Are you laying in bed exhausted but wide awake? Maybe it’s pain racing thoughts or waking up gasping for air. Your insomnia may be due to an underlying medical condition more than stress  or bad sleep habits. Today we will look at four medical conditions that can disrupt your sleep.   I’m Dr.Vickie Petz Kasper.

If you’re ready to take control of your health, you’re in the right  place. Whether you’re focused on prevention or you’re trying to manage a condition. I’ll give you practical steps to start your own journey toward better health because healthy looks great on you.

 This is episode 1 62. Is your health keeping you awake? Four medical conditions that cause insomnia.  Not sleeping is frustrating not only during the long nights, but also dragging through the day without the mental clarity you need. And maybe you know why you can’t sleep, or maybe you’re trying to treat the symptoms without addressing the root cause.

Today we’re going to look at four medical conditions that keep you from getting the rest you need. Because if you can identify the cause, you can get started on a path to better sleep. So let’s pull back the covers and see what wakes you up. Number one is ouch. Chronic pain can keep you tossing and turning low back pain, shoulder pain, arthritis, fibromyalgia.

All of these things can cause discomfort, which makes it hard to fall asleep and stay asleep. Pain and sleep have what we call a bidirectional relationship. Think of it like a two-way street. Pain makes it harder to sleep and poor sleep makes pain worse. Climbing under the covers can be uncomfortable and that can aggravate pain.

Plus, even if you can get to sleep, pain can tap you on the shoulder or anywhere else for that matter and wake you up. This leads to fragmented sleep when what you need is deep restorative sleep, which is crucial for healing and less deep sleep. Makes your pain threshold go way down. So that you’re more sensitive to pain.

On top of that, pain is frustrating and insomnia is maddening, and when they get in bed together, it can heighten anxiety, which triggers alertness and all of that makes it harder to drift off to dreamland.  Arthritis is not a good bed partner. Inflammation and stiffness tend to get worse when you’re inactive.

That’s why you feel like the tin man who needs a shot of oil to get moving in the morning. Non-restorative sleep latches onto fibromyalgia too, and it doesn’t let go. Sleeping position can worsen back pain, shoulder pain, and carpal tunnel syndrome. So optimize your sleep position for better sleep. If you have arthritis, use supportive pillows to reduce any pressure on joints. If you have nerve pain like carpal tunnel syndrome, try sleeping in a brace to immobilize your wrist. And if you have back pain, put a pillow under your knees or sleep on your side with a pillow between your legs and before you go to bed, try taking a warm bath or using a heating pad because that can relax your muscles and help with stiffness. Cold packs can be even better at reducing inflammation and also try gentle stretching exercises or massage before bed to relieve the tension in those muscles. But don’t do a strenuous workout that will just increase your cortisol levels and keep you from sleeping. 

The most important thing is to always address the root cause. If you are having unexplained pain, you need to work with your doctor to manage your condition.  

Number two is gastroesophageal reflux disease. Do you wake up with heartburn or maybe even a sore throat? It might be your stomach acid, keeping you awake.

Acid reflux symptoms can worsen during the night disrupting sleep.  Here’s what happens. Many people experience heartburn, regurgitation, and just discomfort when laying down, and that makes it difficult to fall asleep or stay asleep. The reason is that gravity keeps stomach acid down during the day, but then when you lay down flat, that acid easily flows back up into the esophagus. This can lead to a burning sensation or an irritation in the throat, or even coughing and choking. Many people with gastroesophageal reflux experience brief wakenings throughout the night, even though they may not realize it, it often occurs during REM sleep, which is that mind restoring deep sleep. 

And acid irritation can stimulate the throat and the lungs, which can cause coughing, wheezing, or a sensation of mucus buildup that makes it harder to breathe comfortably and stay asleep. Years ago, I was misdiagnosed with asthma when what I really had was severe reflux because I was on prednisone, all that acid would go down into my lungs and I would wake up sputtering and coughing.

But it wasn’t asthma. It was a spasm of my larynx, which is where your airway closes off for a brief period of time, and that’s not pleasant. 

It can also irritate the vocal cords causing hoarseness or even a sour taste in the mouth.

Some people just have chronic GERD. Some people have a hiatal hernia. Pregnancy certainly makes it worse and so does obesity,  so here are some suggestions. First of all, sleep on your left side. This keeps the stomach in a position that’s lower than the esophagus, and so that kind of helps manage the reflux just by using gravity. 

More effective than that is to elevate your head. You can either use a wedge pillow or just put some bricks under the headboard of your bed to raise it by a few inches,   and especially avoid late night eating. Don’t eat within two to three hours before your bedtime and avoid large meals, spicy foods, citrus, alcohol, caffeine, and fatty foods before bed.

And if this is something that only bothers you occasionally, it’s certainly fine to take an over the counter antacid, but this is also a condition that needs to be evaluated by a healthcare provider to make sure nothing else is going on.  

 Reflux disease can be confused with sleep apnea as well. Sleep apnea is a serious medical condition. It’s usually characterized by loud snoring or waking up choking. As you can see, that could be confused with gastroesophageal reflux disease, but  it can also be periods of time where you don’t breathe at all, and what happens is your oxygen levels go down and that affects all of your organs, especially your brain and your heart. It can put you at risk for heart disease, high blood pressure, stroke, and dementia. 

