Sleep Disorders and Problems
Symptoms, Treatment, and Self-Help for Common Sleeping Problems
Many of us experience trouble sleeping at one time or another. Usually it’s due to stress, travel, illness, or other temporary interruptions to your normal routine. But if sleep problems are a regular occurrence and interfere with your daily life, you may be suffering from a sleep disorder. Sleep disorders cause more than just daytime sleepiness. They can take a serious toll on your mental and physical health, leading to memory problems, high blood pressure, weight gain, and impacting your immune system, heart health, energy levels, and mood. But you don’t have to live with a sleeping problem. There are many things you can do to help yourself get a good night’s sleep and improve your overall health.
What you can do
- Recognize the signs and symptoms of sleep disorders or problems
- Understand how your daytime habits affect the quality of your sleep at night
- Understand the role of your circadian rhythm plays in sleep disorder
- Start keeping a sleep diary
- Find out when you need to contact a doctor about sleep problems
- Learn more by reading the related articles
What is a sleep disorder or sleep problem?
A sleep disorder is a condition that frequently impacts your ability to get enough quality sleep. While it’s normal to occasionally experience difficulties sleeping, it’s not normal to regularly have problems getting to sleep at night, to wake up feeling exhausted, or to feel sleepy during the day.
Frequently having trouble sleeping can be a frustrating and debilitating experience. You sleep badly at night which leaves you feeling dead-tired in the morning and whatever energy you have quickly drains away throughout the day. But then, no matter how exhausted you feel at night, you still have trouble sleeping. And so the cycle begins again, taking a serious toll on your mood, energy, efficiency, and ability to handle stress. Ignoring sleep problems and disorders can damage your physical health and lead to weight gain, accidents, impaired job performance, memory problems, and put a strain on your relationships. If you want to feel your best, stay healthy, and perform up to your potential, quality sleep is a necessity, not a luxury.
Even if you’ve struggled with sleep problems for so long that it seems normal, you can still learn to sleep better. You can start by tracking your symptoms and sleep patterns, and then making healthy changes to your daytime habits and bedtime routine. If self-help doesn’t do the trick, you can turn to sleep specialists who are trained in sleep medicine. Together, you can identify the underlying causes of your sleeping problem and find ways to improve your sleep and quality of life.
Signs and symptoms
Everyone experiences occasional sleeping problems, so how can you tell whether your sleeping problem is just a minor, passing annoyance or a sign of a more serious sleep disorder or underlying medical condition?
Start by scrutinizing your symptoms, looking especially for the telltale daytime signs of sleep deprivation.
Is it a sleep disorder?
- feel irritable or sleepy during the day?
- have difficulty staying awake when sitting still, watching television or reading?
- fall asleep or feel very tired while driving?
- have difficulty concentrating?
- often get told by others that you look tired?
- react slowly?
- have trouble controlling your emotions?
- feel like you have to take a nap almost every day?
- require caffeinated beverages to keep yourself going?
If you are experiencing any of the above symptoms on a regular basis, you may be dealing with a sleep disorder. The more you answered “yes”, the more likely it is that you have a sleep disorder.
Types of common sleep disorders and problems
Insomnia, the inability to get to sleep or sleep well at night, can be caused by stress, jet lag, a health condition, the medications you take, or even the amount of coffee you drink. Insomnia can also be caused by other sleep disorders or mood disorders such as anxiety and depression.
Whatever the cause of your insomnia, improving your sleep hygiene, revising your daytime habits, and learning to relax will help cure most cases of insomnia without relying on sleep specialists or turning to prescription or over-the-counter sleeping pills.
Sleep apnea is a common (and treatable) sleep disorder in which your breathing temporarily stops during sleep, awakening you frequently. If you have sleep apnea you may not remember these awakenings, but you’ll likely feel exhausted during the day, irritable and depressed, or see a decrease in your productivity. Sleep apnea is a serious and potentially life-threatening sleep disorder, so see a doctor right away and learn what you can do to help yourself.
