WebMD Health - Sleep Disorders

Sep 27, 2011 9:03 PM

6 Surprising Sleep Wreckers

Do you wake up in the morning feeling more tired than you did when you went to bed? If so, something is disturbing your sleep. But do you know what it is?

Some reasons for sleep loss are obvious -- espresso nightcaps, wailing newborns, and insensitive neighbors playing the drums. But the causes of sleep loss aren't always so clear.

"People often don't have any idea what's disturbing their sleep," says Thomas Roth, PhD, director of the Sleep Disorders Center at Henry Ford Hospital in Detroit. "There's a lot of misattribution. They assume it's one thing, but it's actually something else entirely."

Why such confusion? "People often wake up in the night without realizing it," Roth tells WebMD. "You can be awake one or two minutes at a time in the night and you won't remember it the next day."

While some of these unremembered wake-ups are normal, too many will leave you chronically exhausted. And many common causes of sleep loss result in just this sort of brief, hard-to-catch awakening -- making it even harder to sort out the cause.

Here are six surprising causes of disturbed sleep.

Sleep Wrecker 1: Pets in Bed

While lots of people let their pets snuggle in bed with them for comfort, evidence suggests that animals in bed make it harder to sleep.

According to a survey by the Mayo Clinic Sleep Disorders Center, 53% of people who sleep with pets say that their animals disturb their sleep. Animals just don't have the same sleep and wake cycles that we do. So 3 a.m. to your cat might seem like an excellent time to start pouncing on your feet. Even more subtle disturbances -- the clanking of the tags on your animal's collar as it shuffles around -- can wake you up.

If you're feeling chronically exhausted, take a break from the interspecies slumber parties to see if it makes a difference with your disturbed sleep.

"Really, there are other places for your dog to sleep besides your bed," says Jodi A. Mindell, PhD, professor of psychology at St. Joseph's University in Philadelphia and author of Sleep Deprived No More. If you can't bear to kick your pets out of the bedroom, which is the ideal, at least set up a new spot for them on the floor.

Sleep Wrecker 2: Alcohol and Nightcaps

As a cause of sleep loss, this is often a surprise to people. Doesn't drinking make you drowsy? Isn't that why people have nightcaps? Isn't that why college parties always end with everyone passed out on the floor?

But the body's response to alcohol is more complicated than you might think. "Alcohol affects the rhythm of sleep," says Mindell. "It acts as a sedative at first, but then a few hours later when blood alcohol level drops, it will wake you up again."

To prevent your glass of wine from waking you up later, stop drinking two to three hours before bedtime.

Sleep Wrecker 3: Undiagnosed GERD

People who have GERD -- gastroesophageal reflux disorder -- often find the nights difficult. Once they're lying down, the acid can back into the esophagus, causing heartburn and pain. Some try to sleep propped up on pillows to cope.

"Acid reflux is a biggie when it comes to disturbed sleep," says Ronald Kramer, MD, a spokesperson for the American Academy of Sleep Medicine and specialist at the Colorado Sleep Disorders Center in Englewood, Colo. "Whenever I see a person with sleep problems, I always screen for it."

What you might not know is that GERD doesn't always cause such dramatic symptoms. Some people might only have one constant symptom: disturbed sleep.

"Even if you rarely have pain, the acid can still be waking you up at night," says Kramer. GERD can cause other nondescript symptoms too, like chronic cough. If you have GERD that's interrupting your sleep, getting treated for it is important. Not only will treatment help you sleep, but it will reduce the risk of serious health problems later.

Sleep Wrecker 4: Medicine, Vitamins, and Supplements

Some of the most common causes of disturbed sleep are in your medicine cabinet, but you might not suspect them at all. Common drugs, like steroids for asthma and beta-blockers for high blood pressure or heart problems, can keep you up at night.

Despite being called "narcotics," so can opioid drugs for pain. While they relieve pain quickly -- and can make you feel drowsy in the process -- they can also lead to sleep apnea.

Botanical supplements can cause sleep loss, too. Supplements like ginseng and guarana are stimulants. Even vitamins aren't free of risk.

"Vitamins B6 or B12 can give people vivid dreams, and that can wake people up," says Mindell. "It's much better to use those in the morning."

If you're having chronic sleep problems, go to your doctor with a list of all the medicines, vitamins, and supplements that you use. Ask if any of them could be causing your sleep problems.

Sleep Wrecker 5: Pain -- Even Mild Pain

Just about any painful condition can cause disrupted sleep. Headaches, back pain, arthritis, fibromyalgia, and menstrual pain are all common causes.

What you might not realize is that the pain doesn't even have to be particularly severe to cause sleep loss. In fact, it doesn't even have to wake you up.

Pain signals sent out by your body can fragment your sleep, reducing the amount of time you spend in deep, restorative sleep. You might not wake up, but your sleep will be less restful.

"People with chronic pain often wake up feeling more tired than they were when they went to bed," says Roth.

Even if you have only mild chronic pain, it's worth checking it out with a doctor.

Sleep Wrecker 6: Being Exhausted -- as Opposed to Sleepy

Here's a common scenario. You come home from a long day at work, completely exhausted. You stumble into the bedroom, fully expecting that as soon as your head hits the pillow, you'll be out.

But somehow, that's not what happens. 45 minutes later, you're still staring at the ceiling. What's gone wrong?

"Contrary to what people think, being exhausted doesn't necessarily make people sleep better," says Roth. "There's actually a big difference between being exhausted and being sleepy." Roth points out that if you ran 50 miles and then dropped down in bed, you would unquestionably be exhausted. However, your body might be far too revved up to sleep.

Regardless of how worn out you feel, always take some time to unwind. "Don't rush to bed after a stressful day," says Roth. Instead, spend some time sitting quietly first. It could save you lots of tossing and turning later.

Or Is It a Sleep Disorder?

Of course, you could also have an undiagnosed sleep disorder, one of the common but hardly surprising wreckers. About 40 million people in the U.S. suffer from sleep disorders, conditions that can seriously interfere with the quality of your rest.

For instance, periodic limb movement disorder (PLMD) causes your legs to jerk rhythmically while you're asleep, disturbing restful sleep. Sleep apnea causes snoring and brief interruptions in your breathing, which can also wake you from deep sleep.

Since these conditions only manifest themselves when you're asleep, you might not know you have the symptoms. Many people have sleep disorders for years before they're diagnosed.

Or your partner may have the sleep disorder -- disturbing your sleep as well.

"If your spouse is snoring and kicking in the night, neither of you are going to sleep well," says Mindell.

There are plenty of other causes of disturbed sleep -- a bedroom that is too hot or too cold, shades that don't block enough light, noises that can be muffled by a sound machine, hot flashes during menopause. Figuring out what might help can take some trial and error.

The important thing is to take action. If you're having trouble sorting out what could be causing your disrupted sleep, ask your doctor or schedule an appointment at a sleep clinic.

You should also take time to think more seriously about sleep and how much you're getting. Do you need four or five cups of coffee to get through a typical day? Do you always have to sleep in on the weekends? Do you tend to fall asleep immediately as soon as you get into bed? Those are typical signs of sleep deprivation, says Roth.

"People learn about nutrition and exercise in grade school, but nobody teaches us anything about the importance of sleep," says Roth. "As a society, we need to accept that better sleep has to be a priority."

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