How Common Medical Conditions and Their Treatment Can Affect Your Sleep

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Author:

William Bulman, MD

Columbia Presbyterian Medical Center

Medically Reviewed On: March 31, 2006

To sleep well through the night, without interruption and for a sufficient amount of time, is to feel awake and healthy the following day. As a general internist, I care for patients with a wide range of complex problems, from hypertension to heart disease to diabetes, yet simple problems with sleeping are very common complaints I encounter in practice. Nearly one in seven Americans has sleep-related complaints. Part of my job is to determine which complaints reflect simple insomnia, and which complaints might reflect a more serious medical problem.

Insomnia

Although the term insomnia is used to describe a multitude of sleep disturbances, most people complain of one of a few specific problems with their sleep patterns: poor sleep quality, difficulty in initiating sleep, nighttime arousals, or insufficient quantity of sleep. Difficulty in initiating sleep is most often a problem with what doctors refer to as "sleep hygiene" - the activities that precede and surround the act of going to sleep. Daytime napping, drinking alcohol or caffeine-containing beverages in the evening, or routinely using one's bed for awake activities like reading or watching TV can make falling asleep or staying asleep difficult.


Please see our "Sleep Hygiene" article for a full discussion of this topic.

Although not common, problems with initiating sleep may be the result of underlying medical illness. In fact, disruptions of the normal sleep cycle are often some of the earliest clues that disease is present and, in certain circumstances, are the only warning signs that a problem exists.

Subtle signs of illness

Depression is perhaps the best example of a medical condition that can present with subtle sleep disturbances. Depression frequently results in difficulty with falling asleep or with staying asleep, and early morning awakening is a common symptom. In many instances these symptoms can be much more prominent than actual depressed mood, and both doctors and patients may overlook these subtle signals. New problems with sleep, often accompanied by daytime fatigue, loss of interest in daytime activities, or unplanned weight loss are often warning signs of serious but treatable depression.

Nighttime arousal is another common sleep-related complaint that can point to a specific medical problem. Many chronic medical conditions have symptoms that flare during sleep, causing frequent mid-sleep awakenings and resultant daytime fatigue. These conditions can develop very slowly over time, leaving people unaware that they have a significant problem.


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