No doubt a healthcare provider visit seems in order for a nagging cough, intolerable pain, or concerning symptoms that may need further assessment, but what about seeking an evaluation for sleep? In fact, there may be many reasons to talk to a practitioner about sleep.
Whether someone cannot sleep due to insomnia or has loud snoring or multiple other problems linked to sleep disorders, it may be time to schedule an appointment. Let’s explore 5 symptoms and conditions that may be linked to sleep and that may benefit from an evaluation, testing, and treatment.
1. You can’t sleep
Insomnia is the most widely encountered sleep problem in the primary care setting. As defined by the International Classification of Sleep Disorders (ICSD), insomnia is difficulty falling or staying asleep or sleep that is not refreshing in the absence of another sleep disorder.1
Generally, it is understood that if it takes more than 20 to 30 minutes to fall asleep or to get back to sleep after waking in the night, this is problematic. It may also be associated with early morning awakenings. People with insomnia have other symptoms as well, including:
- Decreased energy
- Poor concentration
- Mood problems (anxiety or depression)
- Headache or pain complaints
- Malaise (feeling unwell)
- Dyspepsia (upset stomach)
2. You are told that you snore
Snoring is a common affliction. If it becomes disruptive to a bed partner (or others nearby), it may prompt a sleep evaluation. Loud snoring may be associated with obstructive sleep apnea, but the latter condition may occur even in the absence of known snoring.
Fortunately, snoring can be resolved with proper treatment. Treatments will depend on the underlying contributions and the presence or absence of associated sleep apnea.
These may include over-the-counter interventions (such as nasal strips, saline spray, allergy treatment, positional therapy, etc.), surgery, or even options to address both snoring and sleep apnea such as an oral appliance or continuous positive airway pressure (CPAP).
3. You wake with a morning headache
Headaches frequently interact with sleep. Waking with a headache first thing in the morning may occur for several reasons.
Assuming other concerning symptoms (vision changes, weakness or numbness on one side of the body, nausea or vomiting, etc.) are not present, several types of headaches may be suspected that may be linked to disturbed breathing in sleep.
Sleep apnea may be the primary factor driving these headaches. Oxygen levels drop and carbon dioxide levels increase repeatedly through the night. Carbon dioxide dilates blood vessels to the brain, increasing pressure and often contributing to a frontal headache that fades in the first hours of the day.
Although a guard may alleviate enamel wear and some discomfort, treatment of the underlying breathing issue may be needed to resolve the condition.
4. You are drowsy or fall asleep driving
It is extremely dangerous to drive when overly drowsy. This may manifest as dozing at traffic lights or even nodding off in stop-and-go traffic on a long commute. Accidents that threaten (or take) the lives of the driver and others are unfortunately all too common.
This drowsy driving may occur more often on long drives, or when driving occurs overnight. Falling asleep driving is also more likely with sleep deprivation and untreated sleep disorders like sleep apnea.
For those with chronic problems staying alert behind the wheel, asleep evaluation may be needed to ensure safety. If an accident or near-miss occurs, driving should be ceased until this evaluation is complete.
5. You have recurring nightmares
Nightmares may be disruptive to sleep and are increased in times of stress. They may be associated with other mood disorders, including anxiety and post-traumatic stress disorder. In some cases, nightmares are secondary to another sleep disorder like sleep apnea.
Fortunately, there are some effective treatments, including medications like prazosin as well as dream rehearsal therapy. If an underlying sleep disorder is suspected, testing may lead to the cause and ultimately to the resolution of the bad dreams.
Source: American Academy of Sleep Medicine. International classification of sleep disorders, 3rd ed. Darien, IL: American Academy of Sleep Medicine, 2014.
Qaseem A et al. Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2016;165(2):125-133.