Are you experiencing poor-quality sleep? Could a medical condition be to blame?
Sleep disorders including insomnia, night terrors, narcolepsy, sleep apnea, restless legs syndrome, and many others can cause poor-quality sleep. There are also, however, many non-sleep-related medical conditions that can directly impact your ability to get a good night’s sleep. These include the influence of “normal” things such as pregnancy and perimenopause, as well as the symptoms of common diseases including benign prostate disease, arthritis, diabetes, and various others.
It’s important to understand what’s impinging upon your ability to sleep well and to seek appropriate treatment or other management strategies, not just for your sleep, but also for your general health, well-being, longevity, and quality of life.
Medical Conditions & Their Sleep Consequences
It’s not always easy to be aware that you’re not getting a good night’s sleep. You may feel like you’ve slept fine; nevertheless, you feel tired, flat, non-specifically “off”, or moody during the day.
The disturbance to your sleep that causes daytime fatigue may not be from a sleep disorder per se, but rather a symptom of an underlying medical condition.
The specific type of medical issue you are dealing with will dictate how it affects your sleep. For example:
- discomfort due to menopausal hot flashes and night sweats
- pain from arthritis or heartburn
- frequently needing to urinate due to pregnancy, diabetes, or prostate disease
- anxiety associated with a chronic health condition
Medical Conditions That Disturb Sleep
There are many diseases and other health conditions that can disturb sleep; some of these are much more common than others. Below we discuss just a few of the most common of these. Others include but are not limited to heart and liver failure, thyroid disease, kidney disease, fibromyalgia, Parkinson’s disease, Alzheimer’s disease and other dementias, a history of stroke, migraine or cluster headaches, epilepsy, multiple sclerosis, cancer, and mental health disorders including depression, anxiety, bipolar disorder, schizophrenia, and ADHD.
Prostate Disease
The prostate is a male gland located just below the urinary bladder at the base of the pelvis. Its role is to produce seminal fluid, which nourishes and transports sperm. Benign (non-cancerous) swelling of the prostate is extremely common as men age; this is medically referred to as benign prostatic hyperplasia or BPH.
There is a very strong relationship between prostate health and sleep quality. BPH causes symptoms including urinary frequency and/or urgency (especially at night; this is called nocturia), difficulty urinating and an inability to fully empty the bladder, and discomfort when urinating. As such, BPH usually disrupts sleep, and men with the condition may visit the bathroom as many as six or more times per night. This disrupts sleep enormously and can lead to insomnia.
Prostate Cancer also impacts sleep. A cancer diagnosis and living with the disease is usually very stressful. Moreover, the hormone treatments often used to treat prostate cancer can cause hot flashes, anxiety, and insomnia, and removal of the prostate and/or radiation therapy to the pelvis can result in pain and incontinence, which further impacts sleep.
Nocturia is also experienced in numerous other medical conditions including (but not limited to) heart and liver failure, diabetes, urinary tract infection, multiple sclerosis, pregnancy, some medications, and even simply drinking too much liquid after dinner.
Gastro-Oesophageal Reflux Disease
Colloquially known as GORD (GERD in the USA), this condition causes “heartburn” and is experienced by up to 20% of adults in NZ. Heartburn occurs when stomach acid backflows into the oesophagus, burning the tissues (which, unlike the lining of the stomach, are not intended to be exposed to acid). It happens most commonly when the person lies down flat, especially when sleeping on the back or the right side.
Heartburn can be mildly uncomfortable or extremely painful; its symptoms can mimic those of a heart attack (and this is perhaps its most immediate concerning aspect). It can be minimised or even avoided by not consuming alcohol, coffee, or fatty, heavy meals, especially in the evening. Don’t lie down within a few hours of eating, and try to elevate the upper body when you go to bed. If heartburn is chronic or the discomfort is moderate to severe, you need to see your GP for a proper diagnosis. This will ensure you access appropriate treatment and management. Prescription medication to suppress the secretion of stomach acid may be required – it’s not a good idea to rely on over-the-counter antacids too heavily or for too long.
Diabetes
Diabetes is a chronic, increasingly common metabolic disorder characterised by high levels of glucose (sugar) in the blood and an insensitivity of the cells to insulin. Over time, the pancreas may fail to produce insulin altogether. Uncontrolled, diabetes can lead to an array of serious health problems. It can disturb sleep due to night sweats, urinary frequency, extreme thirst, itchy skin, and the symptoms of low blood sugar (hypoglycaemia). Diabetes can also eventually cause nerve damage, particularly in the legs and feet.
Osteoarthritis
Arthritis is a group of more than 100 diseases and osteoarthritis is the most common of these. It occurs when the protective cartilage that caps the bones in joints becomes damaged, causing swelling, stiffness, inflammation, pain, diminished movement, and permanent anatomical changes within the joints. It’s most prevalent in the fingers, knees, hips, and spine, though it can affect the entire body. Osteoarthritis is more common in women and is very common from middle age. The associated stiffness and pain can make it difficult to achieve comfortable sleep; moreover, steroid medicines prescribed to alleviate symptoms can cause insomnia.
Perimenopause/Menopause
Perimenopause is the period of up to ten years preceding menopause, which reflects the end of a woman’s fertility. During this time and for up to a decade (or even longer) after menopause, the hormonal changes a woman undergoes can wreak utter havoc on her sleep. These can cause hot flashes, night sweats, joint pains, urinary symptoms, heart palpitations, anxiety, increased snoring, insomnia, and more. Understandably, sleep and menopause are not a great combination. You should see your GP to find the most appropriate methods of managing these troublesome symptoms and navigating this transformative period of life (and it’s certainly not all bad!) as comfortably and healthily as you are able.
Pregnancy
Sleeping issues are a well-known part of pregnancy. Most women will experience insomnia, nighttime heartburn, nausea, urinary frequency, restless legs syndrome, snoring/sleep apnoea, and general physical discomfort. The unpleasant symptoms directly associated with pregnancy will generally resolve after the baby is born – though this is when infant-related sleep deprivation begins.
You must see your GP regularly for checkups, especially if you have new symptoms. This will enable your GP to properly identify and diagnose medical conditions as early as possible for the best outcome.
Does Snoring Have an Impact?
Regardless of any medical issues you may be dealing with, your sleep will most certainly be disturbed if you snore.
Snoring compromises how you breathe while you are asleep – and reduces the amount of oxygen that can circulate in your blood and feed the brain and other organs. Snoring doesn’t just diminish the quality of your sleep while you are asleep; it can cause you to wake frequently (especially if you have sleep apnea).
Snoring can also aggravate the symptoms of other medical conditions that disturb your sleep.
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