What's waking you?

You’re not an insomniac, you can fall asleep easily, but something always stirs you from your lovely slumber. There are many reasons why your sleep may be disturbed: here are the key ones, and what you can do about them. By Alex Gazzola.


Restless legs

What is it? Also known as Ekbom’s Syndrome, this is characterised by tingling, twitching and discomfort in the legs, and an urge to move them repeatedly in order to relieve the unpleasant feelings. Some patients describe an annoying ‘crawling’ sensation.

Why does it happen? The causes are generally unknown. In some cases, it is a side-effect of certain drugs and medications (such as anti-depressants, anti-histamines or steroids), or of kidney problems or an underactive thyroid.

What should I do? Stretching, movement and massages can help relieve symptoms - both before bed and if you are woken during the night.

Any extra tips? Professor Chris Idzikowski, a sleep researcher and medic, says: “In many young women, low iron levels can be associated with the development of restless legs and related ‘creepy-crawly’ sensations up, down and around the leg. Many women who are vegetarians may be low on iron, and it seems pregnant women suffer from this problem more than anyone else too”. Speak to your doctor or dietitian about your iron intake - they may recommend a blood test.

Nocturia

What is it? Having to get up to urinate more than once during the night.

Why does it happen? Usually, especially among younger people, this happens because you have drunk too much fluid before bed-time, or you didn’t empty your bladder properly and fully before lights-off. Yoga and Pilates or any other activity which works the pelvic area can tighten the muscles around your bladder too, giving you the urge to empty your bladder more regularly, including at night. Other possibilities include underlying cystitis or (more rarely) an early sign of diabetes. In men, it could also be benign prostatic hyperplasia (BPH) - a natural swelling of the prostate gland, increasingly likely as men get older.

What should I do? Just get up out of bed calmly, walk to the bathroom, empty your bladder, don’t flush the toilet (the noise will wake you further), and try to avoid turning on lights if you know you can make the journey to the bathroom safely. Avoid looking at the time, and just go back to bed.

Any extra tips? Try to plan for the event so that your journey to the bathroom is easy and not disruptive - leave relevant doors open and toilet seats down. Rather than drink less total fluid during the whole day, drink more in the morning and afternoon, and less at night - especially late at night. Get your blood sugar levels tested to ensure it is not diabetes.

Night cramps

What is it? A night cramp is a sudden sharp pain caused by a muscle spasm, usually in the calf.

Why does it happen? Mostly, the cause is unknown. However, like restless legs, some medications and drugs can occasionally be to blame. Other possible causes include muscular strain, dehydration and excess alcohol.

What should I do? Stretching may help, and massaging the effected area can ease the pain. It is a good idea to work regular, gentle calf stretches into your day-to-day exercise or fitness routine. Speak to your doctor if you are regularly affected. The drug quinine is sometimes used to treat night cramps, but there are a lot of contra-indications with its use, so you must seek proper medical advice.

Any extra tips? Sleep researcher Dr Neil Stanley says: “There are some supplements especially designed for cramps which you could try, and some studies suggest taking magnesium salts and/or calcium may help. The herb valerian may help relax muscles. But unless it is troubling you regularly, occasional cramps are quite normal and something most people learn to live with”.

Hunger and thirst

What is it? Waking up with hunger pangs or dry mouth and throat, and with a strong urge to eat and/or drink.

Why does it happen? Thirst in the night can often be brought on by having drunk too much alcohol earlier that day. Hunger can be due to a drop in blood sugar levels. “You really ought not to wake up hungry,” says nutrition scientist Anna Denny, “so if it happens regularly you may need to look at what you are eating as an evening meal, because it may not be substantial enough”.

What should I do? “If you wake up hungry and can’t get back to sleep, do eat something small, like a piece of toast or an apple,” says Denny. “It should fit in with a healthy and balanced diet. Unfortunately, you are more likely to choose an apple during the day than in the middle of the night, so be careful not to go for biscuits or chocolate as night-time snacks”.

Any other tips? If you have drunk alcohol, drink at least a large glass of water before going to bed. Keep some water by the side of your bed to sip in case you wake up dry-mouthed. Eat a proper evening meal - but not too late at night.

Night sweats

What is it? Medically known as hyperhidrosis, this is basically excessive sweating during sleeping - which can be severe enough to wake you. Night sweats are not usually related to heat or the environment, so are just as common in cooler months as warmer ones.

Why does it happen? “The most common cause in women is menopause, but other causes include bacterial or viral infections, an overactive thyroid, or certain medications - especially diabetes medication,” says Dr Neil Stanley.

What should I do? It is important to see your doctor if you are waking with night sweats. A doctor can perform thyroid, liver and kidney function tests, and take blood tests, to eliminate any underlying medical cause.

Any extra tips? Stress and depression can sometimes contribute or cause night sweats, so do talk to someone about this if either applies to you. Have light natural cotton bedding and nightwear - do not wrap up too warmly at night. Smoking and alcohol should be avoided. The herb black cohosh may help middle-aged women - but always seek advice from a herbalist and doctor before taking it.

Snoring

What is it? Noisy vibrations in your mouth and throat when you are asleep.

Why does it happen? There are muscles in your throat, mouth and nose which keep your airways open during the day and which relax at night - this relaxation can sometimes cause these airways to close up, restricting incoming and outgoing air, making the vibrations more likely.

What should I do? Snoring is not usually a health problem, unless it wakes you up and disturbs your sleep or that of your partner, or if you are tired during the day and are waking up not feeling fully refreshed. Smoking, alcohol and allergies can all contribute to snoring, and if you are overweight, losing weight can help.

Any extra tips? There are some over-the-counter products such as nasal strips and throat sprays which claim to help by opening up and lubricating the airways, and which some people find very useful. You could also try elevating the end of your bed, and experimenting with different pillows. If you have blocked nasal passages, clearing them up with a eucalyptus steam inhalation may also help.

Acid reflux

What is it? Also known as gastro-oesophagal reflux disease (GORD), acid reflux occurs when the stomach’s acid contents spill back into the oesophagus (foodpipe). It can cause heartburn and is particularly troublesome at night when you are lying down.

What causes it? It can be aggravated by alcohol, coffee, fatty foods and smoking. Pregnant women and those who are overweight are more susceptible.

What should I do? Avoid eating heavy meals at night, and raise the end of your bed. There are medications you can take, such as antacids, and some traditional remedies include pure liquorice, aloe vera and slippery elm.

Any other tips? Acid reflux can also be caused by a problem with the valve where the oesophagus meets the stomach, so do see your doctor if you are experiencing severe symptoms.

Sleep apnoea

What is it? In this condition, sufferers stop breathing - many times during the night.

Why does it happen? It happens when the muscles in the throat relax completely that a total blockage of the airways results. Deprived of oxygen, your brain wakes you up and you start breathing again. “This can happen hundreds of times a night, and you may not remember any of the incidences, but it can make you feel exhausted the next day, making everyday tasks like driving more dangerous,” says Dr Neil Stanley. “Sleep apnoea may increase the risk of cardiovascular problems, such as stroke or high blood pressure. It tends to be associated with the overweight, but even slim people can be affected”.

What should I do? If you think you are suffering from sleep apnoea - possibly because a partner has suggested it - you must seek medical advice. Treatment may involve the use of a continuous positive airways pressure (CPAP) machine to keep you properly ventilated at night.

Any other tips? Maintain your ideal weight - it really will help.

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