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Sleep Disorders

Wake up after short sleep

11/12/2008

Question:

I would say about 3-4 times a week I wake up after about 10-20 minutes of sleep. It is rare that I have a problem falling a sleep. And after I wake up I do not have a problem falling back to sleep, but then I will wake up every 2-3 hours, with no problem falling back to sleep again. I do have asthma and am starting to hurt in my joints. And within a few hours of getting up I feel very tired. This makes it that if I sit down to watch TV etc I usually fall asleep for an hour. My question I am curious about is why I fall asleep easily but wake up after 10-20 minutes?

Answer:

It sounds like what you are really describing is not so much a problem with insomnia, but more a problem with fragmented or interrupted sleep. This can be frustrating and lead to poor sleep with the expected consequences of daytime sleepiness, fatigue and a poor sense of well-being.

There is a long list of problems that could interrupt your sleep, ranging from common sleep disorders to other illnesses or medications to environmental causes. For example, if awakenings are associated with chest tightness, cough, or wheezes and occurs toward the morning hours, then asthma may be a factor. Or if the awakening was associated with pain, then your joint symptoms may be the cause. Furthermore, heart burn, post nasal drip, and other medical conditions (such as heart failure, depression, etc.) are all causes of multiple awakenings per night. Sometimes, the medications used to treat medical conditions can lead to sleep interruption or fragmentation.

Some common sleep disorders that may interrupt sleep include sleep apnea and periodic limb movement disorder. Patients with sleep apnea may awaken several times per night and not be aware of the episodes of upper airway obstruction that lead to the awakenings. Periodic limb movement of sleep (or frequent leg jerks in sleep) may produce several awakenings without the patient being aware of the cause. Environmental causes of interrupted sleep might include a bedroom that is too hot, too bright or too noisy (i.e. from the TV on or a snoring bed partner). The presence of pet in the bed may be a cause of sleep disturbance called environmental sleep disorder. Of course, the use of caffeine, tobacco or alcohol near bedtime can also fragment sleep.

More information is needed to further understand your problem. Important factors will include investigating for the conditions and problems listed above, in addition to determining your bed time, wake up time and total hours in bed. If you are not obtaining adequate sleep, this could explain your sleepiness.

The fact that you have daytime sleepiness warrants a thorough evaluation for the cause of sleep disturbance. I suggest you talk to your primary care doctor about your problem. Referral to a Sleep Specialist for additional evaluation is probably reasonable. The key to helping you lies in sorting what factors in your specific case need to be addressed.

For more information:

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Response by:

Rami N Khayat, MD Rami N Khayat, MD
Clinical Assistant Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University