15 Reasons to Talk to Your Healthcare Provider About Your Sleep

Diverse Symptoms May Benefit from Testing and Treatment

No doubt a healthcare provider visit seems in order for a nagging cough, intolerable pain, or concerning symptoms that may need further assessment, but what about seeking an evaluation for sleep? In fact, there may be many reasons to talk to a practitioner about sleep.

reasons to talk to your doctor about sleep

Verywell / Laura Porter

Whether someone cannot sleep due to insomnia or has loud snoring or multiple other problems linked to sleep disorders, it may be time to schedule an appointment. Let’s explore 15 symptoms and conditions that may be linked to sleep and that may benefit from evaluation, testing, and treatment.


You can’t sleep

Insomnia is the most widely encountered sleep problem in the primary care setting. As defined by the International Classification of Sleep Disorders (ICSD), insomnia is difficulty falling or staying asleep or sleep that is not refreshing in the absence of another sleep disorder.

Generally, it is understood that if it takes more than 20 to 30 minutes to fall asleep, or to get back to sleep after waking in the night, this is problematic. It may also be associated with early morning awakenings. People with insomnia have other symptoms as well, including:

  • Fatigue
  • Decreased energy
  • Poor concentration
  • Mood problems (anxiety or depression)
  • Headache or pain complaints
  • Malaise (feeling unwell)
  • Dyspepsia (upset stomach)

If it occurs at least three times per week and lasts for at least three months, it is called chronic insomnia.

According to the American College of Physicians, chronic insomnia should be treated first with cognitive behavioral therapy for insomnia (CBTI). In some cases, sleeping pills have a limited role, but they may have long-term side effects that are best avoided. 


You are too sleepy during the day

Excessive daytime sleepiness may be a sign of underlying sleep disorder like sleep apnea or even narcolepsy. These conditions undermine sleep quality, leading to frequent brief awakenings.

It is also likely in the context of sleep deprivation. Most adults need seven to nine hours of sleep nightly to feel rested with a regular sleep-wake schedule. For those who sleep less than their sleep need, sleepiness inevitably results. 

This excessive sleepiness may be noted when sedentary, such as while reading, watching TV, riding in the car, or sitting in a meeting. It may be identified with a subjective questionnaire like the Epworth sleepiness scale.

To objectively understand its severity and cause, a diagnostic polysomnogram and multiple sleep latency test (MSLT) may be recommended. 

Beyond treating an underlying sleep disorder and ensuring adequate hours of rest, stimulant medication may be necessary.


You are told that you snore

Snoring is a common affliction. If it becomes disruptive to a bed partner (or others nearby), it may prompt a sleep evaluation. Loud snoring may be associated with obstructive sleep apnea, but the latter condition may occur even in the absence of known snoring.

Due to the potential for long-term health consequences, it is important to know if sleep apnea is present. A home sleep apnea test or diagnostic polysomnogram may be recommended.

Fortunately, snoring can be resolved with proper treatment. Treatments will depend on the underlying contributions and the presence or absence of associated sleep apnea.

These may include over-the-counter interventions (such as nasal strips, saline spray, allergy treatment, positional therapy, etc.), surgery, or even options to address both snoring and sleep apnea such as an oral appliance or continuous positive airway pressure (CPAP).


You are a woman past menopause

Women who are no longer having regular menstrual periods for more than one year have entered menopause. This may occur naturally as estrogen and progesterone levels fall in the body.

It can also occur after surgical removal of the ovaries (often as part of a procedure called total hysterectomy and bilateral oophorectomy). Treatment for certain cancers may also lead to the onset of menopause. 

Sleep often worsens, with increased insomnia, night sweats, teeth grinding, and other symptoms. These symptoms may be due to the increased risk of sleep apnea in menopause.

Prior to menopause, the risk of sleep apnea in women is approximately 1 in 200. At perimenopause the prevalence increases to 1 in 20, and by the age of 65 it is estimated that 1 in 4 women have sleep apnea. The symptoms in women may differ from men, and there is often a delay in identification and treatment of the condition.


You have restless legs at night

Restless legs syndrome (RLS) is characterized by an uncomfortable feeling that typically affects the legs in the evening when sitting or lying down. It is associated with an urge to move and these symptoms are relieved by movement, such as shifting the legs or getting up and walking around.

