by Dr Deborah Lee, Dr Fox Online Pharmacy
Photo by Alexandra Gorn on Unsplash
https://unsplash.com/photos/smuS_jUZa9I
1 in 3 Brits suffer from insomnia – difficulty getting off to sleep or waking frequently in the night – meaning they wake up unrefreshed in the morning. Insomnia affects all ages but is even more common in older people. So which night-time health problems could be affecting your sleep? Many medical conditions can affect sleep. Let’s take a look.
Sleep apnoea
Around 10 million people in the UK suffer from sleep apnoea, but this is likely to be a large underestimate as 90% of those who have it, are completely unaware. Sleep apnoea occurs when the tissues at the back of the throat and upper airways collapse during sleep leading to disordered breathing, often with loud snoring. It’s usually the bed partner who complains vociferously. They can be heard to stop breathing in their sleep for up to 30 seconds at a time – only to startle but not wake, and start breathing again. This can happen up to 400 times a night – but they are totally unaware.
Sleep apnoea is dangerous as it can cause high blood pressure, heart disease and cardiac arrhythmia. If you or your partner could have sleep apnoea, see your GP. Treatments such as continuous positive airway pressure (CPAP) or a mandibular device are highly effective.
Night sweats
If you wake up drenched in sweat at night, with wet pyjamas and bedclothes – this is called a night sweat. It is different from just feeling a bit hot in bed. Night sweats can be a sign of a medical condition including some types of cancer including leukaemia and lymphoma. They are common in menopausal women or can occur with thyroid disease or low blood sugar. Always take night sweats seriously and see your GP. The treatment depends on the underlying cause. Note that for menopausal women, although there is a range of options, HRT is the most effective way to stop hot flushes and night sweats.
Restless legs syndrome (RLS)
1 in 10 of the population suffers from RLS, in which they have an irresistible urge to move their legs. There may also be a horrible crawling sensation in the legs, plus the limbs may jerk of their own accord – known as periodic limb movements.
No one knows what causes RLS, but it may be due to impaired dopamine levels in the brain.
See your GP if you think you might have RLS. In severe cases, it is sometimes treated with medication such as gabapentin or pregabalin.
Nightmares
Nightmares are very common, affecting 10-50% of children, but they can occur at any age. The person often wakes in the second half of the night, distressed having had vivid dreams. They seem to occur during REM sleep, and no one really knows why. They may be related to a traumatic event, and if they are frequent or troublesome, Cognitive Behavioural Therapy (CBT) or psychotherapy are the best options.
Night terrors
Night terrors tend to occur in children although occasionally affect adults. 40% of children between the ages of 3 and 12 have these. They tend to occur 3-4 hours after going to bed. The child doesn’t wake up but is thrashing around in the bed with a rapid heart rate, sweating and dilated pupils. After 10 minutes or so it passes, and they go back to sleep with no memory of what has happened in the morning.
It can be very distressing witnessing this as a parent. However, don’t attempt to wake them, just comfort them and guide them gently back to sleep. They do tend to grow out of these as they get older.
See your GP if you are unsure of the diagnosis, or if these night terrors are so severe, they are affecting everyday life including performance at school.
Sleepwalking
6.9% of the population will sleepwalk at least once in a lifetime. It usually happens within 1-2 hours of getting into bed, during non-REM sleep. The sleepwalker may do odd things while they are up and about, such as peeing in strange places, and people have even been known to drive the car or commit murder!
Don’t attempt to wake a sleepwalker, just guide them gently back to bed. Make sure they are safe and can’t have an accident while sleepwalking such as falling down the stairs. If it is interfering with daily life, see your GP.
Teeth grinding
Clenching your teeth involuntarily overnight is called bruxism. The majority of people are unaware they do it. It affects up to 50% of children, 16% of adolescents 8% of older adults and 3% of the elderly. An astonishing degree of force can be applied when we do this unwittingly – up to 250 pounds at a time. It can occur up to 100 times a night. This can cause broken chipped teeth, mouth pain, neck pain, and morning headaches.
Bruxism is linked to other sleep disorders such as sleep apnoea. The best way to diagnose it is by having overnight polysomnography in a sleep clinic. Treatments depend on any identifiable cause, but one of the best ways is the use of an orthodontic mouth guard. See your GP or your dentist if you think you might have bruxism.
Final thoughts
We all need 7 hours of good quality sleep per night. Yet for many of us, this seems an impossible goal.
If you can’t sleep, could you have one of the above medical/sleep conditions?
What actions could you take?
Don’t suffer in silence – get help without delay.
