A sleep disorder is when people wake up at night for a long time and then lie awake for a long time. They don't get enough sleep the next day. Frequent consequences are tiredness, irritability, listlessness and poor performance.
Trouble sleeping through the night can be caused by bad behavior, physical and psychological problems. These include, for example, the consumption of alcohol or medication, respiratory or thyroid disorders, anxiety disorders and depression. External circumstances such as noise and light can contribute to problems sleeping through the night. Difficulty staying asleep and falling asleep, where sufferers need more than 30 minutes to fall asleep, are the most common sleep disorders.
Treatment depends on whether or not a cause can be found and what the nature of the cause is. Most patients receive sleep counseling or education. They often have to improve their sleep hygiene, i.e. get rid of unfavorable habits. Medication can also be helpful at times.
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Sleep Disorder Causes And Risk Factors
Doctors do not always find a cause for problems sleeping through the night. On the other hand, there are a number of different causes to consider.
Unfavorable behaviors, habits and living conditions:
- Drinks containing caffeine (e.g. coffee, cola) and/or smoking or nicotine can disturb sleep at night in the form of withdrawal symptoms.
- Alcoholic beverages help you fall asleep, but often prevent you from staying asleep.
- Rich food can be heavy on the stomach, an empty stomach can also be disturbing.
- Irregular sleep times can make it difficult to sleep through the night.
- Lack of exercise leads to an underutilized body, exercise before going to bed is also a hindrance. Regular endurance sports during the day are best.
Unfavorable sleeping environment:
- Mattresses that are too hard or too soft
- Pillows that are too high or that slip easily
- External sources of interference such as lots of light or noise, e.g. B. by snoring partners or road traffic
- Stale, stuffy air
- Room temperature too high or too low
- Duvets that are too warm or too thin
Many medical conditions can disrupt sleep. For chronic insomnia, the doctor should know about all disorders, especially those that
- obstruct breathing (respiratory diseases, e.g. cough). This often also applies to heavy snoring and always to obstructive sleep apnea syndrome (OSAS).
- lead to restless sleep, can be associated with waking reactions (cardiovascular diseases, e.g. high blood pressure, cardiac arrhythmias) or force waking up at night (e.g. strong urge to urinate with an overactive bladder, benign enlargement of the prostate).
- lead to severe, noticeable symptoms (stomach disorders, e.g. burning in the stomach, headaches such as migraine, diseases of the joints and/or muscles such as e.g. rheumatism and cramps, skin diseases with severe itching such as e.g. neurodermatitis).
- trigger nervous disorders such as some neurological diseases (e.g. Parkinson's disease, dementia, multiple sclerosis, restless legs syndrome, also called restless legs syndrome).
- associated with hormonal disorders (e.g. hyperthyroidism).
Special life phases and circumstances:
- Pregnancy and menopause are associated with hormonal fluctuations that can disrupt sleep.
- Shift work forces unfavorable rhythm changes in the daily routine.
- Long-distance travel often leads to jet lag with difficulty sleeping.
- Unfamiliar sleeping places when traveling can trigger sleep problems.
If you have trouble sleeping, it always makes sense to go through the medication you are currently taking with your doctor or pharmacist. Because numerous drugs are able to prevent falling asleep or staying asleep, such as the following:
- Some medicines for high blood pressure (e.g. beta-blockers, calcium antagonists)
- Statins (against high blood fats)
- Some hormonal drugs
- Appetite suppressant
- Medicines for asthma
- Antibiotics
- Some painkillers
- Migraine tablets
- Drugs used to treat Parkinson's disease
- Some psychotropic drugs
- Sleeping pills can lead to problems sleeping through the night if you take them continuously or after stopping them
Risk factors
There are many risk factors that can promote insomnia. Of course, this includes the above-mentioned causes – i.e. unfavorable habits, many illnesses, the use of certain medications, street noise at the place of residence and so on. Shift work has a particularly heavy impact: every second shift worker complains of sleep disorders. Disorders also increase with age. Around four out of ten people over the age of 65 say they suffer from sleep disorders. There are also risk factors that have a particularly strong influence on certain forms of sleep maintenance disorders. This includes, for example, obesity in sleep apnea.