RLS may affect 1 in 10 people. It can be exacerbated by an iron deficiency (with a serum ferritin level less than 70) or due to another coexisting medical condition. This discomfort may make it hard to fall asleep.

It can also disrupt sleep at night—of the affected individual or their bed partner—as it overlaps with periodic limb movements of sleep (PLMS), a finding noted on a diagnostic polysomnogram.

Treatment may include iron replacement (if deficient) as well as prescription medications, including ropinirole (Requip), pramipexole (Mirapex), and others.


You sleepwalk or have other sleep behaviors

Sleep can be dangerous. This is especially true if a person who is asleep begins to have complex sleep-related behaviors. Talking (and even laughing) may be fairly common.

Children are prone to sleepwalking (somnambulism) and sleep terrors, and these episodes sometimes persist into adulthood. If it can be done while awake, it may be done while asleep, with behaviors that may include eating, cooking, driving, sex, and even crimes. 

It is also possible to act out dreams in a condition called REM sleep behavior disorder (RBD). Hitting, kicking, and grabbing commonly occur in RBD, often associated with a dream that has a defensive element. Injuries may occur as sleepers leap from bed, hit their bed partner in the face, or crash into the bedside lamp or nightstand.

Due to the risk of injury, certain safety precautions must be taken. In addition, it is important to rule out the contribution of an underlying sleep disorder that leads to sleep fragmentation. This is most commonly sleep apnea, but narcolepsy is another possible contributor.

Treatment may require addressing the underlying disorder or the use of high-dose melatonin or prescription medications such as clonazepam.


Being a night owl affects your life

Circadian rhythm disorders may also be a reason to talk to a healthcare provider about sleep. The most common condition is known as delayed sleep phase syndrome (DSPS).

It is better known as being a “night owl.” It affects about 10% of people, has a genetic predisposition, and often begins in adolescence. With DSPS, someone may not naturally fall asleep until 2 a.m. or later and desire to wake in the late morning or even early afternoon. 

In attempting to go to bed earlier, severe sleep-onset insomnia may occur. It can be profoundly difficult to wake in the earlier morning, often causing problems with tardiness, absenteeism, and family conflict. Sleep deprivation from an abbreviated sleep period overnight may have other long-term consequences. 

CBTI may be helpful, as can a regular sleep-wake schedule with 15 to 30 minutes of morning sunlight (or light box) exposure upon awakening. In some circadian disorders, low-dose melatonin may also have a role in treatment.


You wake with a morning headache

Headaches frequently interact with sleep. Waking with a headache first thing in the morning may occur for several reasons.

Assuming other concerning symptoms (vision changes, weakness or numbness on one side of the body, nausea or vomiting, etc.) are not present, several types of headaches may be suspected that may be linked to disturbed breathing in sleep. 

Sleep apnea may be the primary factor driving these headaches. Oxygen levels drop and carbon dioxide levels increase repeatedly through the night. Carbon dioxide dilates blood vessels to the brain, increasing pressure and often contributing to a frontal headache that fades in the first hours of the day. 

In addition, bruxism at night may be secondary to sleep apnea, with muscle tightness affecting the temporomandibular joint (TMJ) as well as the back of the head and into the neck and shoulders.

Although a guard may alleviate enamel wear and some discomfort, treatment of the underlying breathing issue may be needed to resolve the condition.


You are drowsy or fall asleep driving

It is extremely dangerous to drive when overly drowsy. This may manifest as dozing at traffic lights or even nodding off in stop-and-go traffic on a long commute. Accidents that threaten (or take) the lives of the driver and others are unfortunately all too common.

This drowsy driving may occur more often on long drives, or when driving occurs overnight. Falling asleep driving is also more likely with sleep deprivation and untreated sleep disorders like sleep apnea. 

As Dr. William Dement, the father of modern sleep medicine, liked to say, “Drowsiness is red alert!” Drowsy drivers should pull off the road at the first sign of sleepiness.

For those with chronic problems staying alert behind the wheel, a sleep evaluation may be needed to ensure safety. If an accident or near miss occurs, driving should be ceased until this evaluation is complete.


You grind or clench your teeth

Though often attributed to stress, grinding or clenching teeth at night may be a sign of obstructive sleep apnea, as noted above. It can lead to wear and damage to the enamel of the teeth. This may cause tooth fractures and require expensive dental work. It may also exacerbate TMJ dysfunction and lead to facial or head pain. 

