It seems that every time Sarah goes to bed, something happens to wake her up. It might be stress – she prepared for an important presentation at work and is worried about how it will be received. A car alarm is triggered in the middle of the night and no one turns it off. She overdid her running earlier in the day and her knee is throbbing.

Sleep difficulties are linked to physical, emotional and environmental factors. Many of these, particularly the environmental factors, are modifiable.

Environmental Factors

• Room temperature that’s too warm or too cold
• Light at night, especially from electronic devices
• Consuming caffeine or alcohol close to bedtime
• Smoking cigarettes
• Changes in your sleeping location or patterns. For example, sleeping in a separate room from your partner to avoid their loud snoring after you’ve been sleeping together for many years.
• Cognitive/Emotional Factors
• Stress, anxiety – even everyday frustrations—can lead to interruptions in your sleep patterns, making it difficult to attain deep, restorative sleep.
• Mild cognitive impairment or other cognitive issues can be disorienting and worrying, and keep you from sleeping soundly.

Chronic health conditions

These include:

• A sleep disorder such as sleep apnea, which is considered a leading cause of interrupted sleep. – Pain from arthritis and other musculoskeletal conditions, which can keep you awake or wake you suddenly during the night.
• Medication interactions, misuse, or overuse can lead to sleep problems
• Heartburn can flare up at bedtime and interrupt sleep. According to the National Sleep Foundation (NSF), 80% of people with gastroesophageal reflux disease (GERD) say they have had nighttime heartburn.
• Nocturia, or waking up in the middle of the night to urinate, increases with age, as older bodies produce less of an antidiuretic hormone that enables the retention of fluid.