Eight hours in bed and no rest
Imagine Zoriana: she spends eight hours in bed but feels drained in the morning. Lately she has also noticed a dry mouth and headaches in the mornings.
Or Yurii, who sleeps enough by the clock but often wakes because of pain in his shoulder. It matters that he tells the doctor about the pain, not only the tiredness.
Or Vlas, who falls asleep to a news radio broadcast and leaves it on until morning because it makes him feel calmer. He sleeps almost eight hours but wakes feeling as if he has been listening to the news all night.
Or Rymma, who gets up at six on weekdays and sleeps until lunchtime at weekends. By Wednesday she feels as if she has not slept at all.
Zoriana has a dry mouth and morning headaches that are worth telling a doctor about, Yurii is woken by pain, Vlas is disturbed by the radio left on, and Rymma’s routine keeps shifting. The section “Why hours of sleep do not explain everything” explains why the number of hours alone is not enough.
If at least one of these stories resembles yours, note what happens at night and how you feel during the day. If none of them fits, answer the questions in the section “How do you feel first thing in the morning?”.
How do you feel first thing in the morning?
Unrefreshing sleep is a state in which a person sleeps long enough but still feels tired, sleepy, heavy or short of energy after waking. Think of your last morning and answer these questions:
- How long has sleep not left you feeling rested?
- How many hours do you usually sleep?
- Do you have trouble falling asleep, or wake during the night or too early?
- Do you feel marked sleepiness during the day?
- Is there loud snoring, pauses in breathing, a feeling of choking or a dry mouth after waking?
- Do you have headaches in the morning?
If you are at risk of falling asleep at the wheel during the day, go straight to the first point of the section “Unrefreshing sleep: the first steps”. If you answered “yes” to the fifth or sixth question, see the second point there as well.
If for several weeks you have been getting enough hours but not enough rest, a doctor can help find what stops your sleep from restoring you.
Consultation booking form.Where assessment of unrefreshing sleep begins
For new or persistent physical symptoms, start with a family doctor. Further investigations depend on your symptoms and examination, not a standard checklist. Mood or anxiety difficulties can also be discussed with a psychiatrist.
The initial psychiatric consultation page shows what a first consultation with a psychiatrist consists of. The specialists’ areas of work are collected on the clinic’s doctors page.
Brief notes on each night and the day after
To make it easier for the doctor to understand, and for you to spot patterns, keep brief notes for a while:
- when you went to bed and got up, how many times you woke and why, if you know;
- how you felt in the morning and during the day;
- caffeine, alcohol, physical activity and daytime naps.
Alongside this, it helps to look at:
- Your routine. Keep fairly stable sleep and wake-up times and leave enough time for night-time sleep.
- Your evenings. Cut down on alcohol in the evening and caffeine in the afternoon, and make your bedroom comfortable; regular physical activity can also improve sleep. If, like Vlas in our example, you fall asleep to the radio, set a sleep timer and keep the air raid alert app switched on.
- Not just more sleep. If you regularly sleep long enough but do not feel restored, sleeping longer is unlikely to solve the problem. It is important to find the cause.
Why hours of sleep do not explain everything
Feeling restored depends on more than time in bed. Sleep can be interrupted by pain, as with Yurii in our example, by breathing problems or by frequent waking. Other health conditions can also keep tiredness going, so it is worth describing the night and the day together.
If low mood and loss of interest in life persist along with unrefreshing sleep, a doctor may also assess for depression. Unrefreshing sleep on its own does not yet mean that you have this disorder.
Similar complaints to tell apart
Unrefreshing sleep is often confused with neighbouring complaints. Compare which is closer to your experience.
- Excessive sleepiness. During the day you feel drowsy to the point of falling asleep unintentionally. See the page on excessive sleepiness.
- Light sleep. You feel that you sleep too lightly and wake at sounds. Compare with the description of light sleep.
- Insomnia. It is hard to fall asleep or sleep long enough, so you simply do not get enough hours. The page on insomnia explains how its forms differ.
- Constant fatigue. You have no energy all day, and it is not only about sleep. See the page on constant fatigue.
These complaints often occur together, and one of them on its own decides nothing.
Unrefreshing sleep: the first steps
- If sleepiness is so marked that there is a risk of falling asleep while driving or during other potentially dangerous activities, stop those activities until the cause is found.
- If there is loud snoring, pauses in breathing during sleep, morning headaches, marked daytime sleepiness or falling asleep unintentionally, a medical assessment is especially important.
- If unrefreshing sleep lasts several weeks, gets worse or comes with constant daytime tiredness, sleepiness and reduced performance, see a doctor.
- If your mood is persistently low, you have lost interest or marked anxiety has appeared as well, see a mental health professional.
- If the cause is clear, such as a disrupted routine like Rymma’s in our example, start with the steps in the section “Brief notes on each night and the day after”. If things do not improve, go back to point 3.
If point 2, 3 or 4 is closer to you, book a consultation. Your sleep notes will be useful at the appointment.
Consultation booking form.Common questions
No. Duration does not guarantee restoration. Disruptions, breathing, routine and other causes of fatigue may need assessment.