Sleep disorders

A sleep disorder (also called a sleep-wake disorder) is a condition that consistently interferes with how you sleep. This usually involves having difficulty falling asleep, staying asleep, or getting enough quality sleep. Some disorders can cause you to sleep too much. Sleep disorders often occur alongside other medical issues, such as heart disease, obesity, and anxiety.  

Sleep disorders can affect two types of sleep:

• Rapid eye movement (REM) sleep: This type makes up around 25 percent of sleep and is when most dreaming happens.
• Non-REM (NREM) sleep: This involves three stages of sleep, including the deepest part of slumber.

In general, when a person falls asleep, they experience three NREM stages followed by REM sleep. This process is called a sleep cycle. One sleep cycle usually lasts between 90 and 120 minutes. Most people who get 8 hours of sleep go through four or five sleep cycles during that time.  

Sleep disorders may also interfere with your circadian rhythm. This refers to the 24-hour schedule that your body follows, also known as your internal body clock. If you sleep at night, a chemical known as adenosine steadily increases in your brain during the day and peaks in the evening. Adenosine ordinarily helps prepare the body for sleep. Then, as you sleep, the body breaks down adenosine, reducing its levels, and the cycle starts over the next day.

Other factors such as exposure to darkness and light influence your circadian rhythm and tell your brain when it’s time to sleep and wake up.

Why is sleep important?

Sleep is a basic biological need, just like breathing and eating. You may be unconscious during sleep, but your body is at work. Complex biological processes—many of which researchers are still trying to understand—are taking place to prepare your mind and body for another day.  

Getting adequate sleep helps:

• Support healthy brain function
• Facilitate growth and development in children and teenagers 
• Strengthen the immune system, which helps the body resist infection and illness
• Regulate hormones that control whether you feel full or hungry
• Repair heart tissue and blood vessels
• Lower your risk of various medical conditions, such as high blood pressure (hypertension), type 2 diabetes, and heart disease  

In addition to the physical health benefits, good sleep allows you to function better mentally. You’re more likely to be productive at work or learn more at school. With restful sleep, you’ll be better equipped to regulate your emotions, interact with others, and make smart decisions. Sleeping well also reduces your chances of getting in an accident, such as a fall or car crash.

How much sleep do I need?

How much sleep a person needs will depend on their age. The Centers for Disease Control and Prevention (CDC) offers the following age-based guidelines for daily sleep:

• Newborns (ages 0 to 3 months): 14 to 17 hours  
• Infants (ages 4 to 12 months): 12 to 16 hours, including naps
• Toddlers (ages 1 to 2 years): 11 to 14 hours, including naps 
• Preschool children (ages 3 to 5 years): 10 to 13 hours, including naps
• School-aged children (ages 6 to 12 years): 9 to 12 hours
• Teens (ages 13 to 17 years): 8 to 10 hours
• Adults (ages 18 to 60): 7 or more hours
• Adults (ages 61 to 64): 7 to 9 hours
• Adults (ages 65 and older): 7 to 8 hours

In general, most HCPs advise adults to get between 7 to 9 hours of sleep daily. Dealing with issues like sickness, stress, or sleep deprivation (lack of sleep) may mean you occasionally need more than 9 hours of sleep at a time. Consistently sleeping for more than 9 hours, however, is associated with an increased risk of health issues stroke, obesity, and depression.

How common are sleep disorders?

Between 50 and 70 million people in the U.S. have a chronic sleep disorder. Research suggests that many sleep disorders are on the rise.

Sleep health in the U.S. is generally poor. A significant percentage of adults and children fail to get enough sleep, even if they don’t have a sleep disorder. Many people simply don’t allow enough time for sleep.

According to a CDC survey conducted between 2013 and 2022, insufficient sleep was reported among:

• 36.1 percent of adults (ages 18 and older)
• 77.3 percent of high school students
• 35 percent of children (ages 4 months to 14 years)

In one large 2022 survey, just 32 percent of people in the U.S. reported getting “very good” or “excellent” sleep.

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Different sleep disorders can cause different symptoms. In general, though, having a sleep disorder means you don’t get enough quality sleep. Sleep deprivation can result in:

• Daytime sleepiness
• A frequent urge to nap
• Trouble focusing or paying attention
• Difficulty solving problems, making decisions, or finishing tasks
• Increased forgetfulness 
• Decreased performance at work or school
• More frequent falls or accidents
• New or worsening feelings of anxiety or depression
• Unusual irritability or difficulty controlling emotions

In children, symptoms of sleep disorders often involve increased irritability, fussiness, and periods of hyperactivity. 