It’s more common in men than women, but women certainly can get it and they especially get it after menopause . The soft palate gets a little more lax. It’s more common in people who are overweight, but that does not always hold true. If you are having any symptoms of obstructive sleep apnea, it’s important to see your healthcare provider and have a sleep study if you are in fact doing what we call desaturating, meaning that those oxygen levels are going down. You need an official sleep study to see if you would benefit from an implantable device or a CPAP machine. And if you are diagnosed with sleep apnea and you’re overweight, losing weight can certainly help, as well as avoiding anything sedating like alcohol, sleeping pills, or antihistamines. 

There are lots of medical conditions that can cause you to not sleep.  Things like thyroid disease, diabetes, heart failure, COPD. But today I want to talk a little bit about mental health conditions like anxiety and depression, because your mind isn’t the only thing affected. Your sleep is too. 

You see, mental health and sleep are deeply connected. Poor sleep can worsen mental health. While mental health disorders make it harder to sleep, it’s a vicious cycle, and understanding the connection is the first step toward breaking it.

So let’s go to mini medical school for just a moment and see how mental disorders can affect sleep. You see, chronic stress increases the levels of cortisol and what we call adrenaline, and that makes it harder for your body to wind down  and cortisol levels that are high in the evening can actually interfere with melatonin production, which is the sleep hormone, so that can delay sleep onset. On top of that, mental health conditions can reduce deep sleep, which is that slow wave sleep, and it also can reduce REM sleep, which is when you’re dreaming, that can lead to fragmented and non-restorative sleep.  The problem with depression is a lot of times people go into REM sleep too quickly and they have vivid dreams or nightmares. 

One of the characteristic findings of depression is people who wake up super early in the morning and can’t go back to sleep. Then you can start associating the bed with stress, and that just makes insomnia worse over time. The same with anxiety.  Worrying and overthinking at night can lead to difficulty falling asleep.  It can also make your muscles tense, make your heart race, and make you feel like you’re having a panic attack. 

People with a DHD often struggle with delayed sleep on set too. They just stay up half the night even though they’re exhausted, because a lot of times their brains can’t make that transition from awake to asleep, and they’re more prone to restless sleep, frequent waking, and grogginess in the morning.

So what do you do about it? 

While overall lifestyle is super important for treating ADHD, depression and anxiety, it’s also very important to be under the care of a healthcare provider and a mental health care provider. Counseling can be very effective for dealing with anxiety and depression. 

But if your symptoms are less serious and you just have spinning thoughts that won’t stop, the main thing I suggest is learn to relax your body and your mind. We have to put our minds in neutral. And I think a lot of us go through the whole day, just go, go, go, go, go, and then we lay down at night, and our brains won’t turn off because they don’t ever turn off. I’m going to give you my very best tip on how to shut down your mind – journaling. I always say it’s a cheap psychiatrist.  And that’s just one simple step you can take to try to shut off your mind. But I heard a sleep specialist say one time that relying on sleep tips is kind of like asking a nutritionist, “How can I eat heart healthy?” And they say, “Eat more broccoli.” It’s a lot more complicated than that, and that’s why I created a comprehensive online digital course called Unlock the Secret to Sleep Your Personalized Sleep Solution.

I hope you won’t miss the opportunity to enroll in this course. It’s only available until March 12th, 2025.

The course will be released on March 17th. And I also have a FREE LIVE SLEEP MASTERCLASS happening tomorrow morning at eight o’clock. It’s free, but registration is required. There’s a link in the show notes or you can just go to healthy looks great on you.com and look for “Six Surprising Reasons You’re Tossing and Turning.” We’ll talk about those six reasons and what you can do about it.

A lot of people have had insomnia for such a long period of time that they’ve lost hope that anything can help them sleep better, and it’s just not true. You can sleep better. Are there magic wands? No. It takes some work, but I can help you every step of the way. 

I want to leave you with one tip. Don’t watch the clock. If you wake up during the night, resist the urge to pick up your phone and see what time it is. If you have an alarm set, you can rest easy. You’re not going to oversleep, and you don’t need to know what time it is. All that does is expose your brain to blue light, which suppresses melatonin and creates anxiety about what time it is and about not sleeping and that only leads to further insomnia. So don’t watch the clock. That’s my number one piece of advice today. I have lots more I can tell you in UNLOCK THE SECRET TO SLEEP – Your Personal Sleep Solution. I sure hope you’ll enroll today before this opportunity is gone  because when you sleep better, your health is better and healthy, looks great on you.

 The information contained in this podcast is for educational purposes only and is not considered to be a substitute for medical advice. You should continue to follow up with your physician or health care provider and take medication as prescribed. Though the information in this podcast is evidence based, new research may develop and recommendations may change.

UNLOCK THE SECRET TO SLEEP
FREE LIVE SLEEP MASTERCLASS

Resources (may contain affiliate links)

MY FAVORITE SLEEP MASK