Sleep Disorders

When physical illnesses disturb sleep

When physical illnesses disturb sleep

Diseases and pain have a negative effect on sleep. In addition to infections, these are especially common problems with the heart, stomach and lungs as well as hormonal disorders and nervous disorders

Since hormones and organ functions also follow a certain pattern at night, almost every disorder in these areas can affect the different sleep phases and vice versa. Accordingly, emergencies such as stroke, heart attack or asthma attacks often occur at night or early in the morning.

In some diseases, the sleep disorder is one of the hallmark symptoms itself. Other diseases are associated with complaints, which in turn then interrupt the night’s sleep, such as urinary frequency in bladder and prostate or pain and fever in infections and joint disease. After all, skin disorders that are associated with pain and itching often do not make the affected person sleep or only restlessly.

Short explanations can be found here by way of example for the following disease groups:

  • Cardiovascular disease
  • respiratory diseases
  • Stomach disease, heartburn
  • Joint and muscle diseases
  • fibromyalgia
  • Headache migraine
  • Neurological diseases
  • Hormone Disturb Kid

Cardiovascular diseases that disturb sleep

During the night, the heartbeat slows down and the blood pressure drops. Every waking up, be it consciously or unconsciously through nocturnal breathing interruptions, for example, boosts heart rate and blood pressure. Such ups and downs put a strain on the heart and can eventually lead to persistent high blood pressure , which in turn causes nocturnal restlessness. People with obstructive sleep apnea are increasingly at risk of developing high blood pressure and suffering from possible sequelae such as heart attack or stroke.

Cardiac arrhythmias also stress the heart at night. The body mobilizes more stress hormones . The night’s sleep can suffer from this.

cardiac insufficiency (heart failure) decreases the output power of the pump element. As a result, less blood gets into the vessels. This results in an undersupply that can lead to wake-up reactions to stimulate the heart to more power. In cases of right heart failure or severe insufficiency of the entire heart, increased accumulation of fluid in the body tissues due to the backflow of blood.

When lying down, the body can excrete it better again. The resulting urinary frequency ensures additional nocturnal toilets. Also occurring shortness of breath hinders the falling asleep. People who suffer from chronic heart failure are also more at risk of developing sleep apnea.

This also applies to coronary heart disease . Here are arteries that supply the heart, narrowed or closed, so that the heart gets less blood and thus less oxygen. A vicious circle arises when those affected at the same time suffer from sleep apnea, in which the oxygen content in the blood through the respiratory failure repeatedly falls short term.

Symptoms : In the foreground are the typical signs of the respective heart condition. This can be shortness of breath during physical activity or even lying down (just struggling for air at night), inner restlessness, arrhythmia with palpitations or stumbling, heart pain, swelling in the legs , tightness in the chest, anxiety , dizziness. Even bluish lips and fingernails indicate a lack of cardiac output. In addition, sleep and sleep disorders occur. High blood pressure manifests itself at first only by little or no complaints. Unexplained sleep problems can be an indication here.

Diagnosis: If the heart disease is not yet known, the doctor will detect it during physical examinations. He will check the blood pressure, listen to the heart and have an electrocardiogram (ECG) as well as usually a stress ECG performed. If you suspect a cardiac arrhythmia, a heart failure or a heart failure, a long-term ECG, blood tests and an echocardiogram, an ultrasound of the heart, may be indicated. Other possible diagnostic methods that may be used include a cardiac catheterization , for example to detect and treat possibly narrowed coronary vessels, or special methods of magnetic resonance imaging.

If the medical history and symptoms suggest that the patient is suffering from sleep apnea at the same time, the doctor will investigate. Helpful information can be given here depending on the severity of the symptoms a polygraphy or polysomnography in the sleep laboratory (more on this in the chapter “Sleep Disorders – Diagnosis” ).

Therapy: The treatment depends on the underlying disease. These may be medications or other therapeutic measures, such as a bypass or bypass operation, the onset of a pacemaker. If sleep apnea is present, it will be treated accordingly (see also chapter “Sleep Disorders: Snoring, Sleep Apnea “). This can also improve blood pressure and heart function.

A healthy lifestyle supports the therapy significantly and thus helps to reduce the sleep problems.

Detailed information on the different clinical pictures as well as on diagnosis and therapy can be found in the guidebooks on high blood pressure, myocarditis , cardiac arrhythmia, heart failure (myocardial insufficiency, heart failure), coronary heart disease (coronary heart disease ( CHD )).