Other signs and symptoms are specific to various types of sleep disorders (see below).

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There are more than 80 different types of sleep disorders. These fall into six main categories:

• Insomnia disorders: These involve having difficulty falling or staying asleep.
• Circadian rhythm disorders: These interfere with a person’s normal sleep-wake cycle.  
• Hypersomnia disorders: These make it difficult to stay awake during the day.
• Parasomnia disorders: These involve unusual behaviors during sleep, such as talking, walking, or eating. 
• Sleep-related movement disorders: These involve physical urges or movements that interrupt sleep.
• Sleep-related breathing disorders (also called sleep-disordered breathing): These disrupt how a person breathes during sleep. 

Some of the most common types of sleep disorders include:

Insomnia

Having trouble falling asleep or staying asleep is called insomnia. It’s the most common sleep disorder. Many people experience short-term insomnia at some point in their lives due to factors like stress, trauma, jet lag, illness, or a busy schedule. In fact, around one-third of adults in the U.S. report experiencing symptoms of insomnia.

The main signs and symptoms of insomnia include:

• Difficulty falling asleep
• Waking up during the night  
• Waking up unusually early 
• Excessive daytime sleepiness (feeling very tired throughout the day) 
• Frequently worrying about getting enough sleep

Chronic insomnia persists for three months or longer. Various factors can lead to chronic insomnia, including but not limited to:

• Aging
• Frequent stress
• Changes in schedule, routine, sleep habits, or health
• Using nicotine, caffeine, or alcohol too close to bedtime
• Genetics (the traits you inherit from your parents)
• Taking certain medicines (including some antidepressants and blood pressure medications)
• Having certain medical conditions (such as asthma, heart disease, or an overactive thyroid)

The American Psychiatric Association estimates that 40 to 50 percent of people with insomnia also have a mental health condition, such as post-traumatic stress disorder (PTSD), anxiety, or depression.

Insomnia treatment may involve medication, lifestyle changes, cognitive behavioral therapy (a form of talk therapy also known as CBT), or a combination of these approaches. Most cases of insomnia can be cured or improved with treatment.

Sleep apnea

Sleep apnea is a common sleep-related breathing disorder that causes pauses in breathing during sleep. These pauses usually last from 10 to 20 seconds and occur between five and 100 times (or more) per hour. Because the brain awakens slightly when breathing is paused, sleep apnea prevents someone from achieving deep, restful sleep—even if they seem to be sleeping consistently or getting 7 to 9 hours of sleep.

The American Medical Association estimates that around 30 million people in the U.S. have sleep apnea, but only 6 million are diagnosed. Signs and symptoms of sleep apnea can include:

• Loud snoring during sleep
• Choking or gasping sounds during sleep
• Waking up throughout the night, often gasping for air 
• Headache or dry mouth upon waking  
• Excessive daytime sleepiness

Most people with sleep apnea have obstructive sleep apnea (OSA), which occurs when muscles in the back of the throat become too relaxed and collapse, blocking airflow during sleep. Much less commonly, central sleep apnea occurs when the brain doesn’t transmit signals to the muscles that facilitate breathing during sleep.

Anyone can experience sleep apnea, though it most often affects people with overweight or obesity, older adults, and men and people assigned male at birth (AMAB). If left untreated, sleep apnea can increase the risk of heart disease and worsen heart failure. It’s also linked to type 2 diabetes and sudden cardiac arrest.

Treatment for sleep apnea generally involves losing excess weight (if appropriate) and using a continuous positive airway pressure (CPAP) machine. A CPAP machine is a wearable device that helps prop open the airway during sleep.

Mild cases of sleep apnea may be improved with oral devices that keep the tongue or jaw in a certain position during sleep. Less commonly, surgery may be recommended for people with obstructive or central sleep apnea.

Restless legs syndrome

Restless legs syndrome (RLS or Willis-Ekbom disease) is a sleep-related movement disorder that affects as much as 10 percent of the U.S. population. It’s characterized by uncomfortable sensations in the lower body and an intense urge to move the legs and walk around. These sensations may last for an hour or more and usually occur when resting or trying to sleep. Getting up and moving temporarily relieves the discomfort.

