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Sleep Problems

Sleep Problems

What are the most common sleep problems?

The most common kinds of sleep problems are:

  • Insomnia: a hard time falling asleep or staying asleep; poor sleep quality
  • Sleep apnea: breathing starts and stops, interrupting sleep
  • Restless legs syndrome: an irresistible urge to move legs to relieve uncomfortable sensations like “itchy,” “pins and needles,” or “creepy crawly” feeling in the legs
  • Narcolepsy: falling asleep at unplanned times during the day

Other kinds of sleep problems include nightmares, night terrors, sleepwalking, sleep talking, head banging, wetting the bed and teeth grinding. (12)


Do I have a sleep problem?

Everyone has trouble sleeping once in a while. But you may have a sleep issue if you:

  • often have a hard time falling asleep
  • feel tired during the day even if you have had at least seven hours of sleep the night before
  • find it hard to function during the day.

Try keeping a sleep journal for one to two weeks. Record when you go to sleep and wake up; how much time you spend in bed; and your total sleep time. You can share your journal entries withyour healthcare provider when you discuss your sleep issues. (13)


What is sleep apnea?

Sleep apnea is a condition in which breathing temporarily stops during sleep, which deprives the brain and body of oxygen. This lack of oxygen causes people to wake up in order to take another breath. This results in poor overall sleep quality, as people with sleep apnea wake up more than 15 times an hour, each night. (14)

There are three types of sleep apnea:

  • Obstructive sleep apnea: when the upper airways become narrowed or collapse during sleep. This prevents air from getting into and out of the lungs. Excess weight in the neck tends to cause airway collapse, particularly during sleep, when your muscles are relaxed. This is the most common type of sleep apnea.
  • Central sleep apnea: when the brain does not send the proper signals to the muscles needed for breathing for short periods of time during sleep. After awakening and taking a breath, the brain resumes sending the normal signals.
  • Mixed sleep apnea: as the nameimplies, is a combination of the two. (15)

Symptoms of sleep apnea include:

  • Daytime sleepiness
  • Snoring
  • Feeling like you have no energy
  • Morning headaches
  • Difficulty concentrating or solving problems
  • Waking up feeling breathless or like you’re choking
  • Not feeling refreshed when you wake up


What are the risk factors for sleep apnea?

  • Obesity (this is the No. 1 risk factor)
  • Being male
  • Increasing age
  • Having a family history of sleep apnea
  • Having a large tongue, large tonsils or a small jaw bone


How is sleep apnea diagnosed?

Sleep apnea is diagnosed in a special “sleep lab.” A healthcare professional monitors your sleep closely, including how often you stop breathing during sleep. (16)


How is sleep apnea treated?

Treatment options include:

  • Weight loss
  • Changing sleep position
  • Machines placed on the nose or mouth that use forced air to prevent airway collapse (called “continuous positive airway pressure” or “CPAP” machines)


What are the dangers of sleep apnea?

Sleep apnea can increase your risk for:

  • High blood pressure
  • Coronary artery disease
  • Heart failure
  • Stroke
  • Difficulty in school or at work
  • Death from any cause. This is two to three times greater in people with severe sleep apnea compared to those without sleep apnea (17)

Common features of sleep problems:

  • Drowsiness while driving
  • Trouble staying awake when sitting and watching TV or reading
  • Hard time staying focused or performing tasks while at work, school or home
  • Sleepy-looking appearance
  • Memory problems
  • Slow response time
  • Mood swings
  • Needing to nap during the day (21)


What sleep aids can I buy without a prescription?

Over the counter (OTC) sleep aids are recommended for short-term sleep problems that only happen once in a while. (18) Sleep aids should not be used by pregnant or nursing women, babies or children without a healthcare provider’s permission. (19) Some common ingredients in sleep aids are:

  • Diphenhydramine and doxylamine:These are sedating antihistamines that help make people sleepy. Side effects may include daytime drowsiness, dry mouth, dizziness and memory problems.
  • Melatonin: Helps control the body’s sleep-wake cycle. It may help treat jet lag or reduce the time it takes to fall asleep. Common side effects include daytime sleepiness, dizziness and headaches.
  • Valerian: May reduce the amount of time it takes to fall asleep. Promotes better sleep overall. Side effects may include headache, stomach upset, mood swings and heart problems. (20)

Ask your pharmacist to help you find a sleep aid for your needs.


What can I do for aches and pains that keep me up at night?

If pain is the main reason you are unable to fall asleep or stay asleep, talk to your healthcare provider about the source of your pain. Pain is how your body lets you know something isn’t quite right, so don’t ignore it. (22)


Here are some tips that may help ease your pain:

  • Do some light stretching or yoga before bedtime.
  • Try taking a warm bath or shower to soothe sore muscles.
  • Use a pillow designed to keep your neck aligned to reduce the risk of pain
  • Use a heating pad on the achy area, but don’t fall asleep with the pad still on to prevent accidental burning. (23-24)

Talk to your healthcare provider if your pain is severe, lasts for several days, is a new type of pain, makes you feel queasy, gives you a severe headache or causes you chest pain. (25-26) OTC pain medications like acetaminophen, aspirin, ibuprofen or naproxen can help minor aches or pains feel better in the short term.

Many pain products come in a nighttime version. They contain medication plus asleep aid, such as diphenhydramine, to help make you sleepy. (27)


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