Respiratory Diseases: Aerial distress makes sleeping difficult

Sufficient oxygen, which the body gets over the air, is essential for a relaxed night’s sleep. Anything that impedes oxygen uptake via the lungs also interferes with sleep. This can be a stuffy nose in case of a cold , sinusitis , bronchitis, pneumonia or bronchial asthma. The respiratory distress associated with an acute or chronic lung disease as well as possible coughing spells prevent those affected from falling asleep and falling asleep. Asthma attacks often occur towards morning when the REM phases are more frequent (see also chapter “Why sleep is so important” ).

READ  Sleep disorders: snoring, sleep apnea

Symptoms : falling asleep or staying asleep, morning awakening, shortness of breath, shortness of breath. In case of bronchitis or lung diseases: cough with sputum or dry cough, dizziness , pain in the chest area, possibly fever; in asthma often morning asthma attacks. Problems in the paranasal sinuses indicate persistent cold , coughing while lying down, headache, pressure in the nose and ear space, fatigue.

Sleep disorders
Diagnosis : If you are coughing and having a runny nose that goes beyond the limits of a common cold, your GP will first listen to the lungs and assess the nasopharynx. If necessary, he will refer you to an ear, nose and throat doctor, a pulmonologist or an allergist.

Depending on suspicion, X-rays of the sinuses or lungs, a laboratory examination of nasal or bronchial secretions and a pulmonary function test may be indicated. If necessary, further ENT medical examinations and possibly special allergy tests will ensure the diagnosis.

Therapy : It depends on the underlying disease. An important part of the treatment of respiratory diseases are often special preparations for inhalation dar. As medicines are here, for example, anti-inflammatory and bronchial dilating agents for bronchial asthma question. The symptoms can also relieve tablets for sucking or swallowing, heat applications, for allergic cause, if necessary, a hyposensitization treatment. Against inflammation caused by bacteria doctors prescribe antibiotics, if indicated. Incidentally, it is also important for respiratory tract illnesses to strengthen respiratory function through a healthy lifestyle with adapted physical activity. With the therapy, the sleep disorders usually improve as well.

Read more about individual respiratory diseases in the guidebooks Bronchial asthma, acute bronchitis, chronic bronchitis , pulmonary embolism , pneumonia, lung cancer.

Gastric disorders: restless sleep in the morning

A common reason for disturbed sleep early in the morning is heartburn as part of a reflux disease. Around this time, the REM sleep phases occur more frequently, in which the stomach forms more acid. It then flows back into the esophagus when the person is lying around causing a painful burning sensation. Many people who suffer from it also have more attacks of coughing in the morning.

gastric ulcer also causes more pain around the morning, since the diseased gastric mucosa is itself more sensitive to the aggressive acid.

Symptoms : problems falling asleep due to stomach pressure, stomach pain, coughing . Waking up in the morning due to stomach ache, heartburn, often associated with acid regurgitation, coughing attacks with sputum, pain in the chest . Maybe nausea , vomiting.

Diagnosis : If the symptoms indicate a stomach problem, the doctor will initiate specific examinations, such as various laboratory tests, after an initial examination. Depending on suspicion, he attracts a specialist in gastrointestinal diseases (gastroenterologist). Possible further investigations include, among other things, a gastroscopy (gastroscopy).

Therapy : As a rule, the treatment of the underlying disease also improves the sleep disorders. An adapted, healthy diet , stress relief, relaxation as well as possibly acid-inhibiting drugs (proton pump inhibitors) and with appropriate evidence antibiotics against the bacterium Helicobacter pylori are used especially in gastritis and gastric ulcer.

For gastric diseases inform the adviser “heartburn”, “gastritis (gastritis)”, “gastric duodenal ulcer”.

Painful joint and muscle diseases often rob sleep

All diseases associated with pain interfere with sleep. This includes the whole spectrum of internal and external injuries, which will not be discussed here. Very common sleep disorders are back pain, muscle tension as well as calf cramps, which can be the expression of very different health problems.

Many people with joint disorders ( arthritis ) or chronic joint diseases such as inflammatory rheumatism (rheumatoid arthritis) are constantly sleeping badly. In Bechterew’s disease, low back pain in the early morning is typical and often trendsetting. Tendinitis and tumors in the bones and joints prove to be painful and exhausting . However, some medications for the treatment of inflammatory joint disease may also lead to sleep disorders.