Someone with restless legs syndrome may experience a tingling “pins and needles” feeling in their feet or a sensation in their legs that may be described as:

• Itching
• Gnawing
• Burning
• Aching or throbbing 
• Crawling
• Bubbling
• Tugging or pulling

It’s also possible to experience these sensations in the arms. Restless legs syndrome symptoms tend to worsen in response to stress or strong emotions. They may also be worse or occur more frequently in older adults. Anyone can develop restless legs syndrome, though it affects women and people assigned female at birth (AFAB) more often.

Additionally, restless legs syndrome may occur more frequently in people who are pregnant or have certain medical conditions, including Parkinson’s disease, diabetes, multiple sclerosis, and chronic kidney disease. Low levels of iron or dopamine (a chemical that affects movement) in the brain may also play a role in the condition.

More than 80 percent of people with restless legs syndrome also have a condition called periodic limb movement of sleep (PLMS). This causes involuntary leg or arm movements (such as jerks or twitches) that may occur every 15 to 40 seconds during sleep.

Restless legs syndrome is a lifelong condition that can be improved or managed with treatment. Many restless legs syndrome treatment plans include medication and behavioral changes, such as:

• Cutting out caffeine, alcohol, and nicotine
• Relaxing muscles before bed with stretches or a warm bath
• Keeping a regular sleep routine

Sleep bruxism

Sleep bruxism, or teeth grinding, is a common type of sleep movement disorder. Someone with bruxism may unknowingly clench their jaw and grind their teeth as they sleep. The condition is often accompanied by other sleep issues, such as sleep apnea and snoring.

In addition to teeth grinding, symptoms of bruxism include:

• Chipped, cracked, loosened, flattened, or worn teeth
• Jaw or neck pain
• Jaw tightness or an inability to fully open or close the jaw
• Facial soreness
• A dull headache that originates around the temples
• Worsening tooth sensitivity or pain
• Ear pain  

Factors like stress, anxiety, alcohol use, caffeine use, and smoking can contribute to bruxism, as can having epilepsy, ADHD, and Parkinson’s disease. Bruxism can also run in families.   

Treatment for bruxism often involves wearing a mouthguard during sleep. Treating underlying conditions such as anxiety and managing stress can also help ease teeth grinding and improve symptoms.

Shift work sleep disorder

Shift work sleep disorder is a type of circadian rhythm disorder that affects people who work nontraditional hours, such as night shifts, early-morning shifts, or rotating shifts. Between 10 and 40 percent of workers with such hours are estimated to have shift work sleep disorder.

Shift work sleep disorder occurs when a person’s work hours don’t line up with their internal body clock. For example, someone who works a night shift will need to sleep during the day, when the sun is out. Sunlight tells your brain that it’s time to wake up and sets in motion various biological processes that spur your body to become active. This can make it difficult to sleep well during the day.

Having a rotating schedule also makes it difficult to establish and follow a set sleep schedule, which is an important part of achieving consistent, refreshing sleep. 

Common signs and symptoms of a shift work sleep disorder include:

• Insomnia, which often occurs in people who work between 4 a.m. and 7 a.m.
• Sleepiness at unwanted times, which may be more common in people who work night or early-morning shifts

Improving shift work sleep disorder focuses on helping to match a person’s body clock with their work schedule. This may include taking medications or supplements to promote sleep, avoiding sunlight when sleeping during the day, or using bright light therapy (strategically timed exposure to light) upon waking up.

Narcolepsy  

A type of hypersomnia disorder, narcolepsy causes sudden, uncontrollable sleep. A person with narcolepsy may fall asleep while eating, speaking, walking, or driving. (This is sometimes described as a “sleep attack.”) Sleep attacks may occur several times a day and last a few minutes or hours at a time. In between sleep attacks, someone may feel rested and energized.

Narcolepsy is uncommon, affecting around 37 per 100,000 people in the U.S. Symptoms of narcolepsy can occur at any age but tend to first develop between the ages of 7 and 25. In addition to uncontrollable periods of sleep, other possible narcolepsy symptoms include:

• Excessive daytime sleepiness
• Insomnia
• Sleep paralysis (an inability to move or speak for a few seconds or minutes when falling asleep or waking up)
• Hallucinations (temporarily seeing vivid images that aren’t real) when falling asleep or waking up  
• Cataplexy (a sudden loss of muscle tone and voluntary muscle control while awake, often in response to strong emotions)

Type 1 narcolepsy refers to narcolepsy that includes cataplexy. Type 2 narcolepsy, which is much more common, does not involve cataplexy.