Sleep Disorder Symptoms
Do you wake up one or more times during the night and then have trouble falling asleep?
Do you lie awake for a very long time after waking up, sometimes for agonizing hours?
Do you feel tired, weak and listless on the following days or do you react irritated too quickly?
These are signs that could indicate a problem sleeping through the night. The following complaints are typical:
- Waking up one or more times during the night with difficulty going back to sleep afterwards
- Long periods of lying awake that are perceived as distressing, often into the early morning
- Thoughts revolve around insomnia or the difficulty of falling asleep again, fear of not being able to fall asleep again
- The feeling of not getting enough rest at night because sleep is too short and/or not restful
Although some sufferers fall asleep again and again after waking up, their sleep is only light and restless. Depending on the cause, problems sleeping through the night can also trigger symptoms such as sweating or rapid heartbeat.
In any case, those affected do not have enough restful sleep. This leads to further complaints in the days that follow. Often several of the following occur:
- Weakness, listlessness, lack of drive, tension, bad mood, irritability and difficulties in performing as usual, concentrating and remembering things
- Difficulty getting out of bed because you feel tired, unrefreshed, and lacking in energy in the morning
- Long wake-up phase until you feel really awake after getting up
- Severe daytime tiredness, sometimes despite feeling good sleep, and possibly unintentionally falling asleep during the day, for example while reading or watching TV, sometimes even microsleep
- Headache after getting up with no apparent cause
- Rumination, anger, worry or anxiety because of poor or insufficient sleep, fear of the next night
Waking up at night is not the real problem with sleeping through the night. Most people wake up more often at night, sometimes more than 20 times. But they don't notice it or suffer from it because they fall asleep again afterwards and sleep well. Most people who are affected by problems sleeping through the night suffer because they have a very difficult time falling asleep after waking up at night, often hours later. Here one can speak of a kind of falling asleep again.
When is sleep seriously disturbed?
Many people occasionally have trouble sleeping through the night. Frequently, temporary circumstances are to blame that put a psychological strain on them, such as an upcoming exam, an upcoming trip, unfamiliar sleeping places, problems at work or the like. If the cause is known, is temporary and it is difficult to relax, short-term sleeping pills can be helpful in such cases. Those affected will sleep well again as soon as the stressful situation is over.
Sometimes unfavorable behavior in the evening is also responsible, such as a sumptuous dinner, coffee or alcohol consumption.
Initially, people who have trouble sleeping through the night should remain relaxed and try to find out where the disorder is coming from. Fears and worries about not getting enough or bad sleep can make sleep disorders worse.
Good quality sleep means feeling comfortable and rested through sleep. You don't have to sleep a certain number of hours. The duration of sleep must meet the individual need for sleep. If everything fits, it is also unnecessary to adhere to certain sleeping times. Sleep needs, sleep duration and sleeping habits vary greatly from person to person.
When to the doctor?
After four weeks, insomnia is generally considered “morbid”. A professional clarification is recommended at the latest when those affected have poor sleep three or more times a week over a period of more than four weeks - and their well-being and performance suffer greatly. Treatment is particularly necessary when the sleep disturbance severely impairs the quality of sleep.
Especially in the case of very poor sleep quality and/or a completely unclear cause, it is often better to seek advice earlier. Difficulty sleeping through the night can lead to those affected changing their behavior in order to sleep better again. As a result, they can develop bad habits that increase their sleep problem and make it more difficult to treat.
According to the “International Classification of Sleep Disorders”, all sleep disorders up to four weeks are considered acute and those lasting six months or more are considered chronic. At periods in between, they are subacute.