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Sleep problems

Key points about common sleep problems

Nearly everyone has difficulty getting to sleep from time to time, but for some people, this can be a regular ongoing problem.
When this happens, not only do you feel tired but it can really interfere with your day-to-day functioning and affect your health.
Learning how to manage sleep problems can greatly improve your quality of life.

Man sleeping on back with his mouth open

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Sleep problem	Description
Insomnia	This is a condition where you are having trouble sleeping or staying asleep for long enough. It generally includes difficulty getting to sleep, staying asleep (poor sleep quality) or waking much too early. Read more about insomnia.
Obstructive sleep apnoea (OSA)	This is a condition in which you stop breathing while you are asleep. The usual symptoms are snoring, not feeling refreshed on waking, day-time sleepiness, altered mood and morning headaches. Read more about obstructive sleep apnoea.
Snoring	This is where you make a snorting or rattling noise when you breathe during sleep. The noise comes from the vibrating of the soft palate and tissue in your mouth, nose or throat. Some people snore occasionally and the sound they make isn't too loud, while others may snore every night, loud enough to be heard in the next room. See our tips to reduce snoring.
Sleep deprivation	This is a condition that develops if you don't get enough sleep, or you sleep at the wrong time of day (that is, you're out of sync with your body's natural clock). It also includes not sleeping well or getting all of the different types of sleep that your body needs. Read more about the different types of sleep, signs you aren't getting enough sleep and sleep deprivation and parenting.
Restless legs syndrome	This a sleep disorder that causes an intense, often irresistible urge to move your legs. This sensation is brought on by resting, for example lying down in bed or sitting for prolonged periods, such as when you are driving or watching a movie. It typically occurs in the evening, making it difficult to fall asleep and stay asleep. It can lead to daytime sleepiness, irritability and concentration. Read more about restless legs syndrome.

If you have any problems with sleeping, answer the questions in the Twenty Winks Sleep Questionnaire and get suggestions and information that's relevant to you and your situation.

If you often have trouble getting to sleep or if you often wake during the night, then you may not be getting enough sleep. Some of the tools or quizzes used to assess sleep are shown below.

Tools and quizzes to assess your sleep
You can fill these in at home and if the results indicate that you may have a sleep problem, print your results and discuss these with your family doctor. Twenty Winks Sleep Questionnaire Goodfellow Unit and Healthify He Puna Waiora Provides you with personalised information and links to more information based on your responses. The Auckland Sleep Questionnaire(external link) Goodfellow Unit, University of Auckland To help you establish the causes of your sleep problems. The Epworth Sleepiness Score(external link) To help you recognise possible sleep apnoea. Te Kete Haerenga sleep and sleep tips [PDF, 136 KB] Healthify He Puna Waiora Use this sleep tracker to see what you are doing during the day and before sleep to help you improve your sleep habits.

Tools and quizzes to assess your sleep

You can fill these in at home and if the results indicate that you may have a sleep problem, print your results and discuss these with your family doctor.

Twenty Winks Sleep Questionnaire Goodfellow Unit and Healthify He Puna Waiora
- Provides you with personalised information and links to more information based on your responses.
The Auckland Sleep Questionnaire(external link) Goodfellow Unit, University of Auckland
- To help you establish the causes of your sleep problems.
The Epworth Sleepiness Score(external link)
- To help you recognise possible sleep apnoea.
Te Kete Haerenga sleep and sleep tips [PDF, 136 KB] Healthify He Puna Waiora
- Use this sleep tracker to see what you are doing during the day and before sleep to help you improve your sleep habits.

Not getting enough sleep, or getting poor-quality sleep, increases the risk of high blood pressure, heart disease, obesity and diabetes. That means it’s important to take steps to get good quality sleep.

If you are experiencing the effects of poor sleep, making a few changes to your daily routine and habits can make a big difference. Try these strategies to help you sleep better at night.