A person with narcolepsy enters REM sleep—the stage of sleep when dreaming takes place—much faster than someone without narcolepsy. The exact cause of narcolepsy is unclear, but low levels of a brain chemical called hypocretin is likely to blame for type 1 narcolepsy. Factors that may play a role in hypocretin levels include brain injuries, genetics, and autoimmune disorders (disorders that cause the immune system to mistakenly attack healthy cells).

Narcolepsy is a lifelong condition. Treatments like medication and behavioral changes (such as taking regularly scheduled naps) can help reduce symptoms.

Idiopathic hypersomnia  

Idiopathic hypersomnia causes sleepiness during the day and is similar to narcolepsy. But unlike narcolepsy, idiopathic hypersomnia doesn’t involve sleep attacks or cataplexy.

Symptoms of idiopathic hypersomnia tend to develop slowly in adolescence or young adulthood. They may include:

• Difficulty waking up or experiencing a strong urge to go back to sleep (sleep drunkenness)
• Sleeping for long periods at a time (10 hours or longer) but feeling unrefreshed
• Excessive daytime sleepiness, even after napping
• Grogginess  

The cause of idiopathic hypersomnia is unclear. (“Idiopathic” describes something with an unknown cause). Some researchers believe the condition is linked to brain damage, infection, or low levels of histamine in the brain. (Histamine is a chemical that plays a role in allergic reactions.)  

Treatment can help improve idiopathic hypersomnia symptoms and increase energy levels. Most idiopathic hypersomnia treatment plans involve taking medication and implementing healthy sleep habits, such as sticking to a set sleep schedule and avoiding or limiting alcohol and caffeine.

REM sleep behavior disorder

REM sleep behavior disorder (RBD) is a type of parasomnia that involves acting out dreams. Dreams occur during the REM stage of sleep, which typically takes place around 90 minutes after falling asleep and lasts for around 10 minutes. Most people go through multiple REM cycles during a typical 8 hours of sleep.

RBD generally involves physically or vocally acting out a dream. For instance, if a person dreams about playing in a baseball game, they may make the motion of swinging a bat, jump out of bed to run the bases, and shout for joy after crossing home plate. Someone with RBD will likely be able to remember details of this dream upon waking.

A person may experience up to four RBD episodes per night based on how many REM cycles they enter. Episodes of RBD may become more physically active or even violent over time. Without treatment, many people with the condition end up accidentally injuring themselves or their bed partner.

RBD is rare, affecting around 1 percent of the U.S. population. It’s most common in adults older than 50 and men and people AMAB. Having a certain type of RBD (called isolated RBD) significantly increases the risk of neurodegenerative disorders like Parkinson’s disease and Lewy body dementia. (Neurodegenerative disorders are those that involve progressive deterioration of the brain.)

Secondary RBD, which has an underlying cause, is considered a side effect or symptom of narcolepsy, Parkinson’s disease, or antidepressant use. RBD that’s related to medication is called drug-induced RBD.

Treatment for RBD generally involves taking medication, improving sleep habits, and implementing safety precautions to avoid injuries. This may include removing weapons or sharp items from your bedroom or sleeping with a large pillow between you and your bed partner, if you have one.

Sleepwalking

Sleepwalking (somnambulism), like RBD, is a form of parasomnia. But it differs from RBD in that it does not involve dream reenactments. Unlike RBD, sleepwalking usually causes a person to open their eyes and leave the room they’re sleeping in.

Sleepwalking is common in children, and it’s not unusual for adults to experience it on occasion. But frequent sleepwalking could indicate a sleep disorder. Someone who sleepwalks may:

• Be unresponsive to others
• Have a glazed-over expression
• Mumble
• Be difficult to wake up
• Have no memory of sleepwalking after waking up
• Be confused or sometimes violent after waking up
• Have sleep terrors, which may cause them to shout or flail their arms or legs   
• Perform routine activities or display odd behaviors while sleepwalking, such as rearranging furniture  

Various factors can contribute to sleepwalking in adults, including alcohol use, stress, travel, fever, sleep deprivation, other sleep disorders, and gastroesophageal reflux disease (GERD). Sleepwalking may also be a side effect of certain medications, including sedatives and antidepressants.