Restless legs syndrome (RLS)
Restless legs syndrome (RLS) is a sleep disorder that causes an almost irresistible urge to move your legs (or arms) at night. The urge to move occurs when you’re resting or lying down and is usually due to uncomfortable, tingly, aching, or creeping sensations. There are plenty of ways to help manage and relieve symptoms, though, including self-help remedies you can use at home.
Narcolepsy is a sleep disorder that involves excessive, uncontrollable daytime sleepiness. It is caused by a dysfunction of the brain mechanism that controls sleeping and waking. If you have narcolepsy, you may have “sleep attacks” in the middle of talking, working, or even driving.
Although no cure yet exists, a combination of treatments can help control symptoms and enable you to enjoy many normal activities
Circadian rhythm sleep disorders
We all have an internal biological clock that regulates our 24-hour sleep-wake cycle, also known as our circadian rhythms. Light is the primary cue that influences circadian rhythms. At night, when there is less light, your brain triggers the release of melatonin, a hormone that makes you sleepy. When the sun comes up in the morning, the brain tells the body that it’s time to wake up.
When your circadian rhythms are disrupted or thrown off, you may feel groggy, disoriented, and sleepy at inconvenient times. Circadian rhythms have been linked to a variety or sleeping problems and sleep disorders, as well as depression, bipolar disorder, and seasonal affective disorder (the winter blues).
Shift work sleep disorder
Shift work sleep disorder occurs when your work schedule and your biological clock are out of sync. In our 24-hour society, many people have to work night shifts, early morning shifts, or rotating shifts. These schedules force you to work when your body is telling you to go to sleep, and sleep when your body is signaling you to wake.
While some people adjust better than others to the demands of shift work, most shift workers get less quality sleep than their daytime counterparts. As a result of sleep deprivation, you may struggle with sleepiness and mental lethargy on the job. This cuts into your productivity and puts you at risk of injury.
To reduce the impact of shift work on your sleep:
- Take regular breaks and minimize the frequency of shift changes
- When changing shifts, request a shift that's later, rather than earlier as it's easier to adjust forward in time, rather than backward.
- Naturally regulate your sleep-wake cycle by increasing light exposure at work (use bright lights) and limiting light exposure when it's time to sleep. Avoid TV and computer screens, use blackout shades or heavy curtains to block out daylight in your bedroom.
- Consider taking melatonin when it's time for you to sleep.
Delayed sleep phase disorder
Delayed sleep phase disorder is a condition where your biological clock is significantly delayed. As a result, you go to sleep and wake up much later than other people. This is more than just a preference for staying up late or being a night owl, but rather a disorder that makes it difficult for you to keep normal hours—to make it to morning classes, get the kids to school on time, or keep a 9-to-5 job.
- People with delayed sleep phase disorder are unable to get to sleep earlier than 2 to 6 a.m. no matter how hard they try.
- When allowed to keep their own hours (such as during a school break or vacation), they fall into a regular sleep schedule.
- Delayed sleep phase disorder is most common in teenagers, and many teens will eventually grow out of it.
- For those who continue to struggle with a biological clock that is out of sync, treatments such as light therapy and chronotherapy can help. To learn more, schedule an appointment with your doctor or a local sleep clinic.
Jet lag is a temporary disruption in circadian rhythms that occurs when you travel across time zones. Symptoms include daytime sleepiness, fatigue, headache, stomach problems, and insomnia. Symptoms are more pronounced the longer the flight and flying east tends to cause worse jet lag than flying west.
In general, it usually takes one day per time zone crossed to adjust to the local time. So, if you flew from Los Angeles to New York, crossing three time zones, your jet lag should be gone within three days.
Resetting your internal clock: How to reduce jetlag
There are ways to help reset your internal clock when you travel through time zones. If you'll be traveling through several time zones, as when flying coast to coast, you can gradually adjust your sleep time. For example, three days before you plan to travel from the West Coast to the East Coast, go to bed half an hour earlier than usual, and get up half an hour earlier the next morning. The next night, go to bed an hour earlier than usual and get up an hour earlier. The day before you travel, make it 90 minutes. By the fourth day—the day of your trip—you'll find it easier to adjust to your new time zone.