Symptoms : Joint and muscle pain often prevent them from falling asleep or wake them up at night, for example, when the diseased joint gets into an unfavorable position when lying down. In addition, there are the typical symptoms of the respective disease, such as short-term morning stiffness in the joints in osteoarthritis, tensing, limited mobility, swelling of the joint .

In rheumatoid arthritis, morning stiffness lasts longer. Other common symptoms include inflammatory swelling, weakness, tiredness and fever. In Bechterew’s disease, low back pain often causes premature wakeup in the morning. These are often the first significant complaints.

Diagnosis and therapy : If the medical history indicates a joint disease, the physician will initiate the respective examination steps. After a confirmed diagnosis, the treatment is focused on the underlying disease. Prepare the sleep problems problems, the doctor also takes into account when choosing the medication. For example, in the case of arthritis, he will be careful to use an active ingredient that does not in turn increase sleep problems, or he prescribes suitable combinations.

Find out more about the causes, symptoms, diagnosis and therapies of various joint and muscle diseases in the guidebooks “Back Pain” , “Rheumatoid Arthritis” and “Osteoarthritis”.


Wear on the knees, hips and hands is almost a part of everyday life in the second half of life, but can also affect younger people

Fibromyalgia syndrome: sleep disorders as a major symptom

Another symptom associated with muscle and joint pain is fibrositis or fibromyalgia syndrome. This disease manifests itself in muscle and joint pains as well as in many other ailments. The exact cause is not yet clear. New research suggests that fibromyalgia sufferers have damaged small nerve fibers that end up in the skin. Among other things, these so-called small fibers transmit pain sensations. Fibromyalgia syndrome is common in some families. Much more women are affected than men. In addition, the clinical picture often causes depression , but not always.

READ  Sleep Disorders: Restless legs and other movement disorders during sleep

Symptoms : Those affected have chronic pain in certain areas, such as the back, neck , shoulder, arms, or legs. Often, swelling and morning stiffness come to it. Sleep disorders, especially sleep disorders, are among the hallmark symptoms. The patients feel exhausted during the day but can not fall asleep in the evening, despite their tiredness. Other complaints include difficulty concentrating, headaches, excessive sweating , gastrointestinal problems and often depressive moods and fears.

Diagnosis : A pathological physical change, such as rheumatism, can not be demonstrated in laboratory medical examinations or in imaging techniques. The doctor will also consider possible drug revenues in an exclusion diagnosis. Notes give the physician the leading symptoms such as pain, tiredness and sleep disorders. Comprehensive psychological diagnostic procedures complete and consolidate the diagnosis.

Therapy : The treatment always includes the physical, the social and the mental side. These include comprehensive strategies for coping with pain , relaxation techniques, exercise training, psychotherapeutic procedures, especially cognitive behavioral therapy . Depending on how pronounced the disease is, doctors use medicines primarily as antidepressants. The remedies can also make it easier to fall asleep and sleep through without being addicted to other sleep aids (see also chapter “Medication, sleep aid” ). The doctor only selects additional medicines as needed, very specifically and for a limited time. Painkillers are often not suitable.

Further information can be found in the guide “Fibromyalgia syndrome”.

Months of pain in multiple parts of the body? Cause can be a fibromyalgia. More about diagnosis and treatment of fibromyalgia syndrome (FMS)

Headache, Migraine: Nocturnal sleep attacks

Certain forms of headache and migraine attacks often occur at night during one of the sleep phases, often in REM sleep. Migraine can also disturb the deep sleep phases. People who suffer from migraine are particularly sensitive to a change in their sleep-wake cycle. Anyone who sleeps shorter during the week and gets up earlier, but wants to sleep at the weekend, often has to fight more with migraine attacks. On the other hand, if the nights are regularly long or short, it will improve the discomfort.

Experts are largely agreed that migraine emanates from the central nervous system and thereby nerve agents such as serotonin play a role. The energy exchange between the nerve cells is susceptible to interference, and of course also during sleep. Thus, migraine and various forms of headache are also among the neurological disorders (see following section). A familial predisposition is likely in migraine.

