Sleep problems: When a good night’s sleep is just a dream

Many of us find sleep tricky.

Whether we’re too busy to go to bed on time, frequently lie awake until the early hours, or have a toddler who apparently thinks 3am is morning, sleep problems can be a real struggle. In fact, in 2020, the Mental Health Foundation found that 48% of adults and 66% of teens felt that poor sleep had negatively impacted their mental health.

Sleep problems: When a good night's sleep is just a dream

Who struggles with sleep problems?

While we don’t all have to contend with sleep disorders, many of us do cope with poor sleep, sleep problems, and/or with feeling tired all the time.

In 2020, 52% of women and 44% of men reported that poor sleep negatively impacted their mental health.

There are many sleep disorders. We will not be the first person to have struggled with sleep in the way we do.

Sleep and mental health

Mental health and sleep are linked. Sleep problems and poor sleep can contribute to poor mental health. Poor mental health can contribute to poor sleep and sleep problems. It can become an unhelpful cycle.

Most of us can probably relate to the experience of struggling to cope with our emotions when tired. It’s often harder to regulate ourselves. We might snap at loved ones or be extra-tearful.

If we’re on mental health medication, then we might find that we don’t sleep enough to ‘sleep off’ the drowsy side effects, so we walk around in a fog.

Lack of sleep has sadly been linked to an increase in suicidal thoughts and attempts, too.

Fear of going to bed

Before we even get as far as snuggling down in our temperature-controlled, perfectly-dark, perfectly-comfy bedroom, some of us start to struggle.

Extreme anxiety around going to bed and/or going to sleep can be debilitating. Psyching ourselves up to go to bed can be a significant challenge. It may take hours and can lead to us being awake until far, far too late. We might even force ourselves to stay awake, even going past the point where we feel sick.

As bedtime gets closer, our anxiety ramps up. While others wind down as the evening progresses, we go in the opposite direction, possibly to the point of panic attacks. We may experience physical symptoms of anxiety, many of which are incompatible with a good night’s sleep. Every time a night doesn’t go quite to plan, it reinforces our anxious feelings.

Each of us will have our own reasons for our fears. We might not know where our fear has come from and need some support to unpick it. Alternatively, we might have a very clear idea – perhaps it’s been triggered by a specific event or circumstance.

If getting into our bed is just too hard, some of us might kip on the sofa, affecting our sleep quality. If we can make it into bed, lying down might be a barrier. So, we do things like creating a comfy nest of pillows and sleeping upright. Some need background noise – TV, podcasts, the shipping forecast, or something else. Some scroll our phones until we drop off. Blue light isn’t recommended when trying to sleep, but different things work for different people. For some of us, these are the things we need to nod off.

We might feel ashamed of our difficulties. It can seem like an odd or ‘ridiculous’ fear to have – but it isn’t. Sleep is complex. Many, many different things affect it and, in turn, it affects many things. There are so many different aspects of sleep which could cause our anxiety levels to rise. These anxieties are real. They can be debilitating. We’re not alone, and we deserve support.

Insomnia

Those with insomnia often struggle to fall asleep and/or stay asleep. There are nights when it doesn’t matter how many sheep we count, how perfect our environment is, and how much sleepy tea we drink, we just can’t get to sleep. Frustratingly, when we do finally nod off, it might not be long before we wake up again… and then struggle to go back to sleep.

We could try bringing out bedtime forward, but that doesn’t always work. Sometimes it means that we just lie awake for longer and still don’t get many hours of sleep in before our alarm blares in the morning.

It can start to affect our relationships, work, and ability to remember things, concentrate, or focus. In fact, it can affect every area of our lives.

If it becomes a regular occurrence, it can be helpful to speak to our local pharmacy and/or GP about any support they may be able to offer.

Nightmares

Most of us will have experienced nightmares at some point. They differ from bad dreams in that they wake us up. For some, nightmares are occasional and unpleasant. For others, they’re regular, affecting how much sleep we get, sleep quality, our mood, and our anxiety levels. We might start fearing sleep.

Sometimes nightmares are bizarre. Sometimes, they tap into trauma or really difficult periods in our lives. They can be extremely vivid. Sometimes it’s hard to tell whether they’re real or not. We might wake up with a speeding heart rate, sweating, and feeling anxious.

Stress, anxiety, post-traumatic stress disorder (PTSD), depression, bipolar disorder, and psychosis can increase our risk of nightmares. Sleep deprivation, medication withdrawal, and some medications can also increase our risk.

If we’re having nightmares more than once a week, they’re significantly affecting our mental health, or they coincide with starting a new medication, it would be helpful to speak to our GP.

Night sweats

We all sweat a bit in our sleep, but some of us sweat heavily. Around 10-41% of us are affected by night sweats. Those aged 41-55 are most likely to be affected.

Menopause, certain medications, hot flashes, hormone changes, cancer, infections or significant reflux can all cause night sweats.

Our body produces too much sweat – more than is needed for temperature regulation. It can disrupt our sleep, disrupt the sleep of anyone sharing a bed with us, and impact our overall quality of life.