Treatment for sleepwalking usually involves addressing underlying conditions and adjusting medications. Therapy, hypnosis, and anticipatory awakening (setting an alarm a few minutes before sleepwalking typically begins) can also be helpful.

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It’s a good idea to speak with an HCP if you have trouble sleeping or are experiencing possible symptoms of a sleep disorder. It’s especially important to seek medical care if your symptoms are affecting your ability to function as you normally would or if they involve physically acting out your dreams. (This is a sign of REM sleep behavior disorder, which can potentially lead to physical injury.)

If left untreated, sleep disorders may contribute to or worsen serious health issues like high blood pressure, heart disease, obesity, and depression.

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The cause of a sleep disorder can vary depending on its type. Often, sleep disorders are linked

to a combination of factors, including:

Underlying medical conditions: These may include nerve disorders, dementia, heart disease, diabetes, lung disease, asthma, and conditions that cause ongoing pain (such as osteoarthritis).

Mental health issues: These may include depression and anxiety disorders.

Genetic factors: Having a family history of sleep disorders or inheriting certain genetic mutations (abnormal changes in genes) can contribute to a sleep disorder.

Substance use: Using caffeine, alcohol, or nicotine too close to bedtime can contribute to sleep issus.

Nontraditional work hours: Night shifts or rotating shifts can disrupt a person’s circadian rhythm.

Low amounts of certain minerals or chemicals in the brain: These may include iron or dopamine (in the case of restless legs syndrome) or hypocretin (in the case of type 1 narcolepsy).

Certain medications: A variety of medications may cause sleep issues as side effects. These include certain types of:

• Antidepressants
• Decongestants
• Beta blockers (used to treat high blood pressure and arrhythmias)
• Steroids (used to lower inflammation)
• Smoking-cessation drugs

Some sleep disorders have specific causes. For instance, many cases of obstructive sleep apnea are a direct result of obesity. (Deposits of body fat around the neck that can impede airflow during sleep). Often, however, the precise cause of a sleep disorder is unknown.

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Several factors can make you more likely to develop a sleep disorder, including:

Age: Sleep disorders become more common with age. Around half of people over age 65 have a sleep disorder.

Sex assigned at birth: Overall, women and people AFAB are more likely than men and people AMAB to experience a sleep disorder. Hormonal changes can play a role in insomnia, for example, notably during a person’s menstrual cycle, pregnancy, and menopause.  

Frequent stress: Experiencing chronic stress can disrupt sleep and increase the risk of sleep disorders. Your body releases a hormone called cortisol in response to stress, which can affect the sleep-wake cycle.

Changes in routine: Big changes such as switching jobs, traveling, moving to a new city, or changing your work schedule can disrupt your normal sleep pattern and make you more vulnerable to sleep disorders.

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If your HCP suspects you may have a sleep disorder, they’ll begin by performing a physical exam and asking you questions about your sleep habits, symptoms, medical history, and what medications or supplements you’re taking, if any.

Your HCP may also ask you to keep a sleep diary to gather more information about your sleep habits. This involves taking note of when you fall asleep and wake up every day, as well as any sleep disturbances you experience, naps you take, and how the amount and quality of your sleep affects how you feel. You would also typically record other factors that may influence your sleep, such as caffeine consumption, stressful events, and exercise.

Wearable smart devices (such as smartwatches) that track sleep cycles can help you keep a more detailed sleep diary. If you don’t have such a device, your HCP may provide you with an actigraph. This small, wearable device resembles a wristwatch and records your movement during sleep. A lack of movement is noted as sleep, while movement is noted as an interruption in sleep. Information collected by the actigraph device will be evaluated by your HCP.

An HCP may make a sleep disorder diagnosis based on the details of a person’s exam and sleep diary. In other cases, your HCP may recommend a sleep study to gather more information and confirm or rule out a sleep disorder diagnosis.

What is a sleep study?

A sleep study (also called polysomnography) is used to help diagnose sleep disorders. This painless, noninvasive test measures several body functions as a person sleeps, including:

• Brain waves
• Breathing rate
• Heart rate
• Eye movements
• Leg movements
• Blood oxygen level

There are several types of sleep studies. Some are performed overnight in a hospital or sleep clinic. Sleep studies that are used to diagnose sleep apnea may be done at home.  

