Restless Sleep: Causes and Treatments
There are many factors — both within our bodies as well as in our environment — that can lead to a poor night’s sleep. Some people who experience restless nights may need to schedule an exam with their doctor, while others may sleep better after improving their bedtime surroundings. There are many steps that you can try to take if you are dealing with restless sleep.
What Is Restless Sleep?
Restless sleep occurs when a person doesn’t sleep well. People may experience tossing and turning, trouble falling asleep or staying asleep, or waking up not feeling well rested. Both adults and children may experience restless sleep.
For a long time, restless sleep was not a medical term, but rather a general term for poor sleep quality. Recently, doctors have come up with a medical definition that describes a disorder seen in children.
In order to get a diagnosis of restless sleep disorder (RSD), children need to meet certain criteria. In children with RSD, the body regularly makes large movements during sleep. This may include kicking, arm flailing, or rolling around. These symptoms happen often — at least five large movements an hour, at least three times per week, for at least three months. Doctors also need to rule out other possible sleep disorders before giving a diagnosis of RSD.
Currently, restless sleep disorder has not been defined in adults, and people over the age of 18 cannot receive a diagnosis of RSD. However, this does not mean that adults don’t experience restless sleep. It’s possible that RSD will become an officially recognized diagnosis for adults in the future. It’s also possible that a restless night’s sleep is actually caused by other sleep disorders.
Related Sleep Disorders
Up to one out of ten Americans have restless leg syndrome (RLS). People with RLS experience uncomfortable sensations that make them feel like they have to move or massage the legs. These feelings often appear in the evening or at night, and can make it hard to get to sleep. Many people with RLS also have a related condition called periodic limb movement of sleep (PLMS). People with PLMS experience arm or leg twitching while sleeping.
Another common sleep disorder is insomnia. Insomnia may cause someone to stay up very late or wake up very early in the morning and be unable to go back to sleep. Many people go through short periods of time where sleep is more difficult. It is less common to experience chronic insomnia, which lasts for at least one month. Insomnia may be caused by stress, mental health problems, medications, or other illnesses.
Sleep apnea is a condition in which a person regularly snores, snorts, or gasps while sleeping. This leads to poor-quality sleep that leaves a person feeling very tired the next day. Sleep apnea may develop on its own or as the result of other conditions like congestive heart failure.
There are also several other types of sleep disorders. Some conditions, like narcolepsy, make it hard for a person to stay awake during the day. Circadian rhythm disorders affect the body’s internal clock. Parasomnia occurs when a person performs unusual activities in their sleep, such as talking, eating, or walking.
How Do You Know If You Have Restless Sleep?
Different sleep disorders cause different symptoms. These may include:
- Taking more than 30 minutes to fall asleep
- Waking up frequently during the night
- Waking up too early in the morning and having trouble going back to sleep
- Feeling tingling or creeping sensations in the legs and needing to move or massage them
- Feeling unable to move when first waking up
- Experiencing sudden muscle weakness while laughing or while feeling scared or angry
- Feeling very tired during the day or napping too often
Some symptoms of poor sleep can only be noticed by someone else, such as a partner or a parent. You may experience sleep problems if someone tells you that you are making gasping or choking noises while sleeping, you stop breathing for a short amount of time, or your limbs are making large jerking movements.
Getting good sleep is very important. The body needs sleep to grow, heal, fight infection, learn, concentrate, and remember. Too little sleep can lead to both physical and mental health problems. If you are experiencing any symptoms of poor sleep, talk to your doctor, who can help you figure out whether you may have a sleep disorder.
How to Stop Restless Sleep
Restless sleep is sometimes caused by health problems. Treating these underlying conditions may help improve sleep. In other cases, people can improve sleep with medications, supplements, or medical devices. Sometimes, more restful sleep can be achieved simply by practicing better habits, both at night and during the day.
Treat Underlying Health Conditions
A good first step in addressing sleep problems is making sure you are in good health. Heart disease, lung disease, pain, nerve problems, and other medical conditions can all lead to worse sleep. Additionally, some medications can cause sleep problems as a side effect.
Sleep problems can also happen as a result of mental health disorders. For example, children with attention deficit/hyperactivity disorder (ADHD) are often restless when they sleep. Anxiety and depression can also make sleep difficult.
If you are experiencing restless sleep, talk to your doctor. Your doctor can help you figure out what is causing sleep problems, detect any underlying health conditions, and diagnose any sleep disorders.
Get More Iron
The body needs the mineral iron to carry oxygen around the body and to build proteins and enzymes that have many different roles in the body. When a person doesn’t have enough iron in the body, they may be diagnosed as iron-deficient.
Iron deficiency may play a role in several sleep disorders, including RLS, PLMS, and general sleep disturbances (GSD). One study also found a connection between iron deficiency and restless sleep disorder in children.
Most people aren’t iron deficient. However, children who are picky eaters or adults who don’t eat balanced meals may not be getting enough of this mineral. Women who have heavy periods may also be iron-deficient. Your doctor can measure iron levels with a basic blood test. If you have low levels of iron, your doctor may recommend taking iron supplements or eating more iron-rich foods.
