Do you have trouble sleeping at night, and wake up feeling dull and tired instead of rested and ready for the day? You could be suffering from a sleep disorder, caused by an underlying medical condition or lifestyle and environmental factors. Common sleep disorders include insomnia, sleep apnoea, restless legs syndrome and narcolepsy.

Dr Toh Song Tar, Senior Consultant from the Department of Otolaryngology at Singapore General Hospital, gives detailed answers to your questions.

Question by caroline

1. What are the reasons that I don't get into deep sleep which I used to be?
2. My eyes don't rest well after the sleep and specific reason? Could it be due to the lasik op that I have gone thru more than 5years ago, as I have this persisted problem since then.

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

1. There are many reasons ranging from life-style behavioural issues to medical conditions. Poor sleep hygiene like drinking too much coffee, watching TV, playing video games & exercising before sleep can cause problems. Life- and work-related stress also can affect someone’s sleep.
2. Poor sleep can give the sensation of being poorly rested. It is unlikely to be due to the previous operation.

Question by s1630548j

Dear Dr Toh

My friend is suffering from insomnia for the past one or two months. She just couldn't get to sleep in the night and subsequently fallen asleep only in the late morning and then felt too tired to wake up or reluctant to wake up.

Please advise how to handle such a suitation.

Thank you.

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

Your friend should get an evaluation by a sleep specialist in insomnia. Issues like poor sleep hygiene, drinking too much coffee, smoking and stress etc. can lead to this.

Question by ireneneo

At times my sleep are disrupted in the midst of sleeping and will continue for several nights.

Eg. Monday night, I will be suddenly awake at 3am and will have a hard time sleeping back again and this cycle will continue at the same timing for the next few nights.

Is there anyways to prevent such occurence?

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

You need to find out why your sleep is affected. It could be environmental factors, stress or medical conditions like sleep apnea, restless leg syndrome etc. It is better to get an evaluation by a specialist.

Question by rsim

Hi Dr Toh,

I have insomnia almost every night, when I go to bed early even though I am tired after a day work, I am not able to fall asleep, often I will toss and turn or lay awake for few hours. I tried milk and other stuff like cool temperature etc etc, nothing helps, is this sympton of sleep disorder?

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

You are suffering from insomnia and should seek evaluation by a sleep specialist in insomnia.

Question by pocoyosky

Hello,

Could you please advise how can we cure sleep disorder, I am suffering from insomnia and I only have less than 6 hours of sleep every day which is very tiring during the day. Is there medication available?

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

You are suffering from insomnia and should seek evaluation by a sleep specialist in insomnia. Medications are available but should be used carefully. The root cause of insomnia must be sorted out. There are also other sleep disorders and treatment will be based on the diagnosis.

Question by sieweng55

Hi Dr Toh

I have 3 questions

1. What are the pre-bedtime snack that can help us to sleep better?
2. Are there any foods that will harm our sleep? Beside foods that contain caffeine. And
3. How long do we need to give our body to proper digest the foods?

Thanks

Regards
SE

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

1. You can try warm milk and banana. They contain tryptophan which is an amino acid that can help people sleep.
2. Generally eating too much before sleep or having a huge supper can disturb sleep. It can precipitate reflux which can cause irritation to the throat and coughing.
3. We need at least 2-3 hours after meal before sleep to prevent acid reflux. Proper digestion of food takes longer.

Question by esim

Hi Dr Toh,

I hardly have deep sleep unless I have wine before bedtime, most of the times, I have difficulties sleeping earlier and I awake easily at slightest noise, I wake up morning feeling unrested, no sleep and I find that this lack of sleep greatly affect me mentally, including my memory power. Am I having sleep disorder? Any solution available?

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

You should look at factors that can affect sleep including caffeine intake, smoking, pre-existing medical conditions, stress etc. and try to remedy them. Taking alcohol to sleep is not advisable as it disturbs the quality of your sleep as well, although you may fall asleep faster. As time passes, the sleep-inducing effect will diminish.

Question by ameliagoodies

Hi Dr,

I'll like to ask if it is common for individuals with sleep apnea to keep waking up at night and to sleep in a sitting position? My specialist has suggested I go for a sleep study in view of some symptoms that were observed - exhaustion when awakened in the morning, tendency to wake up a few times at night. My siblings who slept beside me has commented that I would often sit up at night and sleep while in a sitting position by the bedside while sitting on the floor and that it has become a nightly occurrence. Is such behaviour indicative of obstructive sleep apnea and and thus the need for a sleep study to find out why?

