Sleep Disturbances: When to Seek Neurology Help

Q: Sleep Disturbances: When to Seek Neurology Help

Hello： You mentioned that "there are no issues falling asleep, going to bed at 11 PM and usually falling asleep within half an hour, but I wake up in the middle of the night, and the timing and frequency of waking are inconsistent." I suggest you start by improving your sleep hyg

Insomnia, sleep disorders

Hello, doctor.
Thank you very much for taking the time to respond.
My symptoms are as follows: Two months ago, while preparing for an exam, I experienced some stress and started waking up occasionally in the middle of the night.
However, more than a month ago, after the exam ended, I thought the stress was alleviated and that I would no longer have sleep issues, but I still occasionally wake up at night.
About three weeks ago, it changed to waking up 2 to 3 times every night.
Besides waking up at night, I do not feel any other physical discomfort, but waking up every night affects my mood and makes me a bit anxious about sleep.
I have no issues falling asleep; I go to bed around 11 PM and can usually fall asleep within half an hour.
However, I do wake up at night, and the times and frequency are inconsistent, and it’s not due to needing to use the restroom or outside noise.
I would like to know which specialty I should consult for these symptoms.
Could it be related to autonomic nervous system dysregulation? What kind of tests are usually needed? Would I need to take sleeping pills? Should I consider supplementing with any nutritional health products? Thank you!

Sophy, 20~29 year old female. Ask Date: 2022/06/07

Dr. Jiang Junyi reply Neurology

Hello: You mentioned that "there are no issues falling asleep, going to bed at 11 PM and usually falling asleep within half an hour, but I wake up in the middle of the night, and the timing and frequency of waking are inconsistent." I suggest you start by improving your sleep hygiene.
For instance, try to avoid napping during the day.
Avoid drinking coffee outside of the morning hours.
Refrain from smoking and drinking alcohol, as both can lead to fragmented sleep.
Avoid placing distracting items in the bedroom, such as a television.
Keep the bedroom dark and quiet.
Maintain a regular sleep schedule, going to bed and waking up at the same time every day, including weekends and holidays.
Avoid exercising or eating large meals 2-3 hours before bedtime to prevent affecting sleep quality.
Foods rich in tryptophan, such as dried fish, squid, adzuki beans, small dried fish, soybeans, shrimp, cashews, and black sesame powder, may be beneficial.
If you have related concerns, I recommend discussing them with a sleep medicine specialist for evaluation and treatment.
Thank you for your inquiry, and feel free to reach out for further discussion! Wishing you good health and peace.
Dr.
Jiang Junyi from Taoyuan Hospital cares about you.

Reply Date: 2022/06/07

More Info

Thank you for reaching out with your concerns regarding sleep disturbances. Based on your description, it seems you are experiencing a pattern of waking up multiple times during the night, which can be quite distressing and may impact your overall well-being.
Firstly, it’s important to understand that sleep disturbances can arise from various factors, including stress, anxiety, lifestyle habits, and even underlying medical conditions. Given that you mentioned increased stress during your exam preparation, it’s possible that this has contributed to your current sleep issues. However, since the disturbances have persisted even after the stressor (the exam) has been removed, it may indicate that your body has developed a pattern of disrupted sleep that needs to be addressed.

In terms of seeking help, you might consider visiting a neurologist or a sleep specialist. These professionals can conduct a thorough evaluation to determine if there are any underlying neurological issues or sleep disorders, such as insomnia or sleep apnea, that could be contributing to your symptoms. They may recommend a sleep study (polysomnography) to monitor your sleep patterns and identify any abnormalities.

Regarding your concern about autonomic nervous system dysregulation, while it is a possibility, it is essential to have a comprehensive assessment to rule out other causes. Symptoms of autonomic dysfunction can include irregular heart rates, blood pressure changes, and gastrointestinal issues, among others. If you are not experiencing these symptoms, it may be less likely that this is the primary issue.

As for treatment options, it is not uncommon for healthcare providers to recommend lifestyle modifications as a first step. This includes maintaining a consistent sleep schedule, creating a relaxing bedtime routine, and ensuring your sleep environment is conducive to rest (dark, quiet, and cool). Cognitive Behavioral Therapy for Insomnia (CBT-I) is another effective non-pharmacological treatment that focuses on changing thoughts and behaviors around sleep.

If these strategies do not yield improvement, your doctor may consider prescribing sleep medications as a temporary measure. However, it is crucial to use these medications under the guidance of a healthcare professional, as they can have side effects and may not address the underlying issues.

Regarding nutritional supplements, while some individuals find relief with melatonin or herbal remedies like valerian root, the efficacy of these supplements can vary. It’s advisable to discuss any supplements with your healthcare provider to ensure they are appropriate for your situation and to avoid potential interactions with other medications.

In summary, your symptoms warrant further evaluation by a healthcare professional, preferably a neurologist or sleep specialist. They can help determine the underlying causes of your sleep disturbances and recommend appropriate treatment options tailored to your needs. In the meantime, focusing on good sleep hygiene practices can be beneficial. Remember, you are not alone in this, and seeking help is a positive step towards improving your sleep and overall quality of life.

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