During a sleep study at a hospital or sleep clinic, you’ll spend one night in a private room with a bed. This room may have cameras to record how you move during sleep. Before the test begins, a specially trained technician will place small, sticky disks (called electrodes) on your eyelids, chin, chest, and legs to monitor for body functions that could indicate a sleep disorder.

These electrodes are attached to a computer that collects information. A small clip (called a pulse oximeter) will also be placed on your finger to record your blood oxygen levels as you sleep. Specially trained technicians will evaluate your heart rate, breathing, muscle movement, and other functions while you sleep and assess the information at the end of the sleep study.

During a home sleep study, your HCP will provide you with equipment and instructions to follow. Most home sleep studies involve placing electrodes on certain parts of your body. These electrodes are attached to a small monitoring device that records body functions as you sleep.

When you wake up, you’ll take off the electrodes and return the equipment to your HCP. In some cases, the sleep monitoring device will directly relay your sleep data to your HCP.

Your HCP will provide you with information on how to prepare for your sleep study. You’ll likely need to avoid napping or drinking caffeine or alcohol in the hours before your test. Products like hair gel, makeup, and lotions can interfere with electrode function during a sleep study and should be avoided.

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Asking your HCP questions can help you better understand your condition and make educated treatment decisions. If you have questions or concerns about your diagnosis, don’t hesitate to share them. There are no silly questions when it comes to your health.

Some common questions about sleep and sleep disorders include:

• How much sleep do I need?
• What type of sleep disorder do I have?
• What do you think caused the sleep disorder?
• Is the sleep disorder serious? What is my prognosis (expected outcome)?
• What are my sleep disorder treatment options? Can you explain the possible side effects of treatment? 
• How can I improve my sleep health?
• How long does it take to treat a sleep disorder?
• Should I stop taking certain medications?
• Am I at risk for sleep disorder complications?
• How often should I have follow-up appointments?  
• Could I benefit from speaking with a licensed mental health provider?

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A sleep disorder may be treated by a primary care provider, mental health provider, or a sleep medicine specialist (a medical doctor who specializes in diagnosing and treating sleep disorders). In general, the main goals of sleep disorder treatment are to:

• Reverse or reduce the severity of the sleep disorder
• Improve sleep health
• Prevent sleep disorder complications

Sleep disorder treatment often involves a combination of approaches. Depending on your condition, your sleep disorder treatment plan may include:

Developing healthy sleep behaviors

Implementing healthy sleep behaviors—known as sleep hygiene—is an essential part of improving the duration and quality of your sleep. You can achieve better sleep hygiene by taking these steps:

Go to bed and wake up around the same time every day. Establish a sleep schedule that is consistent across workdays, school days, and days off and adhere to it as best as you can. Remember, adults should allow for 7 to 9 hours of sleep daily.

Start winding down one hour before bedtime. Put your smartphone away and turn off the TV. Bright, artificial light from these devices tells your brain it’s time to wake up. To help you relax, take a warm bath or shower, read a book, or do some gentle stretches. Try to take care of stressful tasks earlier in the day to promote relaxation in the evening.

Spend time outdoors when possible. Research shows that exposure to natural daytime sunlight can help improve the quality of your sleep as well as your mood. One 2021 study published in Journal of Affective Disorders found that increased time spent in outdoor light was associated with better sleep and a lower lifetime risk of major depressive disorder.

Exercise regularly. Getting enough physical activity during the day can improve your sleep as well as your overall health. (Just avoid exercising within four hours of bedtime, if possible.) The CDC advises most adults to get at least 150 minutes of moderate-intensity exercise (such as brisk walking) per week.  

Avoid large meals and certain substances before bedtime. Don’t eat a large meal, drink alcohol, or use nicotine within a few hours of bedtime. It’s also important to avoid drinking caffeinated beverages (such as coffee, tea, soda, and energy drinks) in the afternoon or evening, as the stimulating effects of caffeine can linger for up to 8 hours. 

Optimize your environment for sleep. Keep your bedroom dark, quiet, and cool when it’s time to sleep. Set an alarm if necessary but keep all clocks out of view. Keeping your eye on a clock as you try to fall asleep can contribute to anxiety and may make it harder to fall asleep.

Research shows that warmer sleeping environments may contribute to insomnia. Many experts recommend keeping the temperature between 60 and 67 degrees Fahrenheit during sleep.