Set your body clock – go to bed and get up at the same time each day, including weekends.
Wind down at bedtime – have an hour of quiet time before bed: switch off your electronic device, read, have a bath or listen to music.
Avoid stimulants – within 2 to 3 hours of bedtime don’t: smoke, drink alcohol or caffeinated drinks, eat a heavy meal or do energetic exercise.
Make your bedroom suitable for sleep – keep it cool, dark and quiet and use it only for sleep and sex.
Reduce blue light exposure in the evening – it disrupts your body clock, causing poor sleep. So, if you use your phone or computer in the evening, switch it to night-time setting or, better still, turn it off.
Get up if you can’t sleep – if you can’t sleep after 20 minutes or so, get up and do something boring until you feel tired, then try again. Don’t lie in bed getting frustrated.
Avoid naps – don’t sleep during the day but go to bed earlier in the evening.
Be active in the day – take regular daytime exercise and get outside early to help set your body clock for a good night’s sleep.
Use an app – try an app or online sleep programme.

See also these tips to improve your sleeping habits and our Te Kete Haerenga toolkit for understanding more about your sleep and making a plan to improve it.

Video: Beditation – getting a better night's sleep (35 minutes)

Click the image below to visit the website, scroll down to see the video, then click play.

(external link)
(NHS, UK, 2022)

If these measures haven't helped, then visit your doctor to discuss whether you need other treatment. Your doctor will want to find out about what has been happening in your life, your pattern of sleep and whether you have any other health conditions. This is because the treatment for sleep problems varies depending on the underlying issue.

Sleep disorder	Treatment options
Insomnia	The main treatment options for insomnia is determining if there is an underlying cause and eliminating that cause. It can also help to adopt good sleep habits. Another possible treatment is a type of cognitive behavioural therapy (CBT) that is specifically designed for people with insomnia (called CBT-I). The aim is to change unhelpful thoughts and behaviours that may be contributing to your insomnia. It's an effective treatment for many people and can have long-lasting results. Read more about insomnia.
Obstructive sleep apnoea	The treatments for sleep apnoea include weight loss, cutting down on alcohol, the use of dental appliances such as mouthguards, and continuous positive airway pressure (CAP) machines. Read more about obstructive sleep apnoea.
Snoring	Try sleeping on your side, as this sometimes works for some people. Making changes to your lifestyle such as losing weight, cutting down on alcohol and quitting smoking can be helpful. Talk to your doctor about special devices that you can use in your nose or mouth to reduce your snoring. Read our tips to reduce snoring.
Sleep deprivation	The main treatment for sleep deprivation is to increase your total sleep time. This is mainly done by treating the cause of your sleep deprivation. Your doctor will help you assess the causes of your interrupted sleep. Read more about signs you are not getting enough sleep and coping with sleep deprivation as a new parent.
Restless legs syndrome	There are several medicines that can help. Read more about restless legs syndrome.

A note on sleeping medicines

Sleeping tablets or medicines that encourage sleep are not used often because they have the potential to cause harm. Using sleeping tablets on an ongoing basis can lead to you develop a dependency on them, as well as an increased risk of falls, confusion, dementia and difficulties with driving.

Taking sleeping tablets for more than a few nights in a row can make sleeping difficulties worse. If you're taking sleeping tablets on a regular basis, ask your doctor about ways to help you stop taking them. You may need to stop taking them gradually over several weeks to months before stopping completely.

Read more about sleeping medicines (hypnotics).

Apps reviewed by Healthify

You may find it useful to look at some sleep and snoring apps.

Video: Tips for insomnia: The good sleep guide - Just a Thought

(Just a Thought, NZ, 2022)

Sleep topics
The importance of sleep
Sleep tips
Insomnia | Rarunga moe
Sleep and safe driving
How shift work affects your sleep
Snoring
Te Kete Sleep [PDF, 497 KB]
Twenty Winks Sleep Questionnaire

Sleep(external link) Fresh Mind, NZ
Sleep disorders(external link) Medline Plus, National Institutes of Health
Why sleep matters(external link) Healthy Sleep – Division of Sleep Medicine at Harvard Medical School, US
Common sleep problems(external link) (13 languages) Health Information Translations
10 medical reasons for feeling tired(external link) NHS Choices, UK
5 ways to stop snoring(external link) NHS Choices, UK

