Sleep disorders: causes, medications & what really helps

You lie awake, toss from one side to the other, and the next morning you feel worn out. Sleep disorders – whether difficulty falling asleep, difficulty staying asleep or waking too early – are among the most common health complaints in Germany. What many do not know: some medications can disturb your sleep considerably. From beta-blockers through thyroid hormones to corticosteroids – a look at your medication is worth it.

What you can do right now
When is it more than a bad night?
Common causes
Sleep hygiene: 7 rules
Home remedies & natural sleep aids
Is it down to your medication?
Warning signs: when to see a doctor?
Preparing for the doctor's appointment
How brite supports you
FAQ

With suicidal thoughts or severe psychological strain: Telefonseelsorge crisis line 0800 111 0 111 (free, 24/7; in the US: the 988 Suicide & Crisis Lifeline).

1. What you can do right now

Quick help with sleep disorders

Routine: go to bed and get up at the same time every day – at the weekend too.
Screen: put the smartphone, tablet and laptop away 60 minutes before sleeping.
Temperature: cool the bedroom to 16–18 °C and darken it.
Caffeine: no more coffee, tea or cola after 2 pm.
Check medications: are you taking beta-blockers, levothyroxine, prednisolone or antidepressants? They can disturb sleep.

Crisis support: Telefonseelsorge 0800 111 0 111 (in the US: 988) With days of insomnia accompanied by severe exhaustion, confusion or suicidal thoughts: please seek help immediately. Telefonseelsorge: 0800 111 0 111 (free, round the clock).

2. Understanding sleep disorders – when is it more than a bad night?

Sleep disorders (medically insomnia) become medically relevant when you sleep badly at least three times a week – over a period of more than four weeks.

Form	Description
Difficulty falling asleep	You lie awake for longer than 30 minutes before you fall asleep
Difficulty staying asleep	You wake up at night and do not find your way back into sleep
Early waking	You wake up noticeably too early and are tired nonetheless – typical with depression

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You feel the consequences during the day: tiredness, concentration problems, irritability and reduced performance.

3. Common causes of sleep disorders

3.1 Medications – a frequently overlooked factor

Medication	Why it disturbs sleep	Solution
Bisoprolol, Metoprolol (beta-blockers)	Inhibit melatonin production → nightmares, difficulty staying asleep	Speak to a doctor, add melatonin if needed
Levothyroxine	With an overdose: palpitations, restlessness, insomnia	Check TSH, adjust the dose
Prednisolone (corticosteroid)	Activates the metabolism – especially with evening intake	Always take in the morning!
Citalopram, escitalopram (SSRIs)	Sleep disorders possible especially in the first weeks	Usually normalises after 2–4 weeks
Torasemide (diuretic)	Nocturnal urge to urinate with evening intake	Always take in the morning!

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3.2 Stress and psychological strains

Ruminating, worries, work pressure – psychological stress is the most common cause of difficulty falling asleep. With depression, early waking (4–5 am) is typical.

3.3 Sleep apnoea and snoring

Breathing pauses during sleep lead to unconscious waking and unrefreshing sleep. Typical: loud snoring, extreme daytime sleepiness, a partner reports breathing pauses. It particularly affects people who are overweight.

3.4 Pain and other symptoms

Chronic back pain, joint pain, cough or heartburn can disturb sleep massively.

4. Sleep hygiene: 7 rules for better sleep

Sleep hygiene is the most important non-medication measure with sleep disorders – and the basis of every effective treatment:

Fixed times: go to bed and get up at the same time every day (at the weekend too).
Bedroom = sleeping room: use it only for sleeping. No television, no working in bed.
Screen break: put the smartphone and laptop away 60 minutes before sleeping. Blue light inhibits melatonin production.
Temperature: 16–18 °C, well ventilated and darkened.
No caffeine after 2 pm: caffeine has a half-life of 5–6 hours – an afternoon coffee still has an effect at midnight.
No alcohol as a sleep aid: alcohol lets you fall asleep faster, but disturbs staying asleep massively (REM sleep fragmentation).
Relaxation: progressive muscle relaxation after Jacobson, the 4-7-8 breathing technique (breathe in 4 sec, hold 7 sec, breathe out 8 sec) or body-scan meditation.

5. Home remedies and natural sleep aids

Herbal remedies can have a supporting effect with mild sleep disorders: valerian (as a coated tablet or tea, the effect builds up over 2–4 weeks), hops (often in combination with valerian), passionflower (especially with stress-related difficulty falling asleep) and lavender (as an oil on the pillow or as a capsule).

Warm milk with honey is a classic – the effect is psychological rather than pharmacological, but rituals help with falling asleep. Sour cherry juice contains natural melatonin and can have a supporting effect.

Melatonin: what is allowed? In Germany, melatonin is available over the counter up to 1 mg as a food supplement. At a higher dose it is prescription-only (Circadin, 2 mg). Melatonin is not a classic sleeping pill but supports the natural sleep-wake rhythm – especially helpful with jet lag and shift work.

6. Is it down to your medication?

Digital medication plan: record all medications – your doctor sees sleep-disturbing active ingredients immediately. → Create a medication plan

Interaction check: several activating medications at once? brite shows the combination. → Start the interaction check

Intake reminder: prednisolone and torasemide in the morning rather than the evening – the right intake time makes the difference. → Set up a reminder

7. When should you have sleep disorders assessed?

Sleep disorders lasting longer than 4 weeks despite good sleep hygiene.
Extreme daytime sleepiness with microsleep or loss of concentration.
Loud snoring with breathing pauses (ask your partner!).
Sleep disorders together with a new medication.
Low mood, hopelessness – Telefonseelsorge: 0800 111 0 111 (free, 24/7; in the US: 988).

8. Preparing for the doctor's appointment – your checklist

Sleep pattern: difficulty falling asleep, difficulty staying asleep or early waking?
Since when? And what has changed (stress, medications, life situation)?
Medications: a complete list – over-the-counter remedies and vitamins too.
Sleep hygiene: sleep times, screen time, caffeine, alcohol?
Accompanying symptoms: snoring, breathing pauses, palpitations, pain?

How brite supports you in keeping an overview

brite helps you to recognise sleep-disturbing medications and to keep to the right intake time.

Digital medication plan – all preparations at a glance, so that sleep-disturbing active ingredients are immediately recognisable. To the medication plan
Interaction check – shows when several activating medications are combined. Check now
Intake reminder – taking prednisolone and torasemide in the morning makes the decisive difference for sleep. Set up a reminder