What Is Restless Sleep?

Restless sleep is when you struggle to fall asleep, toss-and-turn in the night, wake from sleep often, and generally do not feel rested. Seventy percent of American report poor or restless sleep at least one night a month, and 11% report poor sleep every night.

This article will detail the symptoms of restless sleep, some common causes, and what treatment options may be available. You’ll learn what restless sleep looks like, why it’s happening, and what to do next.

Symptoms

A night or two of poor sleep isn’t anything to worry about. However, if sleep issues become chronic, it’s good to take note. Sleep problems can lead to other health issues over time. 

If you have a sleep disorder that results in restless sleep, you may experience:

• Difficulty sleeping
• Reduced cognitive function, including difficulty making decisions and memory recall issues
• Daytime tiredness 
• Physical fatigue including slower or delayed reaction times
• Irritability 
• Depression 
• Personality changes
• Obesity
• Diabetes 
• Heart disease

Causes

There are several common causes of restless sleep. These include:

• Insomnia
• Sleep apnea
• Restless legs syndrome
• Narcolepsy
• Medications and substances

Insomnia

People with insomnia experience restless sleep as a symptom. Restless sleep in insomnia can last for a few days (temporary insomnia) or a few weeks or months (chronic insomnia).

Insomnia symptoms include ​challenges with falling asleep, waking up, and staying asleep for as long as desired or intended.

Chronic insomnia symptoms include more severe sleep challenges, associated mood changes, and health complications associated with a lack of sleep, like memory and concentration difficulties.

A review of studies on chronic insomnia suggests it is a common sleep problem among the general population and also an underdiagnosed and undertreated condition.

Sleep Apnea

Sleep apnea is a sleeping disorder characterized by breathing challenges. A person with sleep apnea can stop breathing during sleep, causing gasping for air or loud snoring sounds. This stop-and-start flow of breathing disrupts the flow of deep sleep. Daytime sleepiness is another associated symptom. Untreated sleep apnea leads to severe health complications, including the risk of heart disease and stroke.

Restless Legs Syndrome 

Restless legs syndrome or Willis-Ekbom disease isn't a sleeping disorder, but it does cause restlessness in the legs that creates sleep difficulties. Since symptoms may become more severe at night, falling asleep or returning to sleep after waking up could become difficult.

Narcolepsy

Narcolepsy is a neurological disorder affecting the brain’s chemical signaling and control of wakefulness and sleepiness. People with narcolepsy experience many symptoms, including restless nighttime sleep with many awakenings.

What Medications Can Cause Restless Sleep?

Many medications, recreational drugs, and substances (such as caffeine and alcohol) can contribute to restless sleep. These include:

• Amphetamines and other stimulant drugs
• Antidepressants such as Prozac (fluoxetine) and Zoloft (sertraline)
• Blood pressure medications
• Cold medications and decongestants
• Diuretics (water pills)
  
• Parkinson's disease medications
• Steroids
  

Treatment

The goal of treatment for restless sleep will be to increase the overall quality of your sleep. Several methods are available. As with any health condition, it’s important to consult with your healthcare provider to determine the best option for you, given your health history. Some options for treating restless sleep include:

Cognitive Behavioral Therapy 

Cognitive behavioral therapy can help someone recognize thought patterns that may be keeping them awake and direct them on how to work on changing those thought patterns.

Cognitive behavioral therapy has been recognized as a first-line treatment for insomnia. In one review study, CBT was found to be as effective as medication for brief treatment and likely more durable or sustainable over time. It’s also shown to be effective when delivered remotely via teletherapy.

Medications or Supplements

There are several over-the-counter (OTC) and prescription sleep medications and herbal remedies that people may use to temporarily help with restless sleep.

Some options you may want to talk to your healthcare provider about include melatonin, a natural sleep aid, or benzodiazepines, a common type of prescribed pharmaceutical sleep aid. It’s always best to give your healthcare provider a complete list of medications and supplements, as some interact with others.

Sleep Hygiene 

Practicing proper sleep hygiene is always recommended to have a restful sleep. Good sleep hygiene habits should include:

• Set bedtime and wake time, including weekends
• Have a quiet, dark, relaxing space to sleep in a room at a comfortable temperature
• Don't have electronic devices, such as TVs, computers, and smartphones in the room
• Avoid large meals, caffeine, and alcohol before bedtime
• Be physically active during the day to help with nighttime falling asleep

Are There Tests to Diagnose the Cause of Restless Sleep?

A healthcare provider can determine the underlying cause of restless sleep in several ways. A medical history, report of symptoms, review of medications, and physical examination is the first step. These may be enough to diagnose the cause.

Further testing may include:

• Sleep log: Keeping a log of your sleep patterns can help the healthcare provider identify possible causes.
• Sleep study (polysomnogram): In this overnight test, electrodes are attached to the body to monitor brain waves, breathing, and movement.
• Sleep-wake actigraphy: A wearable monitor can help the healthcare provider identify sleep disorders.

When to See a Healthcare Provider

If you experience any of the following signs and symptoms of a sleep disorder, it's suggested to discuss your symptoms with a healthcare provider.

• Fall asleep while driving
• Difficulty staying awake when watching tv or reading a book
• Difficulty paying attention or concentrating 
• Problems at work or school
• Feel excessively sleepy or are told you “look tired” a lot
• Memory or response time issues
• Increased desire to nap
• Mood changes not otherwise explained
  

Summary

Restless sleep is when you find falling and staying asleep challenging. You may toss and turn or struggle with some sleep disorder that has other symptoms. Chronic restless sleep can be due to a sleep disorder like insomnia, sleep apnea, or narcolepsy or associated with other medical conditions. Treatment involves cognitive behavioral therapy and sleep hygiene changes and may also include sleep medications.