Symptoms : Breathing difficulties and too early waking up due to severe headaches, often at night or early in the morning. In a migraine, nausea, vomiting, noise and light sensitivity and one-sided emotional disorders , such as on the face or on the hands, can be added.

Diagnosis : The symptoms give the doctor important information, whether it is tension headache, cluster headache or migraine. He will do an in-depth physical examination. Often he also initiates examinations with a neurologist, for example, an electroencephalogram, which records the brain waves. If necessary, the neurologist also examines the brain vessels supplying with ultrasonic (Farbduplex- sonography ), and sets, depending on the suspected Another imaging method a, as a computed tomography (see below section “Neurological disease”).

Therapy : The treatment depends on the type of headache. The goal is sustainable pain management, which includes not only a behavior therapy but also the appropriate use of drugs. Relaxation techniques and a healthy lifestyle support the medical measures and also help to improve the sleep problems (see also chapter “Therapy and self-help” ). Since some migraine remedies can also lead to insomnia, the doctor will adjust his prescriptions accordingly.

You can learn more about the different types of headaches as well as about causes, symptoms, diagnosis and therapies in the guidebooks “Headache” and “Migraine”.

Neurological disorders: False nerve signals disturb the sleep rhythm

During sleep, the nerve cells (neurons) in the brain are highly active and perform essential functions. Temporary influences or chronic illness disturb these activities and thus also the regular course of the sleep phases. Nervous diseases often cause insomnia. The majority of Parkinson’s suffer from sleep problems. Likewise, in other, less common diseases, where neurons in the brain die, sleep disorders occur. Physicians also count inflammation of the brain, such as multiple sclerosis , or brain tumors to other possible triggers.

Illnesses that affect nerves and muscles lead to progressive muscle weakness . These neuromuscular diseases include so-called muscular dystrophies or muscle atrophies. At night, it comes increasingly to respiratory problems, since the relevant muscle functions are limited.

Symptoms of these illnesses : difficulty sleeping and staying asleep as well as waking up early, often due to nocturnal movement disorders, such as the legs, respiratory distress, muscle aches and cramps. Parkinson’s patients, for example, wake up again and again from deep sleep, because they can not turn around because of lack of mobility. They sweat at night and often have problems with the bladder. Tension pain often prevents them from falling asleep.

In addition to the symptoms typical for the individual clinical pictures, such as different movement disorders, the cerebral diseases mentioned usually lead to increased daytime tiredness, concentration problems, depressive moods. Accompanying depression and anxiety often add to sleep disorders.

Diagnosis and treatment: The family doctor will refer his patient to a neurologist if there is a suspicion of a brain disease or a problem in the interaction of nerves and muscles. In-depth neurological examinations, which include, above all, imaging procedures, consolidate the diagnosis.

The treatment depends on the underlying disease. Within the individual treatment strategies, the physician will consider existing sleep problems. Partly he uses anti-depressants, which also improve the quality of sleep.

Further information can be found in the guidebooks “Parkinson’s disease (Parkinson’s disease)”, “Multiple sclerosis (MS)”, “Brain tumors”.

– Stroke: Help immediately!

A cerebral infarction can occur when diseased, “clogged” or torn blood vessels or other disorders hinder or prevent the circulation in a brain area. The affected nerve cells suffer from acute oxygen and nutrient deficiencies. Sometimes they are also blocked by bleeding in their function. Depending on the extent of the damage, different body functions are impaired. Breast disorders in particular cause sleep victims to sleep worse at night. Many sufferers suffer from sleep apnea, which in turn is a risk factor for strokes and heart attacks. The respiratory problems after a stroke occur due to paralysis or loss of function in the responsible muscles.

A stroke is an emergency that must be treated immediately in the hospital, preferably in a hospital with a stroke unit . The further diagnosis and therapy follows the corresponding guidelines and is individually tailored to the needs of the patient.

Find out more about warning signs, diagnosis and therapy in the guide “Stroke (Apoplex)”.


What exactly is a stroke and how do you recognize it? Causes, symptoms, possible consequences and first aid measures

– Polyneuropathy: Diabetes attacks the nerves

Nerve disorders are among the possible complications of diabetes. Diabetic polyneuropathy primarily affects the nerve tracts in the legs and feet, but also in the arms and hands. Pain, tingling, sensitivity to touch and calf cramps put a strain on sleep . It may also affect the autonomic nervous system, which controls, among other things, cardiac activity, circulatory functions, digestion, respiration and sweat production.