More tips to help you adjust:
- Switch as rapidly as possible upon arrival. On a long trip, don’t turn in until it’s bedtime in the new time zone. For the first day or two, spend as much time outdoors as possible to let daylight reset your internal clock.
- Use the sun. If you need to wake up earlier in the new setting (flying east), get out in the early morning sun. If you need to wake up later (flying west), expose yourself to late afternoon sunlight.
- Drink plenty of fluids, but not caffeine or alcohol. Caffeine and alcohol promote dehydration, which worsens the physical symptoms of jet lag. They can also disturb sleep.
- Don’t time-shift. On a brief trip, just one or two time zones away, it may be possible to wake up, eat, and sleep on home time. If so, schedule appointments for times when you would be alert at home.
Adapted with permission from Boosting Your Energy, a special health report published by Harvard Health Publications.
Tracking your symptoms
The first step to overcoming a sleep disorder or problem is identifying and carefully tracking your symptoms and sleep patterns.
Keep a sleep diary
A sleep diary can pinpoint day and nighttime habits that may be contributing to your problems at night. Keeping a record of your sleep patterns and problems will also prove helpful if you eventually need to see a sleep doctor.
Your sleep diary should include:
- what time you went to bed and woke up
- total sleep hours and percieved quality of your sleep
- a record of time you spent awake and what you did ("got up, had a glass of milk, and meditated" for example)
- types and amount of food, liquids, caffeine, or alcohol you consumed before bed, and times of consumption
- your feelings and moods before bed (happiness, sadness, stress, anxiety)
- any drugs or medications taken, including dose and time of consumption
The details can be important, revealing how certain behaviors can be ruining your chance for a good night’s sleep. After keeping the diary for a week, for example, you might notice that when you have more than one glass of wine in the evening, you wake up during the night.
Self-help for sleep disorders
While some sleep disorders may require a visit to the doctor, you can improve many sleeping problems on your own.
Improve your daytime habits
Regardless of your sleep problems, a consistent sleep routine and improved daytime habits will translate into better sleep over the long term.
Stick to a regular sleep schedule. Support your biological clock by going to bed and getting up at the same time every day, including weekends.
Get regular exercise. Regular exercise can improve the symptoms of many sleep disorders and problems. Aim for 30 minutes or more of activity on most days—but not too close to bedtime.
Avoid naps. Napping during the day can make it more difficult to sleep at night. If you have to take a nap, limit it to 30 minutes before 3 p.m.
Limit caffeine, alcohol, and nicotine. Stop drinking caffeinated beverages at least eight hours before bed. Like caffeine, nicotine is a stimulant, and while alcohol can make you sleepy, it interferes with the quality of your sleep and can exacerbate sleep disorder symptoms.
Avoid late meals within two hours of bed. Heavy, rich foods can take a lot of work for your stomach to digest and spicy or acidic foods can cause heartburn.
Get help with stress management. If the stress of managing work, family, or school is keeping you awake at night, learning how to handle stress in a productive way and to maintain a calm, positive outlook can help you sleep better at night.
Develop a relaxing bedtime routine
It’s not just what you do during the day that affects the quality of your sleep, but also those things you do to prepare your mind and body for sleep.
Make sure your bedroom is quiet, dark, and cool. Use a sound machine or earplugs to hide outside noise, a fan to keep the room cool, and blackout curtains or a sleep mask to block out light.
Avoid stimulating activity and stressful situations before bedtime. This includes vigorous exercise, important discussions or arguments, or catching up on work. Instead, focus on quiet, soothing activities, such as reading or listening to soft music, while keeping lights low.
Turn off screens one hour before bedtime. The light emitted from TV, tablets, smartphones, and computers suppresses your body’s production of melatonin and can severely disrupt your sleep. Try listening to an audiobook, podcast, or reading by a soft light instead.