Secondly, I would like to ask what are the common treatment options for obstructive sleep apnea.

Thanks!

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

Yes, you may have obstructive sleep apnea and it is common because the brain registers the drop in oxygen and needs to 'wake up' to open the upper airway, hence the frequent awakenings. The increased effort in breathing can also cause the person to wake up. You need to check if your nose is blocked or congested as this can affect your sleep as well. The common treatments are positive airway pressure, mandibular advancement device and surgeries for the nose, palate, tonsils and base of tongue.

Question by huangnicolette

Dr Toh, My friend got a problem. Which is so bad! When he step into the office, he can easily doze off, like nobody business! He told me at nite he sleep through soundly. Even he sit here and there or lunch. Sure doze off! I told him u got sleep disorder. dont want to admit. with 3cups of kopi also zzz! 57yrs old male. I còuld see. Affecting his job badly! How can this be help? What cause human to like this? Thanks dr toh!

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

Your friend has excessive daytime sleepiness. This can be related to sleep disorders like obstructive sleep apnea, nasal obstruction narcolepsy, restless leg syndrome etc. He may need to check his sleep hygiene and should get an evaluation by a doctor.

Question by eunice.tan01

My spouse has got trouble sleeping at night. Day time he feels sleepy but he does not take afternoon nap too. He has this problems since young and it runs in the family. His siblings and mother have difficulty in falling asleep at night. Till today, no medication or see doctor could help. Doc, what is your advice?

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

You should get a sleep specialist in insomnia to find any treatable cause.

Question by ronwee101

Dear Doctor,

My name is Ronald Wee & I have problem to sleep for 24 hours.

Every night I can only get 3 to 4 hours of sleep.This has happened for 2 months already.

I tried to gety some sleep in the day time ,but still I am unable to sleep. I went to see the doctor and I was given Hydroxine tablet for a week. Still having the same problem.

On my second visit to the same doctor T was prescribe 0.5 mg of Lorizapam to be taken nightly.

I still find no success in getting some sleep.

I am Male 61 years of age and do not know what to do. Can you kindly advice?

Regards
Ron

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

You should get a sleep specialist in insomnia to find any treatable cause.

Question by jacwong20

Hi,

Does drinking tea a few hours (e.g. 2-3 hours) before sleeping, makes more prone to insomnia? Is it proven in any studies?

Is it applicable to all tea types? E.g Bubble Tea Thanks.

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

Tea that contains caffeine can affect sleep. Unless specified, most tea does have caffeine.

Question by linghoong

If sleep apnea is treated using CPAP machine, is it possible to be completely cured to the extent that the CPAP machine is no longer needed in the future?

Why or how does the condition of sleep apnae developed as we age? Is it a hereditary condition?

Is snoring always an indicator of sleep apnea? My son who is 9 years old snores every night. Should I be concerned about this? Can this condition affect someone that young?

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

CPAP and other non-surgical treatments of sleep apnea are able to control sleep apnea but not cure this chronic condition. Weight loss can help but in most instances, not cure it.

Surgical treatment offers a chance to cure and reduce the severity of this disease but with age and weight gain, this condition can recur/relapse.

Patients with sleep apnea have smaller airway to begin with. So with age and weight gain, the tissues in the throat become more lax and tend to collapse. In Asian people, weight plays a smaller role because our Asian bony and soft tissue features predispose us to a smaller airway. Because facial features are passed from parents to children, there is an element of hereditary component.

Snoring means that the airway is narrowed. It may not mean that the person has sleep apnea. However, snoring destroys airway tissues and the nerves in the upper airway, and over a long period of time, predisposes a person to sleep apnea.

Yes, you should be concerned and should get your son evaluated by an ENT surgeon familiar with snoring and sleep apnea. In children, enlarged tonsils, adenoids and nasal allergies and obstruction can lead to airway narrowing.

Question by linghoong

Why or how does the condition of sleep apnae developed as we age? Is it a hereditary condition?

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

Patients with sleep apnea have smaller airway to begin with. So with age and weight gain, the tissues in the throat become more lax and tend to collapse. In Asian people, weight plays a smaller role because our Asian bony and soft tissue features predispose us to a smaller airway. Because facial features are passed from parents to children, there is an element of hereditary component.

Question by janeang

Dear Dr Toh My cousin sleeps around 7 hours every night. However, she doesn't feel refreshed in the morning and sometimes feel reluctant to wake up. She has dark eye bags even though she sleeps around 7 hours every night and looks like she hasn't sleep much. Please advise how to handle such a suitation. Thank you!

