sleep.
• Are you feeling unusually low? If you are waking early in the morning, and you are more irritable and unhappy than usual, your sleep problem might be caused by depression. In this case, you might find our section on DEPRESSION helpful. If your low mood is an ongoing problem, you should definitely talk to your doctor about this.

For more information visit:

• NHS Website
• The Royal College of Psychiatrists
• The Sleep Council

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