During sleep, bruxism may be a self-protective activity that locks the jaw and tongue in a forward position and activates the muscles of the airway. This opens the airway to improve breathing. It may occur in response to sleep apnea during the arousal (or awakening) that terminates the episode.

Treatment of the underlying breathing issue may resolve the bruxism and provide long-term improvement to dental health. 


You wake up frequently to urinate

Frequent trips to the bathroom during the night, a condition called nocturia, may be a surprising sign of sleep apnea. As people get older, they might blame medications, trying to stay hydrated, a weak bladder, or even (for men) prostate problems.

Obstructive sleep apnea increases the acidity of the blood and strains the heart, two factors that will activate the kidneys and lead to increased nocturia. If someone is waking two to three times to urinate at night, treatment of sleep apnea may significantly reduce this, even with the other risk factors left unchanged. 


Your blood pressure is hard to control

Moderate to severe obstructive sleep apnea is strongly correlated with worsening hypertension. The Wisconsin Sleep Cohort Study of 708 middle-aged adults showed the risk of hypertension triples in moderate sleep apnea.

If the high blood pressure is resistant to the use of medications, it is even more likely that sleep apnea underlies the problem. For example, a man with treatment-resistant hypertension who is on three blood pressure medications has a 95% chance of having sleep apnea.

CPAP can lower blood pressure, with some studies showing a drop in the systolic blood pressure by up to 10 mm Hg, especially among those with severe sleep apnea and higher compliance to therapy. 


You have thinking or mood problems

Untreated sleep apnea has deleterious effects on concentration, attention, and short-term memory. When severe, associated with profound drops in the blood oxygen saturation, or higher in REM sleep among women, there is an increased risk of developing dementia.

This may be due to both the drops in oxygen levels as well as the disruption to sleep continuity that may disturb the function of the glymphatic system, a network of vessels that cleanse the brain’s tissues during sleep.

Much like a cleaning crew, if this is not achieved, the debris in the form of protein plaques may lead to degeneration of the brain. This may ultimately contribute to dementia or Alzheimer’s disease. 

Moreover, poor sleep has significant negative effects on mood. The difficulties sleeping that characterize insomnia are especially important. Sleep problems may lead to anxiety, depression, and irritability.

This is a bi-directional relationship, as mood can also undermine sleep. When both are present, research suggests that focusing on improving sleep is more helpful. 


You have recurring nightmares

Nightmares may be disruptive to sleep and are increased in times of stress. They may be associated with other mood disorders, including anxiety and post-traumatic stress disorder. In some cases, nightmares are secondary to another sleep disorder like sleep apnea.

Fortunately, there are some effective treatments, including medications like prazosin as well as dream rehearsal therapy. If an underlying sleep disorder is suspected, testing may lead to the cause and ultimately to the resolution of the bad dreams.


You worry sleep affects your health

It seems like there is a steady stream of new articles on how important sleep is to health and well-being. This can be discouraging if someone is not sleeping well. Indeed, sleep is a pillar of health, along with diet and exercise. It should not be neglected or ignored.

A Word From Verywell

If you have identified reasons why you should discuss your sleep with your healthcare provider, schedule an appointment for the assessment. Try not to treat it as an “add-on” item among other things that you hope to address during the visit, as it may be neglected.

Unfortunately, medical doctors don’t get a lot of education on managing sleep and many primary care physicians may be uncomfortable providing a diagnosis, testing, and treatment. If needed, ask for a referral to a board-certified sleep physician to get the care that you deserve to sleep and feel better.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Academy of Sleep Medicine. International classification of sleep disorders, 3rd ed. Darien, IL: American Academy of Sleep Medicine, 2014.

  2. —Qaseem A et al. Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of PhysiciansAnn Intern Med. 2016;165(2):125-133.

  3. Bixler EO et al. “Prevalence of sleep-disordered breathing in women: effects of gender.” Am J Respir Crit Care Med 2001;163:608–613.

  4. Collop N. The effect of obstructive sleep apnea on chronic medical disorders. Cleve Clin J Med. 2007;74(1):72-8. doi:10.3949/ccjm.74.1.72

Additional Reading
  • Kryger MH, et alPrinciples and Practice of Sleep Medicine. Elsevier, 6th edition, 2016.

By Brandon Peters, MD
Brandon Peters, MD, is a board-certified neurologist and sleep medicine specialist.