If we’re regularly having night sweats, or they’re linked with other symptoms, it can be helpful to speak to our GP. They will be able to investigate any physical causes and might be able to recommend treatment(s) that may help us.

Night terrors

Night terrors usually happen during the ‘deep sleep’, making them different from nightmares. They’re more common in children than adolescents or adults.

Experiencing other sleep disorders, like breathing or gastrointestinal problems, can increase our risk of experiencing night terrors. There may also be a genetic link. Being unwell, sleep deprivation and emotionally tricky times can all act as night terror triggers.

They can be terrifying, even though we’re unlikely to remember specific details of the terror. Our “fight or flight” system is activated. Our heart rate shoots up. We might sweat, overheat, get chills, move around a lot, and shake. Some of us might scream. They can interrupt our sleep and compromise our sleep quality.

If we’re concerned about any night terrors that we, or others, experience, then it’s always a good idea to discuss our concerns with our GP.

Sleepwalking

Some people sleepwalk during ‘deep sleep’. Sleepwalkers often don’t remember their travels. Though the term ‘sleepwalker’ implies walking, some people have been known to do activities like cleaning in their sleep, too.

It isn’t usually dangerous in itself. But if we start sleep-doing risky activities, or we live in an environment unsafe for sleepwalkers, then it can start to cause problems. Making our environment as safe as possible is important if we regularly sleepwalk. This can include things like removing piles of clothes and other trip hazards or using motion-controlled lights.

Sleepwalking triggers can include high stress levels, alcohol consumption, and lack of sleep.

Sleep Bruxism (Teeth-grinding)

Some of us regularly wake up with headaches and a sore jaw and neck. We might struggle to pin down quite why they hurt. It could be that we are grinding our teeth in our sleep.

Clenching and grinding our jaw in our sleep can be caused by high levels of anxiety and stress. The usual sleep-affecting culprits can all act as risk factors, including drinking alcohol, drinking caffeine, snoring, and experiencing low moods.

It can create significant problems for us, affecting our teeth and jaw. It can erode our teeth, and create chronic jaw pain, or jaw locking. If this is something we’re concerned about, then speaking to our dentist may be helpful.

Sleep Paralysis

Sleep paralysis occurs in a state between asleep and awake, usually just after falling asleep or just before waking up. It can be incredibly scary. We’re awake but temporarily can’t use our body. We’re temporarily paralysed. Sometimes, we might feel as though we’re suffocating. Some of us will experience it once, others multiple times. Around 8% of people will experience it at some point in life.

Around 75% of those who experience sleep paralysis will hallucinate. These hallucinations can make it feel like something dangerous is nearby. We may feel like we’re suffocating, flying, or having an ‘out of body’ experience.

Some things increase our likelihood of experiencing sleep paralysis. Other sleep disorders affecting our breathing, insomnia, daytime sleepiness, dissociation, anxiety, panic disorder, and PTSD are all risk factors. Shift workers, abuse survivors, daydreamers, and those with strong imaginations also have a greater likelihood of experiencing it. Given the number of individual factors associated with sleep paralysis, it’s currently unclear whether any of them directly cause it, or whether they’re just related to it.

Though scary, sleep paralysis episodes aren’t usually physically long-lasting.. However, they can cause anxiety around going to bed or falling asleep and insomnia. If significantly impacting our life then we may want to speak to our GP.

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Sleep talking

Like snoring, sleep talking is something that people living with us may notice before we do. Our sleeptalking might be loud, quiet, nonsense, full sentences, individual words, or laughter. It’s fairly common – 17% of people have sleep-spoken in the last three months, and around a third of us will sleep talk at least once in our life. We are twice as likely to sleep talk if we have a diagnosed mental illness.

Sleep talking in itself is fairly harmless, but depending on the extent, it may disturb those living with us. If we’re ever concerned, especially if our sleep talking is combined with other symptoms, then it’s worth speaking to our GP.

Snoring

41.5% of UK adults are affected by snoring. An airway blockage causes the organs helping us to breathe to vibrate, creating a snore. Many snorers won’t notice their snoring, although it may occasionally wake some people up. Usually, it’s a far bigger problem for those we share a room with.

There are a few options to try and reduce snoring. We may choose to make some lifestyle changes, such as maintaining a healthy weight (if we’re able to do so), exercising regularly (within healthy limits), and drinking less alcohol. Popping in to speak to a pharmacist might also be helpful as they sometimes have good, individual, advice.

General points

Sleep problems can affect us in different ways. They can negatively impact our mood, increase our anxiety levels, make us feel permanently sleep-deprived and foggy, make it hard to think and leave us so exhausted that we struggle to engage with things we enjoy.

If any of these sleep disorders are significantly affecting us, then it’s worth speaking to a pharmacist and/or GP. Different disorders can have different treatment options – this could be medication, therapy, or something else. Our GP may want to rule out any physical causes of our problems, too.

Sleep Self-Help

There are things we can do to try and improve our sleep. Different things will work for different people, and sometimes pieces of general advice won’t work for us, so it can take a bit of trial and error.

Many of us have sleep struggles. It can significantly impact our mood and overall wellbeing. It’s important to remember that we don’t have to cope with it alone.

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