Are you having trouble getting to sleep at night, and staying asleep? If you're waking frequently and struggling with tiredness in the morning, there may be a medical reason why.
1. Acid Reflux
Acid reflux occurs when the muscle between the stomach and the oesophagus doesn't seal properly. It's most noticeable at night when laid down as this position allows acid to flow out of the stomach, causing heartburn. Hormone changes during pregnancy and eating a poor diet can increase risk, and around 75 per cent of sufferers find it affects their ability to sleep. (1)
2. Restless Legs Syndrome
Restless legs syndrome (RLS) is a condition where there is an uncontrollable urge to move the legs, with the feeling often much worse at night . Both voluntary and involuntary movements can affect quality of sleep, and it takes RLS sufferers around 30 minutes longer to fall asleep on average. It can be difficult to pinpoint a cause, but iron deficiencies could be to blame.
While arthritis itself does not affect sleep, the associated pain can have a big effect. Sufferers may subconsciously move their muscles more frequently in the night to address pain, and many follow an alpha-delta sleep pattern which includes regular waking. (3) The alpha-delta pattern replaces the typical slow wave sleep which is when the highest quality sleep occurs.
Being exhausted is often associated with being sleepy, but actually exhaustion and tiredness are two very different things. In fact, those who feel 'burnt out' - with constant fatigue and emotional stress for example - typically sleep much worse than others, with more awake time during the night, less slow wave sleep (deep sleep), and an overall lower sleep efficiency. (4)
Studies have found that while the average rate of sleep disturbances amongst healthy adults is around eight per cent, this figure rises sharply for people with type 1 and type 2 diabetes , with around 33 per cent who report difficulties sleeping. (5) Sleep disruptions are often related to poor circulation, with leg cramps, burning soles, and a tingling sensation in the feet commonly cited as reasons for poor sleep.
6. Overactive bladder syndrome
Overactive bladder syndrome is when the bladder contracts as if it is full, although it may still be quite empty. The contraction leads to feelings of urgency, and sufferers may feel the need to use the toilet more frequently. Overactive bladder syndrome is associated with a poor quality of sleep, (6) and affects about 16 per cent of men and 17 per cent of women.
7. Nocturnal asthma
Nocturnal asthma leaves sufferers struggling to catch a breath, experiencing chest tightness, and wheezing and coughing during the night. It's thought that common allergens like bed bugs and dust mites in bed linen contribute towards the condition. Around 93 per cent of sufferers report bad sleep, and studies show average sleep time is reduced by around 47 minutes. (7)
8. Irritable bowel syndrome
Irritable bowel syndrome (IBS) is a condition that causes abdominal cramping, bloating and excess gas, and can cause both diarrhoea and constipation. Studies have found that around 71 per cent of IBS sufferers report sleep disturbances, with the most common reason for a lack of sleep being painful stomach aches. IBS is frequently associated with stress. (8)
9. Allergic rhinitis
Around one in five people in the UK suffer with allergic rhinitis - an inflammation of the inside of the nose caused by common allergens like pollen, pet hair, or dust mites . Those with allergic rhinitis are more likely to report insomnia, and are more likely to snore which can affect quality of sleep. Some studies have also shown a link between allergic rhinitis and sleep apnoea. (9)
Studies suggest that around 23 per cent of depressed people experience insomnia (10) - having trouble getting to sleep and staying asleep, and around 6 per cent suffer with hypersomnia - sleeping for excessive periods that can affect day-to-day life. Antidepressants used to treat depression are a recognised contributing factor to sleep disturbance in some people.
1. Shaker, Reza MD et al. Night-time heartburn is an under-appreciated clinical problem that impacts sleep and daytime function: the results of a Gallup survey conducted on behalf of the American Gastroenterological Association. The American Journal of Gastroenterology (2003)
2. Phillips, Barbara MD, MSPH, FCCP et al. Prevalence and Correlates of Restless Legs Syndrome: Results From the 2005 National Sleep Foundation Poll. Chest Journal (2006)
3. Mahowald, Mark W. MD et al. Sleep fragmentation in rheumatoid arthritis. Arthritis & Rheumatism (1989)
4. Ekstedt, Mirjam PhD et al. Disturbed sleep and fatigue in occupational burnout. Scandinavian Journal of Work, Environment, and Health (2006)
5. Sridhar, G.R, and Madhu, K. Prevalence of sleep disturbances in diabetes mellitus. Diabetes Research and Clinical Practice (1994)
6. Stewart, W. F. et al. Prevalence and Burden of Overactive Bladder in the United States. World Journal of Urology (2003)
7. Vir, Ravinder MD et al. Sleep Disturbances in Clinically Stable Young Asthmatic Adults. Annals of Allergy, Asthma & Immunology (1997)
8. Fass, Ronnie MD et al. Sleep disturbances in clinic patients with functional bowel disorders. The American Journal of Gastroenterology (2000)
9. Leger, Damien MD et al. Allergic Rhinitis and Its Consequences on Quality of Sleep: An Unexplored Area. Archives of Internal Medicine (2006)
10. Roberts, Robert E. PhD et al. Sleep Complaints and Depression in an Aging Cohort: A Prospective Perspective (2000)