Stress. Anxiety. Noisy neighbours. Blanket-hogging partners. With the list of things that can disturb a person’s sleep being more of a scroll, it’s no wonder millions of us are affected by sleep-related problems.
Included on that list might be symptoms you don’t even know you’re experiencing as a result of an undiagnosed sleep disorder – or a health condition that’s bringing on a sleep disorder.
“Most people will realise their sleep was disrupted when they feel excessive fatigue the next day, but it’s often difficult to trace this excessive fatigue to symptoms such as congestion, digestive issues or pain,” says Dr Janice Johnston, chief medical officer of US healthcare plan Redirect Health. “Instead, people may misattribute these feelings to a lack of caffeine, a late night or daytime stress.”
If you experience any – or more than one – of the following symptoms after hitting the sheets, it might be time to check in with your doctor.
Gasping for air
Gasping for air is most commonly a sign of sleep apnea, a sleep disorder where your breathing repeatedly stops and starts.
“During sleep, the muscles relax and the throat narrows or closes off,” says Dr. Zeeshan Khan, director of the Institute of Sleep Medicine at Deborah Heart and Lung Center in Browns Mills, New Jersey.
Sleep apnea is also associated with snoring, choking while you sleep and waking up with a dry mouth and headache. “A sleep specialist can order a sleep study to determine if you have sleep apnea, which is typically treated with a device called CPAP – continuous air at a set pressure that splints the airway open,” Khan says.
Postnasal drip is another possible culprit. “When too much mucus makes its way to the back of the throat, it can block airways, causing people to temporarily stop breathing while sleeping,” Johnston says. “This leaves them gasping for air. It can be caused by allergies, changes in weather or the common cold.”
Staying hydrated can help thin out mucus and make it pass more easily. Ditto mucus-thinning agents and saline nasal irrigations. If over the counter strategies don’t cut it, a specialist can curb postnasal drip by prescribing a decongestant to help clear mucus and prevent your throat from becoming blocked, while also checking for other possible causes, such as a sinus condition, like allergies or sinusitis.
Acid reflux can also cause gasping, thanks to acidic secretions from the stomach refluxing up to the oesophagus. “Often, patients will taste an acidic feeling in their mouth,” Johnston says. Sleeping on your left side, elevating the top half of your body with a wedge pillow or popping antacids may help get nighttime gasping under control.
Snoring
Snoring is another common symptom of sleep apnea. “When there’s narrowing along the airway, either in the nose or throat, the tissue begins to vibrate and make a snoring sound,” Khan says. “This can be associated with gasping for air or snorting while sleeping, dry mouth in the morning and nasal congestion.”
It can also be caused by allergies or the common cold, as well as being overweight, Johnston said. Shortness of breath and increased sweating are additional symptoms that might disrupt your sleep.
A sleep specialist can order a sleep study to determine if you have sleep apnea. If there’s no evidence of sleep apnea, then treatment options for snoring include sleeping on your side, raising the head of the bed, utilising nasal strips, nasal sprays or an oral appliance.
Sleepwalking
Sleepwalking is considered a parasomnia, or an undesirable behaviour or experience during sleep. “It’s a disorder during the deepest stage of non-REM sleep when the brain is interrupted and is in a state between sleep and wakefulness,” Khan says.
It can be caused by sleep deprivation, stress, anxiety or fever. Taking certain medications, like hypnotics, sedatives or certain medications used for psychiatric disorders, can also be a contributing factor. Ditto alcohol.
A sleep specialist can diagnose this disorder by taking a thorough history and ordering a sleep study. Preventative measures are recommended (such as adjusting medications and being woken up around 15 minutes before you usually sleepwalk) and triggers like sleep deprivation, stress and alcohol are to be avoided.
Sleep talking
Sleep talking, or somniloquy, is one of the most common parasomnias with an unknown cause. “It’s more frequent in people with mental illnesses and can be associated with sleepwalking and nightmares,” Khan says. Other causes may include emotional stress, fevers and substance misuse.
“These health conditions can lead to a reduced ability to concentrate, extreme mood swings or hallucinations,” Johnston says. “If sleep talking isn’t a normal occurrence and causes alarm, it’s important to see a specialist.”
They can diagnose this disorder by taking a thorough history and ordering a sleep study if needed. “Preventative measures are recommended, where triggers such as stress, sleep deprivation and alcohol are avoided,” Khan says.
Certain medications, like antidepressants, can trigger sleep talking, so your specialist may make adjustments to what you’re taking as well.
Chronic nightmares
Ongoing nightmares can be caused by a number of different psychological triggers, the most common being anxiety and depression. Changes in your schedule that disrupt or reduce the amount of sleep you get can also cause an uptick in nightmares, as can post-traumatic stress disorder.
Treatment for chronic nightmares might be necessary if your nightmares are causing distress, messing with your sleep and interfering with your daytime functioning.
“Chronic nightmares can cause extreme adverse health effects, such as an increased risk of suicide, heart disease and obesity,” Johnston says. “Those suffering from chronic nightmares should seek treatment and advice from a medical professional.”
Your nightmares might be a side effect of a medication you’re on, in which case your doctor might change the dosage or prescription to alleviate your nightmares, Johnston said. They can also help you find time-management, prioritisation and stress-reduction skills that suit your situation if your nightmares are being caused by anxiety and depression.
Imagery rehearsal therapy, which involves changing the ending to your remembered nightmare while awake, then rehearsing the new ending in your mind, can be very successful in treating recurrent nightmares caused by PTSD.
Frequently waking up to pee
Nocturia, or waking up to pee in the middle of the night, becomes more common as you age, but can also be a sign of something else going on.
“It can be caused by the natural aging process of the bladder or triggered by a medical issue,” Khan says. Nocturia can happen on its own or coincide with peeing frequently during the day.
