Sleep, Health & Life Changes
Sleep in the context of pain, menopause, health changes, medication and other physical factors that may affect rest.
Sleep does not happen separately from the body. Pain, hormones, illness, medication, recovery, ageing and changes in routine can all affect how easily we fall asleep, stay asleep and feel rested the next day. Sometimes the most useful sleep question is not, 'What am I doing wrong?', but, 'What else is my body dealing with?'
A change in sleep can be information. It may reflect what is happening physically, hormonally, medically or practically, and it deserves curiosity rather than blame.
Health changes can change sleep
NHS insomnia guidance lists several physical and medical factors that can interfere with sleep. These include long term pain, menopause, restless legs syndrome, sleep apnoea and some neurological or thyroid conditions. Many medicines can also affect sleep.
This matters because a sleep problem is not always best understood as a bedtime habit. If the body is in pain, too hot, short of breath, restless, uncomfortable or adjusting to medication, the sleep system is working within that context.
Sleep can be disrupted by what the body is experiencing. Better sleep support sometimes starts with better understanding of the health issue underneath it.
Pain and physical discomfort
Long term pain can make it difficult to find a comfortable position, stay asleep or return to sleep after waking. Pain can also increase alertness because the brain is receiving signals that something needs attention.
Poor sleep can then make coping with the next day feel harder. The relationship can become circular, with discomfort disturbing sleep and tiredness reducing the resources available for managing discomfort.
If pain is repeatedly disturbing your sleep, it is worth discussing both the pain and the sleep with a GP or another appropriate healthcare professional. Sleep tips alone may not address the underlying problem.
Menopause and perimenopause
NHS guidance recognises sleep problems as a common symptom of menopause and perimenopause. Difficulty getting to sleep or staying asleep can affect daily life, and night sweats can make sleep problems worse.
Menopause can also involve changes in mood, anxiety, concentration, headaches, joint pain and urinary symptoms. Any of these may interact with rest and sleep.
If you think menopause or perimenopause may be affecting your sleep, contact your GP to discuss your symptoms and treatment options. Sleep support can sit alongside medical or hormonal treatment where appropriate.
Temperature changes can wake you or make it difficult to settle again. Regular soaking night sweats that wake you or worry you should be discussed with a GP.
Low mood, anxiety and irritability can occur during menopause and may feel worse when sleep is poor.
Aches and pains may make physical comfort at night more difficult and deserve their own assessment where persistent.
Needing to pass urine more often, including at night, can disturb sleep and may need medical advice if new, persistent or troublesome.
Medication can affect sleep in different ways
Some medicines can make people drowsy. Others can make falling asleep or staying asleep more difficult. The effect can also depend on dose, timing, other medicines and the condition being treated.
NHS Every Mind Matters advises checking the side effects listed with your medicine and speaking with a GP or pharmacist if you think a medicine may be affecting your sleep.
Do not stop prescribed medication suddenly because you think it is disturbing sleep. Some medicines need to be reduced gradually, and stopping without advice can cause withdrawal symptoms or allow the original condition to worsen.
Life changes can alter sleep even when nothing is wrong
Illness, surgery, caring responsibilities, travel, bereavement, a new job, shift work, changes in activity and periods of recovery can all alter the timing and quality of sleep.
NHS sleep guidance also notes that sleep patterns can change as we get older. Some people sleep less at night or doze more during the day. Changes in routine can affect the body clock and the amount of sleep pressure available at bedtime.
A temporary change does not automatically mean that you have developed a sleep disorder. The important question is whether the new pattern settles, whether it is affecting daytime functioning and whether there are other symptoms that need attention.
Practical support when health is affecting sleep
If pain, hot flushes, breathing problems or another symptom is waking you, medical treatment of that symptom may be more important than adding more sleep rules.
Temperature, bedding, pillows, mattress support and access to medication or prescribed aids can make a practical difference to comfort at night.
A reasonably regular waking time and access to daylight can help maintain circadian timing when illness or routine changes have disrupted the day.
Recovery and health changes can alter energy. Build rest into the day where needed without assuming that every period of tiredness has to become sleep.
Both can affect sleep, and their impact may feel different when health, hormones or medication have changed.
If a medicine seems to affect alertness or sleep, ask a GP or pharmacist whether timing or another option should be considered.
When a sleep change deserves medical assessment
New or persistent sleep changes are worth discussing when they are difficult to explain, significantly affecting daytime life or happening alongside other physical symptoms.
Speak with a GP or an appropriate healthcare professional if:
- sleep problems have lasted for months or are making everyday life difficult to cope with;
- pain or another physical symptom is repeatedly disturbing sleep;
- you think menopause or perimenopause is affecting your sleep and want to discuss treatment options;
- night sweats regularly soak your clothes or bedding, wake you or worry you;
- you think a prescribed medicine may be contributing to sleep problems;
- you are regularly very sleepy during the day or struggling to stay awake;
- someone notices your breathing stopping and starting during sleep, or you make gasping, snorting or choking noises.
If insomnia continues after the health issue is addressed
Sometimes sleep remains difficult even when the original trigger has improved. The bed may have become associated with wakefulness, frustration or monitoring, and the sleep problem can start to take on a life of its own.
NICE recommends cognitive behavioural therapy for insomnia, known as CBT I, as first line treatment for long term insomnia. CBT I can include sleep education, stimulus control, sleep scheduling, cognitive approaches, relaxation and relapse prevention.
It can be particularly useful when a health condition and insomnia are both present, because the sleep difficulty can be addressed without assuming that the physical condition is the whole explanation.
Sleep changes can make sense in context
When health changes, sleep may change too. That does not mean that you have failed at sleeping or need a more complicated routine.
Sometimes the most helpful step is to understand the physical, hormonal or medical factor that has changed, and then support sleep alongside it.
Notice the change. Understand the context. Get the right support.
How Wellness Within UK Can Support You
If sleep difficulties sit alongside stress, anxiety, difficult experiences, health changes or recovery, Wellness Within UK can support you in exploring the emotional and behavioural parts of that wider picture. Therapy is not a substitute for medical assessment where a physical condition, medication or sleep disorder may be involved.
Related Support
Research and guidance used
This WWSV article combines current UK health guidance on insomnia, menopause, night sweats, medication and persistent sleep difficulty. The links below go directly to the source information.
UK guidance on physical conditions, long term pain, menopause, medicines and other factors that can contribute to insomnia.
Read NHS guidance →Guidance on medicines, ageing, menopause, illness and routine changes as factors that can affect sleep.
Read NHS guidance →Current NHS information on sleep problems, night sweats, mood changes, pain, urinary symptoms and other menopause related changes.
Read NHS guidance →Guidance on common causes of night sweats and when regular soaking night sweats should be checked by a GP.
Read NHS guidance →NICE information on CBT I as first line treatment for long term insomnia, including sleep education, behavioural approaches, cognitive work and relaxation.
Read NICE information →