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What’s Keeping You Up?

Reviewed By: Steven A. King, M.D.

What's keeping you up?Sleeping difficulty isn’t just an annoyance. Sometimes it signals a medical issue. With proper treatment for these three common conditions, you might be able to end your insomnia.

The inability to sleep can leave you depressed, but the opposite is also true: Depression can make it hard to sleep. People suffering from depression can have trouble falling asleep, staying asleep or attaining the most restorative and restful stage of sleep. They are also five times more likely to suffer from sleep apnea, according to a Stanford University study, but treating that condition with a CPAP (continuous positive airway pressure) machine may improve the symptoms of depression.

Any kind of chronic pain, be it from fibromyalgia, cancer or arthritis, can make it hard to sleep. But the reverse is also true: Not getting enough sleep can exacerbate the pain. “Research has shown that if you disturb sleep, even in a healthy, young, normal adult who has no sleep problems, you lower their tolerance for pain,” says Gary Richardson, M.D., researcher with the Henry Ford Sleep Disorders and Research Center in Detroit. Getting treatment for your pain can help you sleep better at night and sleeping better can reduce daytime pain.

The hormonal changes and hot flashes brought on by menopause can interrupt sleep, but so can snoring and sleep apnea, which become more common as estrogen levels fall during and after “the change.” And insomnia doesn’t always go away once the symptoms of menopause do, says psychologist Shelby Freedman Harris, Psy.D., director of the Behavioral Sleep Medicine Program at Montefiore Medical Center’s Sleep-Wake Disorders Center in New York City. “One of my patients went through menopause 20 years ago and is seeking help now because she says her insomnia didn’t go away,” Dr. Harris says. “At this point it’s not about the menopause. The problem is, to cope with the menopause the patient became used to going to bed early, staying in bed later, napping. All these things actually keep the insomnia going long after menopause is over.”

Other Causes
Sleep apnea, frequent urination, acid reflux and certain medications, including beta blockers and sinus drugs like pseudoephedrine, can also contribute to a tough night’s sleep. If any of these are making it hard for you to feel rested, talk to your doctor about treatment options.




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