Brochures

Sleep problems [PDF, 931 KB] Healthify He Puna Waiora, NZ and Mediboard, 2023
Healthy sleep hygiene [PDF, 306 KB]Auckland DHB, NZ
Common sleep problems(external link) Health Information Translations, 2020 English(external link), Arabic(external link), Chinese (simplified)(external link), Chinese (traditional)(external link), French(external link), Hindi(external link), Japanese(external link), Korean(external link), Nepali(external link), Russian(external link), Somali(external link), Spanish(external link), Vietnamese(external link)
10 tips for a better night sleep(external link) Farmstrong, NZ, 2018
Te Kete Sleep [PDF, 497 KB] Healthify He Puna Waiora, NZ, 2022

Sleep assessment quizzes

Twenty Winks Sleep Questionnaire Goodfellow Unit and Healthify He Puna Waiora, NZ
The Auckland sleep questionnaire(external link) (short version) Goodfellow Unit, University of Auckland, NZ
The Epworth sleepiness score(external link) M.W. Johns 1990-97

Sleep diaries

Sleep diary Healthify He Puna Waiora, NZ, 2023

Apps

Sleep apps

References

Sleep deprivation and deficiency(external link) National Heart, Lung and Blood Institute, US, 2016
de Gage SB, Bégaud B, Bazin F. Benzodiazepine use and risk of dementia – prospective population-based study(external link) BMJ 2012;345:e6231
Hypnotics(external link) NZ Formulary, 2018
Prescribing hypnotic medicines – a focus on zopiclone(external link) BPAC, NZ, 2018
Blue light(external link) Health New Zealand | Te Whatu Ora

Continuing professional development

Webinar: Sleep health, insomnia & practical solutions(external link) Sally Powell, Nurse Practitioner, Masters of Health Sciences

About this presentation:

The impact of sleep deprivation can be significant, with often simple measures making a big improvement to wellness. The range of sleep disorders that affect sleep quality is vast and this presentation will:

Improve knowledge of identifying the aspects of good versus poor sleep health
Outline strategies to enable improvement in sleep quality and reduce the burden in this population.

Video: Sleep health, insomnia and practical solutions

You can watch the video, answer questions and claim hours with a certificate.

(My Health Hub, NZ, 2023)

Sleep assessment questionnaires and scales

Twenty Winks Sleep Questionnaire Goodfellow Unit and Healthify He Puna Waiora
The Auckland sleep questionnaire(external link) (short version) Goodfellow Unit, University of Auckland
The Epworth sleepiness score(external link) M.W. Johns 1990-97
Sleep profile quiz(external link) BBC (5–10mins to fill in online)
Sleep diary (2 weeks)(external link) American Academy of Sleep Medicine

Updates and best practice guides for sleep problems and insomnia

Treating sleep issues(external link) Goodfellow Unit NZ, 2023
Insomnia podcast(external link) Prof Bruce Arroll Goodfellow Unit July 2017
Managing insomnia(external link) Best Practice Journal NZ, 2008
Insomnia treatment in NZ(external link) The NZ Medical Journal, 2012
The Sleep/Wake Research Centre(external link) Massey University, Wellington
Sleep changes in older adults(external link) Family Doctor, American Academy of Family Physicians, 2012

Videos

Sleep well and energise – a no pills approach(external link) Goodfellow Webinar, NZ, 2020
Dr Giresh Kanji discusses the risks of insomnia including anxiety, depression, early death, dementia, cancer, hypertension and ischaemic heart disease.

Sleep and sleep disorders(external link) by Dr Andrew Veale The Goodfellow Unit, NZ, 2018

Management of sleep problems(external link) Goodfellow Unit, NZ, 2020
Dr Matire Harwood from the University of Auckland discusses sleep problems, their causes and how good sleep habits can be developed.

A series of 6 videos from Counties Manukau Health(external link) In this series, Karen Fraser explains what sleep phases are and how to support clients to sleep better.

Sleep restriction therapy

Sleep restriction therapy is a behavioural treatment for insomnia that works by reducing the amount of time spent in bed awake and not sleeping. Several studies have shown it to be effective for many people with insomnia.

Instructions for sleep restriction(external link) Kaiser Permanente Clinics, US
Falloon K, Elley CR, Fernando A, et al. Simplified sleep restriction for insomnia in general practice – a randomised controlled trial(external link) BJGP 2015;65(637):e508–e515