Sleep disorders

Overview

With sleep disorders, a rough distinction can be made between difficulty falling asleep and sleeping through the night, waking too early, and feeling tired even after sleeping enough. The consequences can include tiredness during the day and concentration difficulties. Sleep disorders can be caused by mental and physical conditions as well as “bad habits”. Good sleep hygiene (see below) can help prevent these problems.

Symptoms

Everybody has the occasional “bad night”. Chronic, long-lasting problems sleeping at night, however, can have serious consequences.

• Problems falling asleep at night
• Problems sleeping through the night (waking up several times in the night, often with difficulty in falling asleep again)
• Waking up too early (in the morning)
• Unrefreshing sleep (poor sleep quality)

Consequences

• Tiredness during the day and/or tendency to nod off
• Feeling unwell and mood swings
• Difficulties with concentration, focus, memory and ability to perform
• Increased risk of mistakes and accidents
• Worrying, thoughts going round and round in the head while sleeping

Causes and treatment

Causes

Difficulty falling asleep

• Noise, bright light, too warm temperature
• Excessive media consumption
• Stressful situations, brooding, unable to “switch off”
• Restless legs syndrome
• Anxiety about more sleepless nights
• Confinement to bed, physical inactivity (can't become naturally tired by the evening, well-known problem in hospital patients, for example)

Difficulty sleeping through the night

• Pain, feverish illnesses
• Overactive thyroid, cardiovascular or other organ-affecting diseases
• Urge to urinate during the night 
• Side-effects of medication or stimulants (e.g. drinking too much alcohol)
• Sleep apnoea
• Change in time zones (jet lag) or shift work
• Nightmares, sleepwalking ("parasomnias")
• Mental illnesses
  • Waking up very early if suffering from depression and not being able to fall asleep again (typically causes a low mood in the morning)
• Old age (easier to be disturbed while sleeping)

Further treatment by your doctor / in hospital

Possible tests

• Psychiatric/neurological examination
• Activity tracking (e.g. by wearing a tracker on the wrist)
• Sleep laboratory: assessment of sleep by measuring the brainwave curve and vital signs (blood pressure, pulse, oxygen saturation, etc.)

Possible therapies

• General sleep hygiene measures: see below
• Treatment of the underlying disease, if any
• Psychotherapy, relaxation therapy
• By way of exception only: medication

What can I do myself?

These can be described as "sleep hygiene" measures

• Regular sleeping-waking pattern (also on weekends and during holidays)
• Don’t take afternoon or other naps
• Don't work in bed
• Don't go to bed until you're sleepy

Sleep-promoting measures 

• Exercise and sport during the day
• Taking a walk in the evening to put the day to rest (“switching off”)
• Relaxation exercises (e.g. tensing and relaxing the muscles)
• Writing down stressful events and topics that preoccupy the mind (mental “putting aside”)
• Cold or warm (half) bath (effect is individual, try out both)
• Bedroom: well-aired, cool, dark and silent
• Comfortable mattress, not too soft

Avoid the following in the evening:

• Heavy meals, stimulating beverages (coffee, Coke, etc.)
• Empty stomach
• Alcohol (makes it difficult to sleep through the night/reduces deep sleep, urge to urinate during the night)
• Unpleasant discussions and suspenseful movies (emotionally upsetting)
• Regular/long-term use of sedatives
  • Reduces fitness to drive
  • Risk of dependence, incl. withdrawal symptoms
  • Increased tiredness during the day can occur

If sleep just doesn't want to come

• Get up, read something, relax
• Don't put yourself under pressure
• Don't switch on your smartphone or TV

Household remedies

• 1 glass of milk with some almond butter, a tablespoon of honey and a pinch of saffron (alternatively: hot honey milk)
• Tea from lemon balm leaves, chamomile flowers, orange blossoms, lavender flowers or hop flowers
• Valerian drops in warm water
• Herb pillow with valerian root, linden flowers, lemon balm, wild thyme (creeping thyme) and some sage (optional)

When to see a doctor?

• Constantly exhausted and tired during the day
• Chronic, long-term sleeping problems
• Decline in ability to perform
• Severe psychological strain
• Drugs or alcohol abuse

Synonyms

sleep disorders, sleep disorder, insomnia