When you’re having trouble sleeping, you know it. You wake up feeling tired, irritable, groggy…what’s that all about? It’s bad enough when you can’t sleep at all, but many times the problem is one that subtly sabotages the sleep you are managing to get, so the hours you spend in bed don’t refresh and revitalize you the way they should.
Here are five signs that you have a sleep problem or disorder that’s secretly stealing your rest…as well as tips on fixing the issue to get the sleep you need.
1. You sleep poorly and wake with a bad taste in your mouth.
What it’s a symptom of: “Morning mouth” can be a signal of gastroesophageal reflux disease (GERD) or asymptomatic heartburn. Recent sleep studies have shown that up to 25 percent of people who report sleeping poorly without a diagnosed cause have sleep-related acid reflux.
How it interrupts sleep: Acid reflux causes the body to partially awaken from sleep, even when there are no symptoms of heartburn. The result of this “silent reflux” is fitful, uneven sleep.
What to do:
• Follow treatment suggestions for heartburn, even though you aren’t experiencing classic heartburn symptoms: Don’t eat for at least two hours before hitting the sack, and avoid acid-causing foods in your evening meals – alcohol, chocolate, heavy sauces, fatty meats, spicy foods, citrus fruits, and tomatoes all contribute to heartburn and acid reflux.)
• Certain medications, particularly aspirin and other painkillers, are hard on the stomach and esophageal lining, so don’t take them just before bed.
• Sleep studies have shown that sleeping on the left side reduces symptoms, and sleeping on the right side causes them to worsen because acid takes longer to clear out of the esophagus when you’re on your right side. If you prefer to sleep on your back — a position that can increase reflux, elevating your head and shoulders can help.
• Losing weight can do wonders to banish heartburn and acid reflux. And if all else fails, try taking an over-the-counter antacid.
2. You toss and turn or wake up often to use the bathroom.
What it’s a symptom of: Nocturia is the official name for waking up in the middle of the night to use the bathroom. The National Sleep Foundation estimates that 65 percent of older adults are sleep deprived as a result of frequent nighttime urination. Normally, our bodies have a natural process that concentrates urine while we sleep so we can get six to eight hours without waking. But as we get older, we become less able to hold fluids for long periods because of a decline in antidiuretic hormones.
How it interrupts sleep: For some people, the problem manifests as having to get up to use the bathroom, and then being unable to get back to sleep. But for others the problem is more subtle; they may sleep fitfully without waking fully, as the body attempts to signal that it needs to go.
What to do:
• Start with simple steps. Don’t drink any liquids for at least three hours before going to bed. This includes foods with a lot of liquid in them, like soups or fruit.
• Go to the bathroom last thing before getting in bed and relax long enough to fully empty your bladder. It’s also important to get checked for conditions that cause urination problems.
• Diabetes can also cause frequent urination, so if you haven’t been tested for diabetes recently, see your doctor. Certain drugs such as diuretics and heart medications can contribute to this problem; if that’s the case, talk to your doctor about taking them earlier in the day. A prescription antidiuretic can cut down on nighttime urination if all else fails and there’s no underlying issue.
3. Your jaw clicks, pops, or feels sore, or your teeth are wearing down.
What it’s a symptom of: Teeth grinding, officially known as bruxism, is a subconscious neuromuscular activity. Bruxism often goes on without your being aware of it; experts estimate that only 5 percent of people who grind their teeth or clench their jaws know they do it until a sleep partner notices the telltale sound or a dentist detects wear on the teeth. Jaw clenching is another form of bruxism, except you clench your teeth tightly together rather than moving them from side to side. Jaw clenching can be harder to detect than grinding, but one sign is waking with pain or stiffness in the neck.
How it interrupts sleep: Bruxism involves tensing of the jaw muscles, so it interferes with the relaxation necessary for deep sleep. And if you’re fully grinding, your body is engaged in movement rather than resting.
What to do:
• See a dentist, who can look for underlying causes and can prescribe a mouth-guard-type device. If jaw clenching is your primary issue, there are specific dental devices for that as well.
• Experts also suggest giving up gum chewing during the day, because the habitual chewing action can continue at night. Some people who grind their teeth have experienced relief from botox injections to the jaw muscle. Others have had success using a new biofeedback device called Grindcare, approved by the FDA in 2010.
4. You move all over the bed or wake tangled in the covers.
What it’s a symptom of: That kind of movement indicates restless leg syndrome or a related problem, periodic limb movement disorder (PLMD).
How it interrupts sleep: Doctors don’t know exactly what causes these sleep movement disorders, but they do know they’re directly related to a lack of deep, restful, REM sleep. The restlessness can prevent you from sinking into deep sleep, or a muscle jerk can wake or partially rouse you from deep sleep.
What to do:
• See a doctor to discuss your symptoms and get a diagnosis. Diabetes, arthritis, peripheral neuropathy, anemia, thyroid disease, and kidney problems can all contribute to restless legs syndrome and PLMD. Make sure to tell your doctor about any medications you’re taking; a number of medications, including antidepressants, antihistamines, and lithium, can cause restless leg syndrome as a side effect.