Find out in detail about diabetes illnesses as well as possible consequences in the guidebooks “Diabetes Type 1” and “Diabetes Type 2” on our partner portal

– Chronic Fatigue Syndrome (CFS)

Physicians classify this multi-layered complaint complex now internationally as an independent clinical picture within the group of neurological diseases. It is characterized by a state of prolonged extreme fatigue accompanied by numerous other symptoms. Women are more likely to become ill than men. The causes are not clear yet. A genetic predisposition, the consequences of infections with certain viruses, an altered immune situation may play a role. The symptoms often start suddenly, for example after heavy physical exertion or after an infection, for example after a Pfeiffer’s glandular fever . They then stop for several months. Sometimes the disease also develops slowly, the symptoms become stronger over time.

Symptoms : The disease often begins acutely with headache, muscle and joint pain. Also typical are sore throat , swollen, achy lymph nodes, muscle weakness and sleep disorders. Even if they rest for a long time, CFS sufferers are not much better off after that. Sometimes fatigue spreads gradually. The constant depressing tiredness makes daily life very difficult. Those affected often also suffer from concentration problems and memory problems . Many of them develop anxiety and depression. Stress and physical stress can worsen the symptoms.

Diagnosis and Therapy : The complaint pattern provides important clues. The doctor initially excludes other organic or mental illnesses. The treatment includes a series of measures based on the individual condition. These include behavioral and exercise therapies as well as possibly pain therapies. The patients learn to balance stress and recovery times in the right measure for each other. A fatigue syndrome often heals completely after some time.

Read more in the guide “Tiredness – Chapter: Chronic Fatigue Syndrome “.

Constant tiredness sometimes also indicates certain illnesses or a chronic fatigue syndrome

– Dementia: sleep changed sustainably

People who suffer from Alzheimer’s disease or another form of dementia often have marked sleep disorders. The changes in the brain lead to falling asleep and sleep problems and impair deep sleep. Often the REM sleep is particularly lively. Violent dreams, illusions and delusions not only make those affected often startle their sleep, they also often get up in the middle of the night and wander about. Some also suffer from marked daytime sleepiness and sleep significantly more during the day (hypersomnia).

Dementia requires a special diagnosis, therapy and support. Lots of daytime and sunlight, firm sleep rules, relaxation exercises and possibly behavioral support often relieve persistent sleep problems.

Find out more about dementia in the guide “Alzheimer’s disease”.

Alzheimer’s disease is considered the most common cause of dementia. Symptoms: memory loss, orientation problems, sleep disorders

Hormonal dysfunction, metabolic disorders: Sleep is also out of balance

Hormones significantly influence our sleep-wake cycle. Hormonal fluctuations and disturbances therefore often have a significant effect on the quality of sleep.

– Hormone disorders

Many women sleep worse during menopause when the hormone balance changes. This change is partly noticeable in physical and emotional complaints. Some suffer from nocturnal sweats, inner restlessness, depressive moods. But even younger women sometimes have to do with the menstruation and during pregnancy with sleep problems.

Such sleep disorders usually go by and can be well controlled with a healthy, sleep-friendly lifestyle (see chapter “Therapy and self-help”).

– Hyperthyroidism

Sleep disorders are among the typical symptoms of hyperthyroidism (hyperthyroidism). The thyroid gland produces essential hormones for our body, which are indispensable for many processes in the organism. Among other things, they influence the central nervous system, the cardiovascular system, digestion, the psyche and much more. In case of an over-function the thyroid gland forms too much thyroid hormone.

Symptoms : In addition to insomnia are other characteristic complaints inner restlessness and restlessness, changing moods, irritability, rapid heartbeat, sometimes heart hunts and heart stumbling. Also, gastrointestinal problems often occur, such as a tendency to abdominal pain , diarrhea . Often a physical restlessness, shaking hands, weakness in the muscles, aversion to heat, hair loss come to it. Typical is cravings with simultaneous weight loss.

Diagnosis and therapy : According to the medical history, the doctor receives first information through a blood test. If necessary, further examinations, such as ultrasound or thyroid scintigraphy, follow . With the treatment of thyroid disorder, usually with drugs that normalize hormone production, improve the sleep problems.

Read more about it in the guide “Hyperthyroidism (hyperthyroidism)”.

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