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

She should get evaluated by a sleep specialist and get an overnight sleep study. She may have a sleep disorder that is disturbing her sleep.

Question by chongweijung

Dear Doctor, I'm 29 years old. Normally, I'll sleep from 11:00 p.m till 6:00 a.m. But recently, I've woken up at 4:30 a.m. with no apparent reason. I go back to sleep after a while but this interrupted sleep has caused problems with my daytime work. Is there any method to 'reset' my sleeping habits to normal?

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

You need to get an evaluation by a sleep specialist to see if you have developed a sleep disorder. An overnight sleep study is required and the treatment depends on the cause.

Question by eccles

I notice my spouse tends to raise his leg up and down repeatedly during his sleep, sometimes with such great frequency and intensity that it also disrupts my sleep at night. Is this condition known as restless legs syndrome and is there any remedy for it please?

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

Yes, your spouse may be suffering from restless leg syndrome and should get a sleep specialist in restless leg syndrome, usually a neurologist, to evaluate the cause of it. There are treatable causes of restless leg syndrome although sometimes it may be idiopathic.

Question by rach_lim8

My sister & I dream every night , even if we wake up in the middle of the night, after getting back to sleep, I can still have another new dream.

Is having dreams every night normal?

Especially for my sister, she will feel very tired after a night of dream.

Please advise. Thanks.

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

Yes, dreaming is normal every night. It means you are in deep sleep.

Question by ncashl

Dear Dr Toh, I have a bad sleeping pattern, normal start to sleep at 10pm and wake up at 1am. For the next few hours I will not be able to sleep. My mind will be occupied with thoughts tied to tasks which I will have to complete. It can be work-related or non-work related, eg, how to paint my house, how to earn enough money to buy new furniture, how to overcome problem and many many others. As long as I think of something, it will keep my mind awake to work on it. I will get back to sleep only at around 5.30am again. I wake up at 6.15am daily feeling tired. This has been going on for the past few years. Even medications for cough and flu doesn't help to get me to sleep. I would like to find out what am I suffering from and any treatment for my sleep pattern. Thank you

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

You have sleep maintenance insomnia and it seems like stress is contributing to it. You should seek evaluation by a sleep specialist in insomnia.

Question by bengbros

Hi Dr Toh,

Is grinning teeth considered as a sleep disorder? I didn't realise that i had this problem until recently when i am married.

Should i consult a ENT specialist or a dentist?

Pls advise,

thanks.

Regards,
Nicholas Png

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

Yes, teeth grinding can be considered a sleep disorder if it disturbs sleep. You should see a neurologist specialising in sleep medicine to evaluate the cause. Sometimes it can be caused by stress, personality or neurological problems. A dentist can prescribe a dental protector to protect the teeth.

Question by moritayumi

Dear Dr. Toh, This is the first time I heard the 'Restless leg syndrome' term. I have 2 questions about this:

1. I usually sleep on my stomach. My partner often notice that I have tendency to lift both of my lower leg up to the sky for hours, once or twice monthy, without me realizing. Is this a kind of sleep disorder?
2. Is kicking floor while sleeping (unconsciously) considered as a sleep disorder ?

Sometimes I will yawn for more than 30 times in the morning. is this due to not enough oxygen in the brain while sleeping? Is it normal?

Thank you :)

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

Yes, you may be suffering from restless leg syndrome and should get a sleep specialist in restless leg syndrome, usually a neurologist, to evaluate the cause of it. There are treatable causes of restless leg syndrome although sometimes it may be idiopathic. It can disturb the quality of your sleep and cause sleep fragmentation, hence the excessive daytime sleepiness the next day.

Question by liz_soh

Hi Dr Toh, Thanks for taking the time to answer our questions. I think I have a sleeping problem. Since young, I am a night owl. My mum would put my sister and me to bed around 9pm. My sister is able to fall asleep soundly but I always had difficulties sleeping. I remembered having to toss and turn in bed for a few hours before I fell asleep. This problem persisted into my teenage years. I recall reading my books late into the night around 11 plus 12am because I did not feel sleepy. When I reached adulthood, my sleeping time is somewhat fixed between 12am to 2am (or later some certain days). Apart from this, I have problems waking up early in the morning. It is a long-life struggle waking up in the morning to go to school (then) /work (now). I usually feel very tired when I wake up and will need about 1.5hrs for my body and mind to be "fully awake". For some strange reasons, I can never wake up before 7am, even if I sleep early the night before. Even if I manage to do wake up at 7am, I will feel very tired by that afternoon. Throughout the years, my mum had been nagging me about my sleeping habits. She keeps asking me to sleep early but I just can't! She can't seem to understand when I tell her I am not sleepy (at 1am). We quarreled many times over this issue. I was wondering if my condition is some form of chronic insomnia. Hope to hear your views on this. Thanks! Regards Elizabeth

