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 diseases

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 frequent urination in bladder and prostate or pain and fever in infections and joint disease. After all, skin diseases that are associated with pain and itching often do not make those affected sleep soundly 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
Headache migraine
Neurological diseases
Hormonal imbalances

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 stress the heart and can eventually lead to a persistent high blood pressure, which in turn makes for 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.

Heart failure (heart failure) reduces the power of the pump organ. As a result, less blood gets into the vessels. This results in a deficiency that can lead to wake-up reactions to stimulate the heart to more power. In right heart failure or severe insufficiency of the entire heart accumulates more fluid due to the backwater in the body tissues.

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 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 tachycardia or palpitations, 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, heart failure, or cardiac insufficiency, 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 magnetic resonance imaging (MRI) procedures.

If the medical history and symptoms suggest that the patient is suffering from sleep apnea at the same time, the doctor will investigate. Helpful hints can be given here depending on the severity of the symptoms a polygraph or polysomnography in the sleep laboratory.

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 there is sleep apnea, it will be treated accordingly. 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: shortness of breath 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.

Symptoms: falling asleep or staying asleep, morning awakening, shortness of breath, shortness of breath. In case of bronchitis or lung diseases: coughing 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.

Diagnosis: If you are coughing and having a cold that goes beyond the scope of a common cold, your doctor 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 the 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 alleviate tablets for sucking or swallowing, heat applications, for allergic cause, if necessary, a hyposensitization treatment. Against inflammation caused by bacteria, doctors prescribe antibiotics when 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 guide-books 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. When the patient is lying down, it flows back into the esophagus and causes a painful burning sensation. Many people who suffer from it also have more attacks of coughing in the morning.

A gastric ulcer also causes more pain around the morning, since the diseased gastric mucosa is then even 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 gastroenterology (gastroenterologist). Possible further investigations include a gastroscopy (gastroscopy).

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

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

Painful joint and muscle diseases often rob sleep

All illnesses that are associated with pain interfere with sleep. This includes the whole range of internal and external injuries that will not be discussed here. Very common sleep disorders are back pain, muscle tension and 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 hours is typical and often trendsetting. Tendinitis and tumors in 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 the affected person from falling asleep or waking them 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 clinical picture 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 the case of Bechterew’s disease, low back pain often causes a premature awakening in the morning. These are often the first significant complaints.

Diagnosis and therapy: If the medical history indicates a joint disease, the doctor will initiate the respective examination steps. After a confirmed diagnosis, the treatment is focused on the underlying disease. Prepare the sleep 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”.

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 small nerve fibers that end up in the skin are damaged in fibromyalgia sufferers. Among other things, these so-called small fibers transmit pain sensations. The 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.

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’t 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’t be detected in laboratory medical examinations or in imaging techniques. The doctor will also consider possible drug intake in an exclusion diagnosis. Notes give the physician the guiding 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 facilitate falling asleep and staying asleep without being dependent on other sleep aids. 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 online just Google “Fibromyalgia syndrome”.

Headache, migraine: nocturnal attacks against sleep

Certain types of headaches 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 migraines 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 neurotransmitters 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 that often start suddenly at night or 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 at a neurologist, for example, an electroencephalogram, which records the brain waves. If necessary, the neurologist also examines the brain-supplying vessels with ultrasound (color duplex ultrasonography) and, depending on suspicion, uses other imaging techniques, such as computed tomography.

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. 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 responsible 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, dyspnoea, muscle aches and cramps. Parkinson’s patients, for example, wake up again and again from deep sleep, because they can’t turn around because of lack of mobility. They sweat more and more 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 increase the sleep disturbances even more.

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. In part, 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 follow 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)”.

– 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 can also affect the autonomic nervous system, which, among other things, controls 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 portals online.

– 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, a changed immune situation may play a role. The symptoms often start suddenly, for example after a lot of physical exertion or after a passing infection, for example after a Pfeiffer’s glandular fever. They then last several months. Sometimes the disease develops slowly, the symptoms become more and more strong 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. The sufferers also often 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. Often a fatigue syndrome heals completely after some time.

– Dementia: Sleep changed permanently

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. Fierce 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 tiredness 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.

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 fluctuations

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 menstruation and pregnancy with sleep problems.

Such sleep disorders usually go by and can be well controlled with a healthy, sleep-friendly lifestyle.

– 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 also affect the central nervous system, the cardiovascular system, digestion, the psyche and much more. In case of an overactive thyroid gland forms too much thyroid hormone.

Symptoms: In addition to insomnia are other characteristic complaints inner restlessness and restlessness, changing moods, irritability, rapid heart rate, 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 the first digestion by 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, also improve the sleep problems.

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