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Sleep Problems, Age 12 and Older

Topic Overview

Everyone has a "bad night" once in a while. Dogs barking, the wind howling, or overeating may make it hard to sleep. It is estimated that 35% of adults have occasional sleep problems, which can have many causes.

Insomnia

The medical term for trouble falling asleep or staying asleep is insomnia. Insomnia can include:

  • Trouble getting to sleep (taking more than 45 minutes to fall asleep).
  • Frequent awakenings with inability to fall back to sleep.
  • Early morning awakening.
  • Feeling very tired after a night of sleep.

But insomnia usually is not a problem unless it makes you feel tired during the day. If you are less sleepy at night or wake up early but still feel rested and alert, there usually is little need to worry. Fortunately, home treatment measures successfully relieve occasional insomnia.

Occasional insomnia may be caused by noise, extreme temperatures, jet lag, changes in your sleep environment, or a change in your sleep pattern, such as shift work. Insomnia may also be caused by temporary or situational life stresses, such as a traumatic event or an impending deadline. Your insomnia is likely to disappear when the cause of your sleep problem goes away.

  • Short-term insomnia may last from a few nights to a few weeks and be caused by worry over a stressful situation or by jet lag.
  • Long-term insomnia, which may last months or even years, may be caused by:
    • Advancing age. Insomnia occurs more frequently in adults older than age 60.
    • Mental health problems, such as anxiety, depression, or mania.
    • Medicines. Many prescription and nonprescription medicines can cause sleep problems.
    • Chronic pain, which often develops after a major injury or illness, such as shingles or back problems, or after a limb has been amputated (phantom limb pain).
    • Other problems that interrupt your sleep, such as asthma, coronary artery disease, chronic obstructive pulmonary disease (COPD), or menopause.
    • Alcohol and illegal drug use or withdrawal.
    • Cigarettes and other tobacco use.
    • Drinking or eating foods that contain caffeine, such as coffee, tea, chocolate, or soft drinks (for example, Coke, Pepsi, or Mountain Dew).

Sleep apnea

Sleep apnea is one of several sleep disorders. Sleep apnea refers to repeated episodes of not breathing during sleep for at least 10 seconds (apneic episodes). It usually is caused by a blockage in the nose, mouth, or throat (upper airways). When airflow through the nose and mouth is blocked, breathing may stop for 10 seconds or longer. People who have sleep apnea usually snore loudly and are very tired during the day. It can affect children and adults.

Narcolepsy

Narcolepsy is a sleep disorder that has distinct symptoms, including:

  • Sudden sleep attacks, which may occur during any type of activity at any time of day. You may fall asleep while engaged in an activity such as eating dinner, driving the car, or carrying on a conversation. These sleep attacks can occur several times a day and may last from a few minutes to several hours.
  • Sudden, brief periods of muscle weakness while you are awake (cataplexy). This weakness may affect specific muscle groups or may affect the entire body. Cataplexy is often brought on by strong emotional reactions, such as laughing or crying.
  • Hallucinations just before a sleep attack.
  • Brief loss of the ability to move when you are falling asleep or just waking up (sleep paralysis).

Parasomnias

Parasomnias are undesirable physical activities that occur during sleep involving skeletal muscle activity, nervous system changes, or both. Night terrors and sleepwalking are two types of parasomnias. Sleep can be hard for people who experience parasomnias. While "asleep," a person with parasomnia may walk, scream, rearrange furniture, eat odd foods, or pick up a weapon.

Parasomnia can cause odd, distressing, and sometimes dangerous nighttime activities. These disorders have medically explainable causes and usually are treatable.

Restless legs syndrome

Restless legs syndrome (RLS) is a condition that produces an intense feeling of discomfort, aching, or twitching deep inside the legs. Jerking movements may affect the toes, ankles, knees, and hips. Moving the legs or walking around usually relieves the discomfort for a short time.

The exact cause of restless legs syndrome is not known. The symptoms of restless legs syndrome most often occur while a person is asleep or is trying to fall asleep. The twitching or jerking leg movements may wake the person up, causing insomnia, unrestful sleep, and daytime sleepiness.

When a sleep problem or lack of time keeps you from getting a good night's sleep, excessive daytime sleepiness may occur. While almost everyone experiences daytime sleepiness from time to time, it can have serious consequences such as motor vehicle accidents, poor work or school performance, and work-related accidents.

Sleep problems may be a symptom of a medical or mental health problem. It is important to consider whether a medical or mental health problem is causing you to sleep poorly. Treating a long-term sleep problem without looking for the cause may hide the real reason for your poor sleep.

Check your symptoms to decide if and when you should see a doctor.