Go to the bathroom (several times). Waking up to go to the bathroom becomes a bigger problem as we age. But by not drinking anything an hour before sleep and going to the bathroom several times as you get ready for bed, you’ll tend to wake up less during the night.
Get back to sleep when you wake up at night
Whether you have a sleep disorder or not, it’s normal to wake briefly during the night. If you’re having trouble falling back to sleep, though, experiment with these tips to see which work best for you.
Tips for getting back to sleep
Stay out of your head. Try not to stress over your inability to fall asleep again, because that only encourages your body to stay awake. Stay out of your head by practicing relaxation techniques such as deep breathing, progressive muscle relaxation, or meditation. Remind yourself that although they’re not a replacement for sleep, rest and relaxation still help rejuvenate your body.
Rub your ears. Rubbing the Shen Men acupressure point at the top of the ear can promote calmness and relaxation. See the resources section below to link to an instructional video.
Roll your eyes. Another simple way to promote relaxation and sleep is to close your eyes and slowly roll them upwards a few times.
Get out of bed and do a quiet, non-stimulating activity. If you’ve been awake for more than 15 minutes, it’s easy to get frustrated. Instead of tossing and turning, get out of bed and read a book or practice one of the above techniques. Make your bed when you get up and keep the lights dim so as not to cue your body to wake up. As soon as you feel sleepy, get back into bed.
Postpone worrying and brainstorming. If you wake at night feeling anxious about something, make a brief note of it on paper and postpone worrying about it until the next day when it will be easier to resolve. Similarly, if a great idea is keeping you awake, make a note of it and postpone thinking more about it until morning.
When to call a doctor
If you’ve tried a variety of self-help remedies without success, schedule an appointment with a sleep specialist or ask your family doctor for a referral to a sleep clinic, especially if:
- Your main sleep problem is daytime sleepiness and self-help hasn't improved your symptoms.
- You or your bed partner gasps, chokes, or stops breathing during sleep.
- You sometimes fall asleep at inappropriate times, such as while talking, walking, or eating.
Provide your doctor with as much supporting information as possible, including information from your sleep diary.
What to expect at a sleep clinic or center
A specialist will observe your sleep patterns, brain waves, heart rate, rapid eye movements and more using monitoring devices attached to your body. While sleeping with a bunch of wires attached to you might seem difficult, most patients find they get used to it quickly.
The sleep specialist will then design a treatment program if necessary. A sleep center can also provide you with equipment to monitor your activities (awake and asleep) at home.
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Resources and references
General information about sleep disorders
An Overview of Sleep Disorders – Guide to the symptoms and treatment of common sleep disorders. Includes video clips from sleep expert Dr. Lawrence Epstein. (Division of Sleep Medicine, Harvard Medical School)
Sleep Problems in Children – Discusses common sleep issues with young children including babies, young children and teenagers. (University of Michigan Health System)
Signs and symptoms
Facts About Problem Sleepiness (PDF) – Downloadable fact sheet on problem sleepiness, including its symptoms, causes, and link to common sleep disorders. (National Heart, Lung, and Blood Institute, National Institutes of Health)
Twelve Simple Tips to Improve Your Sleep – Explore simple tips for making the sleep of your dreams a nightly reality. (Healthy Sleep, Harvard Medical School)
Adopt Good Sleep Habits – Learn how improving your sleep environment and sticking to a regular schedule can improve the quality of your sleep. (Get Sleep, Harvard Medical School Division of Sleep Medicine)
Ear Point (Shen Men) – Video demonstrating how to use the acupressure point to promote relaxation and sleep. (Acupressure Points)
Eye Roll – How to use eye rolls to promote sleep. (Restful Insomnia Blog)
Sleep clinics and centers
Find a sleep center
In the U.S., the American Academy of Sleep Medicine provides a sleep center locator with information on finding a sleep center near you.
In the UK, find sleep clinics, centres, and specialists at UK Health Centre
From our readers:
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