Limit naps. If you must nap during the day, keep it to around 20 minutes or less. Avoid napping after 3 p.m. if you sleep at night. (If you have narcolepsy or another form of hypersomnia, you may be advised to take scheduled naps during the day.)

Medication

Medications, including sleep aids, may be helpful for some people with sleep disorders. Most sleep aids are prescribed on a short-term or as-needed basis.

The type of medication you may need will depend on your sleep disorder. For example:

• Insomnia may be treated with sleep aids such as eszopiclone, zolpidem, ramelteon, doxepin, zaleplon, lamborexant, and suvorexant. The most appropriate medicine for you will depend on whether you have difficulty falling asleep, staying asleep, or waking up at an appropriate time.
• Narcolepsy may be treated with stimulants and medications that help you stay awake during the day. These include armodafinil, modafinil, solriamfetol, and pitolisant. 
• Restless legs syndrome may be treated with medications that affect nerve function, including gabapentin, pregabalin, and gabapentin enacarbil. Medications that influence dopamine levels in the brain, such as rotigotine, ropinirole, and pramipexole, may also be prescribed.
• REM sleep behavior disorder may be treated with clonazepam (a sedative) or a supplement called melatonin (see more below).

Supplements   

Evidence supporting supplement use for sleep disorders is limited, at best. But combining a sleep supplement with good sleep hygiene and other HCP-recommended treatments may be helpful for some people.

Melatonin is commonly used as a supplement for sleep disorders. This is a hormone that your brain naturally produces in the evening when the sun goes down. A melatonin supplement (such as a pill or gummy) contains a synthetic form of this hormone.

When used according to an HCP’s guidance, melatonin supplements may be beneficial for adults with REM sleep behavior disorder, shift work disorder, and jet lag. It can also help some people with short-term insomnia fall asleep faster and help relieve daytime sleepiness. Melatonin is generally not recommended as a treatment for chronic insomnia or for use in children.

In addition to melatonin, other supplements that may help ease sleep disorders include chamomile, valerian, and magnesium. If taking a magnesium supplement, avoid exceeding the recommended dietary allowance for adults of 310 to 420 milligrams per day.   

Be sure to speak with your HCP before trying a sleep supplement or increasing your dosage. Some supplements may not be safe for people who take certain medications or have certain medical conditions. Moreover, the quality, safety, and effectiveness of supplements vary since they aren’t regulated by the U.S. Food and Drug Administration

Cognitive behavioral therapy

Cognitive behavioral therapy for insomnia (CBT-I) is recommended for most people with trouble sleeping related to mental health issues, medical conditions, or lifestyle habits. CBT-I combines talk therapy with sleep education and tips for improving sleep hygiene. It can help people identify and correct unhealthy behaviors and thought patterns that could be causing or contributing to their sleep problems. 

The specific type, frequency, and number of CBT-I sessions you may need will vary according to your condition and progress. Many people with insomnia need at least 6 to 8 sessions, though some people may require longer or shorter treatment.

Implementing lessons learned from CBT-I and achieving lasting results may take some time and patience. But overall, CBT-I is a highly effective sleep disorder treatment option with no known side effects. Ask your HCP about CBT-I and whether it’s right for you. They may be able to refer you to a provider in your area or online.

Continuous positive airway pressure  

A continuous positive airway pressure (CPAP) machine is used to treat many cases of obstructive sleep apnea. A CPAP machine is a wearable mask that’s placed over the nose (and sometimes the mouth). It’s connected to a machine that provides constant air flow to help keep the airways open and breathing uninterrupted during sleep.

Other types of positive airway pressure devices adjust air pressure according to a person’s breathing patterns during sleep. These are called auto-adjusting positive airway pressure machines, or APAP. Others provide different levels of air pressure when a person inhales and exhales (known as bilevel positive airway pressure, or BPAP).  

Bright light therapy

Bright light therapy, also known as phototherapy, can be helpful for people with circadian rhythm disorders. Treatment involves looking into the direction of a light source at set times to help reset a person’s internal body clock. Because exposure to light tells the brain it’s time to wake up, bright light therapy can help people with shift work disorder adjust to night shifts and be better able to sleep when they should.

Light sources used in bright light therapy may include a light box, a lighted visor, or a dawn simulator that slowly brightens a room. The best type of bright light therapy for you will depend on the type and severity of your sleep disorder.