• You can also try making dietary changes to make sure you’re getting enough iron and B vitamins, particularly folic acid, since iron and folate deficiency have been linked to restless leg syndrome. Red meat, spinach, and other leafy greens are good sources of both nutrients, but you may want to take supplements as well.
5. You wake up with a dry mouth or horrible morning breath.
What it’s a symptom of: Mouth breathing and snoring both disrupt sleep by compromising breathing. Look for drool on your pillow or in the corners of your mouth. If you have a partner, ask him or her to monitor you for snoring, gasping, or overloud breathing.
How it interrupts sleep: Mouth breathing and snoring can interrupt sleep because you’re not getting enough air to fully relax. Severe snoring — particularly when accompanied by gasps or snorts — can also indicate a more serious problem with obstructed breathing during sleep.
What to do:
• Train yourself to breathe through your nose. Try snore-stopping nose strips, available over the counter at the drugstore, or use saline nasal spray to irrigate your nasal passages. Experiment with sleep positions; most people have a tendency to snore and breathe through their mouths when sleeping on their backs. Use pillows to prop yourself on your side, or try the tennis ball trick: Put a tennis ball in the back pocket of your pajama bottoms (or attach it some other way), so it alerts you when you roll over.
• If you typically drink alcohol in the evening, try cutting it out. Alcohol, a sedative, relaxes the muscles of the nose and throat, contributing to snoring. Other sedatives and sleeping pills do the same thing, so avoid using anything sedating. Alcohol also can trigger snoring in two other ways: it makes you sleep more deeply initially and is dehydrating.
• Losing weight, even just ten pounds, can help eliminate snoring, studies show. If none of these solutions work, consult a doctor to get tested for sleep-disordered breathing conditions such as apnea.
6. You sleep fitfully, feel exhausted all the time, and wake with a sore throat or neck pain.
What it’s a symptom of: Obstructive sleep apnea is a disorder, defined as breathing interrupted by intervals of ten seconds or more. Experts estimate that 20 million Americans have sleep apnea, and 87 percent of those are unaware they have the problem. One mistaken assumption is that you have to snore to have sleep apnea. In fact, many people with apnea don’t snore.
How it interrupts sleep: Obstructive sleep apnea is the result of the throat closing and cutting off airflow, preventing you from getting enough oxygen. Blood oxygen levels drop, and when the brain knows it’s not getting enough oxygen, it starts to wake up. This causes fitful, unproductive sleep. Weight gain is a major factor in sleep apnea, because when people gain weight, they end up with extra-soft tissue in the throat area, which causes or contributes to the blockage.
What to do:
• See an otolaryngologist, who will examine your nose, mouth, and throat to see what’s interrupting your breathing and how to fix the problem. It’s also important to have your oxygen levels measured during sleep.
• Other options include oral appliances, which change your mouth position by moving your jaw forward to open up the throat, and surgery, including some newer, minimally invasive outpatient surgical treatments.
7. You get a full night’s sleep, but feel groggy all the time or get sleepy while driving.
What it’s a symptom of: This signals circadian rhythm problems or, more simply, getting out of sync with night and day. Irregular sleep patterns, staying up late under bright lights, working a shift schedule, using computers and other devices in bed, and having too much light in the room while you sleep, can disrupt your body’s natural sleep-wake cycle.
Why it interrupts sleep: The onset of darkness triggers production of the hormone melatonin, which tells the brain it’s time to sleep. Conversely, when your eyes register light, it shuts off melatonin production and tells you it’s time to wake up. Even a small amount of ambient light in the room can keep your body from falling into and remaining in a deep sleep. The use of devices with lighted screens is especially problematic in terms of melatonin production because the light shines directly into your eyes. This light is also at the blue end of the spectrum, which scientists believe is particularly disruptive to circadian rhythms.
What to do:
• Try to get on a regular sleep schedule that’s not too far off from the natural cycle of night and day — and preferably the same schedule all week. (Experts recommend 10 p.m. to 6 a.m. or 11 p.m. to 7 a.m. every night, but that’s just a general outline.)
• A trick experts recommend to help night owls reset their internal clocks: force yourself to get up and get into bright light one or two mornings in a row and you’ll be less likely to get that “second wind” and burn the midnight oil or experience nighttime sleeplessness.
• As much as possible, banish all screens, nightlights, and other sources of light from your bedroom. Reading is much more sleep-inducing than looking at a lighted screen, but make sure your reading light isn’t too bright. Does your smoke alarm have a light in it? Put tape over it. Use an alarm clock without a lighted dial, or cover it. If your windows allow moonlight and light from streetlights to shine in, install blackout curtains or shades tightly fitted to the window frames. Don’t charge laptops, phones, cameras, and other devices in your bedroom unless you cover the light they give off.