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

Your biological clock may have been delayed such that you sleep late and wake up late. This is called delayed sleep phase syndrome. Because of society’s norms of schooling and working hours, this can cause problems. You should get an evaluation and see if you can adjust your biological clock. This may take a long time.

Question by karc

What is the remedy for someone who has insomnia and did not manage to sleep for 3-4 nights, due to work stress and working late past mid-night? Please advice. Thanks!

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

You need to know how to manage stress properly and have proper sleep hygiene. Have a strict timetable for proper relaxation and exercise. Do not take too much coffee or alcohol and avoid smoking.

Question by audrey chee

Hi Dr Toh,

I am experiencing insomia frequently and have consulted a doctor on my condition. Their advise was to get in to bed early as a habit. Frankly speaking, I do get in to bed at around 10-10.30 every night but it does not help me to get into deep sleep. Secondly, I realised that I am a light sleeper as I tend to wake up easily over a small little noise. The problem got worst when I have a work issue that is unsettled and it just cant get off my head even when I sleep.

Thus, I would like to seek your advice in treating this sleeping disorder of mine and hope to improve on it.

Audrey

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

You should get an evaluation by a sleep specialist in insomnia. However, simple sleep hygiene practices can be used first, like knowing when to relax, have proper exercise, not drink too much coffee, etc.

Question by sonarflick

No matter how tired I am, I often find myself struggling to sleep. I would then normally surf my phone or read a magazine in bed for another 30 mins - 1 hr before I actually fall asleep. Are there any common types of mild sleeping medications that I can take to help me sleep? May I know what are the side effects of sleeping medications? Thank you.

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

You should get an evaluation by a sleep specialist in insomnia. Using medications to sleep is not advisable unless prescribed by a physician.

Question by dianaong

Dear Dr Toh

Please explain what is restless legs syndrome and narcolepsy? I do not sleep well in the night. I will wake up about 2-3 times and I also have problems getting into sleep.

Thanks.

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

In restless leg syndrome, patients have an irresistible urge to move their legs and during sleep, they move their limbs frequently. That can affect the quality of sleep, and hence cause excessive sleepiness the next day. There are many causes of restless leg syndrome which should be evaluated properly.

In narcolepsy, patients have excessive daytime sleepiness and frequent daytime sleep attacks. They may have cataplexy which during periods of strong emotion, leads to muscle weakness. It is a neurological disorder.

Question by dragonpisces

I have problem staying asleep soundly.After getting up about 3 or 4 hours of sleep to pee,I cannot get back to sleep,and will lie awake for about 3 or 4 hours,or if I fall back to sleep,I will have a disturbing sleep like dreaming all sorts of unusual dreams.What is wrong with me ?

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

You have sleep maintenance insomnia and need to be evaluated. It is normal to dream, but not being able to go back to sleep after waking up should be evaluated.

Question by elysium

I have a 6-year old girl. On occasion she has extremely troubled sleep. She will fret and cry and at times, with arms flailing, will throw her bolster, pillow and blanket away. She wakes with no memories of the episode, but will however complain that she feels extremely tired after. What might be the cause of these episodes? Is there any way to prevent their occurrence / reoccurrence?

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

She may have ‘confusional arousals’. This occurs when she wakes up during periods of deep sleep. It may be harmless but can be a result of nocturnal asthma, sleep apnea and restless leg syndrome. Young children should have a routine for sleep. If it occurs frequently, they should get evaluated to exclude medical conditions.

Question by newsman

I woke up 2-3 times a night to Urinates & woke up with a sore throat & feel tired, like not having a good sleep. Lately prop myself up & sleeping in almost in a reclining chair position. This position enable me to sleep better & woke up only once to urinate & without sore throat. Why ?

Answered by Dr. Toh Song Tar Consultant Dept Of Otolaryngology Singapore General Hospital

You may be suffering from sleep apnea and should definitely seek evaluation. The reason why your throat is sore is that you are using your mouth to breathe, possibly because your nose is blocked. Sleeping in an inclined position allows you to breath more through your nose.

Ref: T12​