What's keeping you awake in the night

Restless sleep is a recurring problem with most of us. And while a snoring partner is one of the primary reasons for you waking up  abruptly in the night, the other factors could be internal and may be related to your health. We get experts to break it down for you.

Headache:

Possible causes: Dr Pratibha Singhal, consultant chest physician, bronchoscopist and sleep disorder specialist from Bombay hospital says, “Obstructive sleep apnea causes recurrent episodes of choking which causes a drop in oxygen levels in the body. This is sensed by the brain and it breaks the sleep cycle. The recurrent night awakenings  causes the person to wake up with headaches. There are other symptoms like nocturnal snoring and daytime sleepiness to name a few.  Sleep apnea poses several health hazards including uncontrolled hypertension, diabetes, etc. It can be easily diagnosed by doing a dedicated sleep study
medically known as polysomnography.”

Solution: Treatment options depend on the results of the study and the advise of your specialist.

Breathlessness:

Possible causes: Sujeet K Rajan, consultant respiratory physician

Bombay Hospital Institute of Medical Sciences, and Bhatia Hospital, says, “Asthma is one of the primary causes of breathlessness and cough at nights. Breathlessness at night in an asthmatic should sound the alarm on uncontrolled disease, and warrant a review of the medication prescribed. Often the disease hasn’t even been diagnosed, as in children with asthma.

Solution: Better control of asthma means better sleep, and therefore better growth. In a patient with cardiac disease, never ignore a night-time cough and breathlessness, especially an episode that wakes up the patient around 2 am. It is often a sign of cardiac decompensation and may need review of treatment, especially drugs to reduce fluid overload in the body, and others to optimise cardiac function.”

Back pain:

Possible causes: Dr Sujeet says, “Usually due to a bad mattress, either too hard or soft. Try putting your hand between your spine and the mattress. If it goes too easily, then the mattress is too hard. If it goes with difficulty, then your mattress is too soft.”

Solution: Mattresses should be changed once in eight to 10 years at least. Also, do not use too many pillows (unless you suffer from acid-reflux), and the ideal possible way to sleep would be to use one pillow below neck, and one below knees to reduce back strain. Patients with arthritis tend to get worse pain at nights, and may benefit with an anti-inflammatory (pain-killer) before sleeping. However, be careful with regular use of these drugs too, as excess use can cause kidney damage.

Leg cramps:

Possible causes: Dr Pratibha says, “Restless leg syndrome RLS is a condition which is characterised by an urge to move , associated with unpleasant sensations that occurs or is worsened by rest and improves with activity. It can occur exclusively at night during sleep and therefore cause sleep disturbances. Various factors like iron deficiency anaemia, kidney failure, fibromyalgia, some neurological diseases and medications have been implicated as a cause.”

Solution: Detailed evaluation by sleep specialist and a polysomnography( sleep study ) is recommended. As the syndrome can vary from night to night. Treatment includes correction of anaemia if detected or treat any other suspected cause. Sometimes some types of oral medicines which alter neurochemical transmitters in the brain may be needed. These are to be consumed only after consulting a specialists.

Cough:

Possible causes: Dr Pratibha says, “In the horizontal position the acid from the stomach can travel up through the food pipe and cause irritation in the throat, which in turn causes cough and sleep disturbance. Some people are inherently predisposed to this and some may have it occasionally when they have had a very heavy meal just before sleeping.”

Solution: Interval of at least two hours between eating and sleeping and eating a light dinner can decrease this.

Sleeping with two pillows and keeping the head high will help in this condition. Antacid medications as advised by your doctor if the symptoms persist. The nose normally drains into the throat. When there is a cold and the sinuses are  filed with secretions they drain into the throat in the lying down position and this triggers a spasm of cough. This can be rectified by sleeping in a slightly propped up position using two pillows. A cough suppressant or cold medicines as advised by the physician may be needed.