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  Sleep Problems: Dealing With Jet Lag
  Sleep: Helping Your Children—and Yourself—Sleep Well

Check Your Symptoms

Do you have sleep problems?
Yes
Sleep problems
No
Sleep problems
How old are you?
Less than 12 years
Less than 12 years
12 years or older
12 years or older
Are you male or female?
Male
Male
Female
Female
Do you think that a mental health problem could be causing your sleep problems?
Sleep problems are a common symptom of depression, anxiety, and stress.
Yes
Sleep problems may be caused by mental health problem
No
Sleep problems may be caused by mental health problem
Have you been thinking about death or suicide a lot?
Yes
Frequent thoughts of death or suicide
No
Frequent thoughts of death or suicide
Yes
Suicide risk
No
Suicide risk
Sleep apnea means that you often stop breathing for short periods of time while you are asleep.
Yes
Symptoms of sleep apnea
No
Symptoms of sleep apnea
Do you have episodes of choking or gasping for breath during sleep?
Yes
Episodes of gasping or choking during sleep
No
Episodes of gasping or choking during sleep
Yes
Illness may be causing sleeping problem
No
Illness may be causing sleeping problem
Do you ever fall asleep at times when you shouldn't?
Yes
Falls asleep at inappropriate times
No
Falls asleep at inappropriate times
Do you ever fall asleep while working or driving?
Yes
Episodes of falling asleep when working or driving
No
Episodes of falling asleep when working or driving
Is sleepiness causing problems at work, school, or home?
Yes
Sleepiness causes problems at work, school, or home
No
Sleepiness causes problems at work, school, or home
Do you think that a medicine may be causing your sleep problems?
Think about whether the sleep problems started soon after you began using a new medicine or a higher dose of a medicine.
Yes
Medicine may be causing sleep problem
No
Medicine may be causing sleep problem
Do you think that the use of alcohol, caffeine, or illegal drugs may be causing your sleep problems?
Yes
Sleep problem may be caused by alcohol, caffeine, or illegal drugs
No
Sleep problem may be caused by alcohol, caffeine, or illegal drugs
Does your sleep improve when you stop using the substance?
Yes
Sleep improves after stopping alcohol, caffeine, or drugs
No
Sleep improves after stopping alcohol, caffeine, or drugs
Do you often use sleeping pills or alcohol to help you sleep?
Yes
Regular use of sleeping pills or alcohol to fall asleep
No
Regular use of sleeping pills or alcohol to fall asleep
Can you sleep without using sleeping pills or alcohol?
Yes
Able to sleep without sleeping pills or alcohol
No
Able to sleep without sleeping pills or alcohol
Have you tried home treatment for your sleep problems for more than 2 weeks?
Yes
Has tried home treatment for more than 2 weeks
No
Has tried home treatment for more than 2 weeks

Many prescription and nonprescription medicines can cause sleep problems. A few examples are:

  • Antidepressants.
  • Cold medicines.
  • Steroid medicines.
  • Nonprescription diet aids.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

There are many things you can do at home for sleep problems. For example:

  • Use your bed for sleeping and sex only.
  • Keep the bedroom quiet, cool, and dark.
  • Try to go to bed at the same time every night and wake up at the same time every day.
  • Don't take naps.
  • Limit caffeine (coffee, tea, sodas with caffeine) during the day, and don't have any for at least 4 to 6 hours before bedtime.
  • Avoid alcohol and nicotine, especially in the evening.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

The risk of a suicide attempt is highest if:

  • You have the means to kill yourself, such as a weapon or medicines.
  • You have set a time and place to do it.
  • You think there is no other way to solve the problem or end the pain.

Many illnesses can cause sleep problems. A few examples are:

  • Heart problems, such as heart failure or chest pain (angina).
  • Circulation problems in your legs, such as peripheral arterial disease.
  • Chronic breathing problems, such as asthma or chronic obstructive pulmonary disease (COPD).
  • Digestive problems, such as gastroesophageal reflux disease (GERD).

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Symptoms of sleep apnea may include:

  • Loud snoring. (But not all people who snore have sleep apnea.)
  • Often feeling very sleepy during the daytime.
  • Episodes of not breathing during sleep.
  • Nighttime choking spells.
  • Waking with an unrefreshed feeling after sleep.

Home Treatment

How much sleep a person needs varies from person to person. The number of hours you sleep is not as important as how you feel when you wake up. If you do not feel refreshed, you probably need more sleep. Feeling tired during the daytime is another sign you are not getting enough sleep. The average total nightly sleep time is 7½ to 8 hours. Healthy adults can require anywhere from 4 to 10 hours of sleep. Many times, simple home treatment can help you get the sleep you need.

If your sleep problem does not require a visit to your doctor, establish a routine to promote good sleep habits:

  • Set a bedtime and time to get up, and stick to them, even on weekends. This will help your body get used to a regular sleep time.
  • Get regular exercise but not within 3 to 4 hours of your bedtime.
  • Wind down toward the end of the day. Don't take on problem-solving conversations or challenging activities in the evening.
  • Take a warm bath before bed.
  • Keep your bedroom dark, cool, and quiet.
  • Remove distractions, such as a clock, telephone, or radio, from your bedroom.
  • Use a humidifier or "white noise" machine to block out background noise in your bedroom throughout the night.
  • Try using a sleep mask and earplugs at night.
  • If you take medicine that may be stimulating, such as antihistamines, decongestants, or asthma medicines, take them as long before bedtime as possible.
  • Reserve the bedroom for sleeping and sexual activities so that you come to associate it with sleep. Go to another room to read, watch television, or eat.
  • After getting into bed, make a conscious effort to let your muscles relax. Imagine yourself in a peaceful, pleasant scene. For more information, see the topic Stress Management.

