10th December 2018
A good night’s sleep can leave you feeling good as new, but we all have those mornings when we wake up feeling… less than refreshed. Even when we’ve had plenty of hours’ sleep, sometimes we can still find ourselves feeling unrestored and tired during the day. If you feel this way on a regular basis, you may be suffering from non-restorative sleep.
Simply put, non-restorative sleep (or NRS) happens when a person is getting a reasonable number of hours of sleep, but still feeling tired or run down. Medically, there is a lot of debate around the validity of non-restorative sleep, as the complaint of feeling unrefreshed is largely subjective and therefore extremely difficult to define and diagnose.
There is very little scientific basis for recognising NRS; for example, polysomnogram sleep studies of people complaining of unrefreshing sleep show very similar patterns of brain and body activity to normal sleepers. The only differences shown by polysomnograms are more regular micro-awakenings, which suggest NRS sufferers do experience more fragmented sleep even if they don’t notice it.
People with suspected NRS tend to score lower on tests of vigilance and motor skills and are more likely to report feeling pain or fatigue, but these are more subjective signals than normally used in traditional medical diagnosis.
Non-restorative sleep is often considered to be a part of insomnia, but specialists disagree over whether NRS alone is enough to diagnose a person with insomnia. A link has also been found between NRS and fibromyalgia/ME, which some specialists use to argue that it should not be included in the insomnia criteria.
A third theory is that non-restorative sleep should be considered and diagnosed as a standalone syndrome in its own right.
The difficulty in classifying how to diagnose NRS means it’s also difficult to determine how to treat it. Standard treatments for insomnia are often irrelevant as these focus on addressing problems falling asleep or maintaining sleep, whereas non-restorative sleepers don’t necessarily experience these issues.
Drugs that enhance slow wave sleep (deep sleep) have also been suggested as a treatment, but there is no evidence that a lack of deep sleep is necessarily the cause of NRS. Some things that have helped NRS sufferers are no different to standard suggestions for anyone looking to improve their sleep, such as regular exercise or keeping your bedroom cool.
With no formal way to diagnose it, non-restorative sleep remains something of a mystery even to sleep and healthcare specialists. It’s difficult to define as its own syndrome without an agreed upon, objective way to recognise it, so, unfortunately, sufferers may remain without proper treatment options for the foreseeable future.
However as mentioned above, they may be able to improve their general sleep routine using natural methods, such as exercising more, switching off screens before bed and making changes to your sleep environment. Read our top tips for a good night’s sleep to find out more, and if symptoms of non-restorative sleep persist you should consult a medical professional.