People who have sleep problems because of an iron deficiency may start sleeping better once they fix the iron imbalance. Children with RSD have fewer symptoms and better sleep after increasing their iron levels. However, this strategy may not be effective for people who have normal levels of iron in the blood.
Medications and Supplements for Sleep
Some sleep aids are available over the counter (without a prescription). These medications may work in the short term, but often become less effective over time. They may also cause side effects like daytime sleepiness or problems remembering things. OTC sleep medications often have long term side effects so please check with your physician about any of these OTC options you are taking or are considering.
More powerful sleep medications can also be prescribed by a physician. These medications can be addictive, so it’s important to follow your physician’s instructions when you take them. Don’t use them at higher doses or more often than prescribed. Prescription sleep aids should generally not be used more than three days a week. These medications may lead to side effects like tiredness during the day, having trouble balancing, or confusion.
Doctors also sometimes recommend medications for specific types of sleeping disorders. For example, people with restless leg syndrome sometimes get relief from anti-seizure drugs or from medications that increase dopamine.
Medical devices such as foot wraps or vibrating pads can also help calm restless feet at bedtime for people with RLS. A continuous positive airway pressure (CPAP) machine is another device that can help treat sleep apnea.
Some people with milder sleep problems may want to try taking natural or herbal supplements. One popular supplement is melatonin. Melatonin is a hormone that is made by the brain once it gets dark outside. It helps you feel sleepy, and may help treat certain sleep problems.
Experts are also studying other natural products to help with sleep. Research into these supplements is still in the early stages, and not all supplements have been tested in humans. It’s not always clear how well these work or who they may help. However, there is some evidence that the following herbs may help improve sleep:
- Semen zizyphi spinosae (SZS)
- Euphoria longan
- Epigallocatechin-3-O-gallate (EGCG, a molecule found in green tea)
If you choose to use a natural or herbal supplement, it is important to let your physician know. Occasionally, natural supplements can cause health problems or prevent other medications from working correctly.
Practice Better Sleep Hygiene
Often, sleep is interrupted due to things in the environment. A noisy household or loud city can often wake people up. In one survey, nearly two-thirds of New Yorkers said that loud noises woke them up at least once a week. Among people who were frequently disturbed by noise, three out of four people said they had problems concentrating during the day because they were so tired.
In order to make the most of your hours asleep, you can try adopting better sleep habits and creating a more restful environment. Tips include:
- Get more light — especially sunlight — during the day.
- Don’t nap in the late afternoon or evening.
- Avoid screens right before bed, including TV, computers, and phones.
- Lower the temperature in your bedroom with air conditioning or fans.
- Keep your room as dark as possible with blinds or curtains, or wear a sleep mask.
- Eliminate sounds by shutting a door, turning off electronic devices, or using earplugs.
- Get up and do something else, such as reading a book, if you can’t get to sleep within 20 minutes of lying down.
Try to develop a consistent sleep schedule by going to bed at the same time each night and setting your alarm for the same time each morning. Try not to deviate too far from this schedule on the weekend or on days off of work or school.
Change Your Diet
Eating a nutritious, balanced diet is a good way to get the best possible sleep. Research has found that not getting enough protein can make it harder to fall asleep and eating too much protein makes it more difficult to stay asleep. Likewise, eating either too many sugary carbohydrates or not enough complex carbohydrates changes sleep. People who follow very low-carb diets such as keto may experience different sleeping patterns than they used to. Finally, researchers have found that people who eat a high-fat, low-fiber diet have more restless sleep.
One way to help ensure you are getting the right balance of nutrients is to follow a healthy eating plan such as the Mediterranean diet. Studies have found that people who follow the Mediterranean diet have longer, higher-quality, less restless sleep. If you would like to read more on the Mediterranean diet, please visit my post Superfoods Part 3: Critical Superfoods for a Health Heart.
Alcohol and caffeine can also cause restless sleep. Avoiding these substances, especially later in the evening, may help you sleep throughout the night.
Researchers don’t yet know exactly how much exercise or which types of exercise are needed in order to improve sleep. However, several studies have found that participants experienced sleep benefits after they followed general expert recommendations for physical activity.
Many expert recommend getting 150 minutes of exercise each week. These minutes can be divided however you want. You can work out for 50 minutes three times a week, or you can exercise for a half an hour five days a week. You can also break up physical activity throughout the day. For an easy way to get more physical activity, try taking a short walk a couple of times a day on each weekday!
Many people experience restless sleep from time to time. However, long-term sleep problems can lead to physical and mental health problems and decrease quality of life.
If you are experiencing restless sleep, the first step is to talk to your physician about this situation. Restless sleep may be the cause of another health condition. Alternatively, you may have a sleep disorder that can be better treated once it is diagnosed. Medications, natural supplements, better sleep habits, a balanced diet, and exercise may all improve the quality of your sleep. If you are having sleep troubles and would like to discuss them with me, please make an appointment.