When you can't get to sleep, try the following:

  • If you are still awake after 15 or 20 minutes, get up and read in dim light or do a boring task until you feel drowsy. Don't lie in bed and think about how much sleep you're missing or watch TV.

Avoid activities that might keep you from a good night's sleep:

  • Do not take naps during the day, especially in the evening.
  • Do not drink or eat caffeine after 3:00 p.m. This includes coffee, tea, cola drinks, and chocolate.
  • Do not smoke or use other tobacco products. Nicotine can disrupt sleep and reduce total sleep time. Smokers report more daytime sleepiness and minor accidents than do nonsmokers, especially in younger age groups. For more information, see the topic Quitting Smoking.
  • Avoid drinking alcohol. It may make you sleepy but also will probably wake you up after a short time.

Try a nonprescription medicine, such as Nytol, Sleep-Eze, or Sominex. Use nonprescription medicines wisely since they can cause daytime confusion, memory loss, and dizziness. Continued use of sleeping pills may actually increase your sleeplessness (rebound insomnia). If you take any prescription medicines, talk with your doctor before trying any nonprescription sleep medicines.

Melatonin is a popular herbal remedy for sleep problems. Experts disagree about its usefulness for sleep problems. Before using any treatment, it is important to consider the risks and benefits of the treatment. For more information, see the topic Melatonin.

If you have several nights of trouble sleeping, review all of your prescription and nonprescription medicines with your doctor or pharmacist to determine whether the medicines you take could be the cause of your sleep problem.

You may have Click here to view an Actionset.sleep problems after traveling (jet lag), especially if you change time zones.

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home treatment:

  • Your sleep problem becomes worse.
  • Your sleep problem lasts longer than 4 weeks.
  • Your symptoms become more severe or frequent.

Prevention

Many sleep problems can be prevented. Avoid activities that might keep you from a good night's sleep.

  • Use your bed only for sleeping. Do not read, watch television, or do paperwork in bed. Reserve the bedroom for sleeping and sexual activities so that you come to connect it with sleep.
  • Do not take naps during the day, especially in the evening.
  • Do not drink or eat caffeine after 3:00 p.m. This includes coffee, tea, cola drinks, and chocolate.
  • Avoid eating large meals close to bedtime.
  • Exercise during the day. Avoid strenuous exercise within 2 hours of bedtime.
  • Do not smoke or use other tobacco products. Nicotine can disrupt sleep and reduce total sleep time. Smokers report more daytime sleepiness and minor accidents than do nonsmokers, especially in younger age groups. For more information, see the topic Quitting Smoking.
  • Avoid drinking alcohol. It may make you sleepy but also will probably wake you up after a short time.
  • Do not engage in stimulating activities at bedtime. Substitute reading or listening to relaxing music for watching television.

You may be able to prevent Click here to view an Actionset.sleep problems caused by jet lag by staying hydrated with water and avoiding caffeine, such as coffee.

Children also need plenty of sleep to grow and develop. It's important to help your child and yourself to Click here to view an Actionset.sleep well with a good bedtime routine.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

  • How long have you been troubled with a sleep problem?
    • What is your major symptom?
    • Does your sleep problem come and go or does it occur every night?
  • What is your normal sleep pattern?
  • What was happening in your life when the sleep problem started?
  • Have you had a sleep problem in the past? If so, how was it treated?
  • Do you have any other symptoms that may be related to your sleep problems? Symptoms may include:
    • Rapid or irregular heartbeat.
    • Nausea or vomiting.
    • Numbness or weakness.
    • Excessive sweating.
    • Feeling like you are not able to get enough air (air hunger).
    • Restlessness, irritability, or feeling on edge.
    • Feelings of overwhelming anxiety or fear.
  • What makes your symptoms better or worse?
  • Have you ever taken prescription or nonprescription medicine to help you sleep?
  • What other prescription or nonprescription medicines do you take?
  • Are you using alcohol or illegal drugs, such as marijuana or cocaine, to help you sleep?
  • What home treatment have you tried? Did it help?
  • Does your bed partner report that you snore or are restless in your sleep?
  • Do you frequently fall asleep during the day, such as at work or while driving?
  • Is your sleep problem interfering with your usual activities?
  • Has anyone else in your family ever been diagnosed with any form of depression or sleep disorder?
  • Do you have any health risks?

Before visiting your doctor, keep a sleep diary(What is a PDF document?) of your sleep patterns for at least 2 weeks.

Credits

By Healthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Specialist Medical Reviewer David Messenger, MD
Last Revised November 27, 2012

Last Revised: November 27, 2012

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