The most obvious cause is drinking too much fluid too close to bedtime. However, other health conditions causing frequent urination at night may be more severe, such as a bladder or urinary tract infection, diabetes, an enlarged prostate gland or chronic kidney failure.
“To monitor the issue, you can first start by limiting the amount of fluid you intake prior to bedtime,” Johnston says. Keep a bladder diary for a few days of how much you drink, how often you have to go the bathroom and roughly how much you peed. (“You should also record any medications you’re taking, any UTIs and any related symptoms,” Johnston says.)
Your doctor can then use this information to determine the possible causes of – and treatment for – your nocturia. Depending on the health condition, treatments can include anticholinergic drugs, which lessen the symptoms of an overactive bladder, or treating the condition or infection, such as diabetes or a UTI.
Teeth grinding
The adverse effects of sleep bruxism, where you clench or grind your teeth while you sleep, can be noticed during the day by a dull headache or sore jaw. It’s considered a sleep-related movement disorder, and according to the Mayo Clinic, people who grind their teeth during sleep are more likely to have other sleep disorders, like snoring and sleep apnea.
“Bruxism can be caused by stress and anxiety, but is more likely caused by an abnormal bite,” Johnston says. “Your dentist can examine the mouth and jaw for signs and symptoms, such as wear and tear on teeth or loose teeth. The dentist can then fit the individual with a mouth guard to protect their teeth at night.”
Falling asleep too fast
Being able to fall asleep quickly isn’t necessarily a bad thing, so long as you wake up feeling refreshed and ready to take on the day.
“However, if you’re getting less than the recommended seven to nine hours of sleep each night and you pass out the moment your head hits the pillow, it could be your body telling you it needs more rest,” Johnston says.
Other signs of sleep deprivation include excessive daytime sleepiness and difficulty regulating emotions or focusing on simple tasks. Another sign is feeling drowsy or dozing off when doing mundane activities, such as watching TV or driving.
“If you suspect you may be experiencing sleep deprivation, you can utilise the Epworth Sleepiness Scale to measure the severity of your sleepiness, but it’s also recommended you seek out a sleep specialist so they can run proper tests to help you get your sleep back on track,” Johnston says, especially if you already practise proper sleep hygiene and sleep deprivation is still a series regular.
It could be a sign of a sleep disorder, such as sleep apnea or narcolepsy, a condition where sleepiness comes out of nowhere and can result in you falling asleep instantly (better known as sleep attacks).
“With narcolepsy, there’s a loss of a neurotransmitter that regulates wakefulness,” Khan says. “In addition to excessive daytime sleepiness and sleep attacks, you may also experience cataplexy (brief periods of muscle weakness) and disrupted nighttime sleep.”
A sleep specialist can diagnose the cause and order a sleep study if needed –and if it turns out you do have narcolepsy, medications can be prescribed to keep you awake.
Sleep eating
Sleep-related eating disorders (SRED) are when individuals consume food while fully asleep and are unaware of their actions. SRED can be drug-induced (using sleep aids is a common culprit) or can occur in people who have other sleep disorders, like restless legs syndrome.
“People who experience SRED are at an increased risk of fatigue, depression and weight gain,” Johnston says. They’re also at risk of burning or cutting themselves when they’re preparing food in their sleep or poisoning themselves by eating non-food substances.
If your SRED is drug-induced, a sleep specialist might recommend using alternate medications or halting the use of certain medications entirely. If not the result of medications, “a medical expert may recommend lifestyle changes to manage stress levels and remove potential hazards that could harm you during an SRED episode,” Johnston says, such as moving furniture so you don’t fall on your way to the kitchen, placing locks on the fridge, cupboards and oven – even putting an alarm on your bedroom door.
How to self-monitor for sleep issues
Your partner or roommates may point out any sleep disturbances you’re experiencing so you can get them checked out, but that’s not exactly an option when you live solo.
“For people who live by themselves, it’s a challenge to monitor for a sleep disorder,” says Dr. Thomas Hammond, board-certified neurologist at the Marcus Neuroscience Institute in Boca Raton, Florida. “Sometimes the house is in disarray but wasn’t that way before they went to bed, making it easier to notice something’s going on.”
Most of the time, though, you might sense something’s off with your sleep – say, feeling excessively tired or irritable during the day, despite getting the recommend hours of shuteye – but not wake up to concrete evidence the next day.
Enter sleep trackers. “There are a number of ways to track sleep to understand the potential symptoms that are occurring,” Johnston says. “These might include wearable devices, bedside devices and bed sensors.”
Wearable devices can collect information regarding movement, heart rate and breathing patterns. “Since many of these devices are multipurpose, users can use them to track eating habits and breathing patterns during the day as well,” Johnston says.
If your usual amount of sleep is decreasing significantly, for instance, you could speculate it’s being caused by symptoms related to your health conditions. You can then compare and contrast this information with your sleep patterns to have a better understanding of what symptoms may be striking during sleep and why.
Bedside devices are placed next to the bed and can collect data regarding breathing habits and body movement. “This information can help to determine if you’re experiencing shortness of breath or excessive movement during sleep,” Johnston said. (The device may also store information about your bedroom environment, such as temperature, ambient noise and light.)
Then there are bed sensors, which can be placed underneath the sheets or mattress. “These sensors collect information regarding movement and heart rate,” Johnston says. “Irregular heart rates can be tied to health conditions, such as hyperthyroidism or excessive stress.” (Some sensors may also track temperature and humidity.)
Once you’ve got two to three weeks worth of sleep data, you can bring it to your next doctor’s appointment for a consult. Because consumer devices aren’t tested or regulated for clinical diagnosis, they won’t be able to use the data to officially diagnose you, but they can at least use the data to help determine whether clinical testing would be beneficial.