Complementary therapies for sleep disorders

Complementary and alternative medicine therapies (natural approaches that don’t involve drugs) aren’t a replacement for medical sleep disorder treatment. Still, when combined with medical treatment, they may help some people with sleep disorders relax and sleep more soundly.

Examples of complementary therapies for sleep disorders include:

• Yoga
• Tai chi
• Herbal teas
• Aromatherapy
• Acupuncture
• Mindfulness and meditation  
• Hypnotherapy

Speak with your HCP to learn more about the potential benefits of complementary and alternative sleep disorder treatments. You may also find it helpful to speak with an integrative medicine specialist (an HCP who combines conventional medical treatments with complementary therapies).

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Underlying medical conditions can cause or contribute to sleep disorders, but the opposite is also true. Sleep disorders and sleep deprivation can affect multiple systems in the body increase the risk of life-threatening health complications.

Possible complications of sleep disorders include:

• High blood pressure
• Heart disease, including arrythmia, coronary artery disease, congestive heart failure, and heart attack  
• Vascular disease (diseases that affect blood vessels)
• Stroke
• Type 2 diabetes
• Obesity  

The longer a sleep disorder goes untreated, the greater the risk of these complications.

Sleep disorders and mental health  

There’s a two-way relationship between sleep disorders and mental health, as well. Mental health issues such as anxiety and depression can cause or contribute to some sleep disorders, and some sleep disorders may result in or worsen anxiety and depression symptoms.

The National Alliance on Mental Illness (NAMI) states that around 50 percent of insomnia cases are associated with anxiety, depression, or psychological stress. Obsessive compulsive disorder (OCD) is sometimes related to poor sleep. Post traumatic stress disorder (PTSD) can cause nightmares that frequently disrupt sleep. Because good sleep is essential to good health, sleep deprivation can aggravate mental health conditions and make them more difficult to treat.

Findings from a 2021 review of 65 studies published in Sleep Medicine Reviews noted that improvements in sleep quality led to greater improvements in mental health. Better sleep had a positive effect on overall mental health, depression, anxiety, rumination, and stress. Small improvements in psychosis (a break from reality that may occur with bipolar disorder and schizophrenia) were also reported.

If you or someone you know needs immediate assistance for feelings of severe depression, anxiety, or hopelessness, contact the 988 Lifeline by texting or calling 988. You can also chat with a counselor online. This service is free, confidential, and available 24/7.

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Not all sleep disorders are preventable, but some are. Shift work sleep disorder can be prevented by working a traditional 9-to-5 schedule (if you have the option to do so). Because obstructive sleep apnea is often linked to obesity, achieving and maintaining a healthy body weight may help you avoid this condition.

You can help reduce your risk of other sleep disorders by following the same sleep hygiene tips that are used to treat them. For example:

• Establish a bedtime routine and aim to go to sleep and wake up at the same time every day.
• Avoid drinking caffeinated beverages in the afternoon or evening.
• Don’t nap after 3 p.m. (unless your HCP tells you otherwise).
• Avoid or limit alcohol and nicotine use, especially close to bedtime.
• Try to spend time outdoors and exercise every day.
• Power down your phone and electronic devices at least one hour before bedtime.
• When sleeping, keep your space quiet, cool, and dark.

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Having a sleep disorder increases your risk of several physical and mental health conditions. Sleep deprivation can cause you to feel irritable, sad, indecisive, or unmotivated. You may find it hard to be fully present during special occasions or participate in activities you once enjoyed. If you drive or operate other forms of machinery, you’re more likely to be involved in an accident.

Thankfully, most sleep disorders are reversible or manageable with treatment. Insomnia is often curable with good sleep hygiene and CBT-I. Sleep apnea can be significantly improved with weight loss, using a CPAP machine, or both. Sleep disorders such as narcolepsy and restless legs syndrome are usually lifelong conditions, but treatment can reduce the severity of symptoms.

Seeking treatment shortly after sleep disorder symptoms develop can help you avoid complications and improve your well-being. Speak with your HCP to learn more about your prognosis, treatment options, and how you can achieve your best health.

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Living with a sleep disorder can leave you feeling frustrated, hopeless, or just plain tired. But help is available and relief is possible. To learn more about sleep disorder symptoms, treatments, and how to lower your risk, speak with an HCP. You can also find helpful resources from organizations such as the Centers for Disease Control and Prevention and the American Academy of Sleep Medicine.

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