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Getting to the root cause of sleepless nights

© Mayo Clinic

Many things can keep us up at night or interrupt our sleep — from something as simple as drinking caffeine too late in the day to worries or stress about a loved one. While a restless night here or there is normal, getting a good night’s sleep has many impacts on one’s health. Not only does sleep help us stay focused, improve concentration and impact mood, but a lack of sleep can lead to diabetes, poor mental health, obesity and injury. In fact, in older adults, sleeping less than five hours a night is associated with a more than 50 percent increased risk of falls. Getting less than seven hours of sleep on a regular basis may cut into your ability to concentrate, make decisions and remember things.

Some sleep habits that everyone can adopt that may make a difference include going to bed at the same time each day; exercising before the evening hours; avoiding caffeine, nicotine and alcohol; and relaxing before bed with a warm bath or by reading something enjoyable.

Despite best practices for better sleep quality, if you find that you still struggle with interrupted sleep, some other factors could be the cause, including:

Sleep disorders

Sleep-related leg cramps, obstructive sleep apnea, periodic leg and arm movements, and restless legs syndrome can jeopardize sleep.

Pain

Conditions that cause chronic pain, including heartburn, arthritis, back pain, cancer pain and headaches, can take a toll on sleep. In turn, poor sleep can increase the perception of pain intensity. Difficulties such as falling asleep or frequent nighttime wakening often are related to poor pain control.

Nighttime urination (nocturia)

Trips to the bathroom are a common reason older adults wake at night. This also increases the risk of nighttime falls.

Illness

Coughing, shortness of breath, chronic pain and even itching can disrupt your sleep. Mental health conditions, such as depression, often are associated with sleep difficulties.

Medications

Drugs that disrupt sleep range from nonprescription decongestants to commonly prescribed drugs such as bronchodilators, some antidepressants and corticosteroids. Other medications such as beta blockers, varenicline (Chantix), some antidepressants and narcotics can cause vivid dreams or nightmares, contributing to sleep difficulty. Some pain relievers also contain caffeine.

Menopause

Up to half of women in menopause report sleep difficulties. Hormone changes may be a factor and result in hot flashes, night sweats and disrupted sleep.

Improving sleep quality may be helped by better sleep habits or being diagnosed and treated for potential sleep problems. If you can’t identify a reason for ongoing sleep loss, talk with your doctor. Determining and addressing its cause can make your nighttime sleep more restful.

Jarrett W. Richardson, M.D.

Dr. Richardson is a psychiatrist and sleep medicine specialist at Mayo Clinic.

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