Sleep Disorders (Insomnia & Sleep Apnoea) — NZ Condition Guide | KiwiMeds

What are Sleep Disorders?

Sleep disorders are conditions that affect the quality, timing, or amount of sleep, leading to daytime distress and impairment. The two most common in New Zealand are insomnia (difficulty falling or staying asleep) and obstructive sleep apnoea (OSA — where the airway repeatedly collapses during sleep, causing breathing pauses). Around 40% of New Zealanders report sleep problems, and OSA affects an estimated 20–25% of middle-aged adults, with many undiagnosed.

Insomnia — Symptoms & Treatment

Insomnia involves difficulty falling asleep, waking during the night, waking too early, or non-refreshing sleep — occurring at least 3 nights per week for at least 3 months. It causes daytime fatigue, poor concentration, irritability, and reduced performance. The most effective treatment is Cognitive Behavioural Therapy for Insomnia (CBT-I), which addresses the thoughts and behaviours that maintain insomnia. Sleep hygiene education is important. Sleeping tablets (including zopiclone — funded by Pharmac — and melatonin) are used short-term only.

Sleep Apnoea — Symptoms & Treatment

OSA symptoms include loud snoring, witnessed breathing pauses during sleep, choking or gasping during sleep, waking with a dry mouth or headache, excessive daytime sleepiness, and poor concentration. Risk factors include obesity, male sex, age over 40, large neck circumference, and a family history of OSA. OSA is diagnosed with a sleep study (polysomnography or home sleep test). Treatment is with CPAP (continuous positive airway pressure) — a machine that keeps the airway open during sleep. CPAP is very effective when used consistently.

Causes and Risk Factors

Insomnia is caused by stress, anxiety, depression, poor sleep habits, shift work, and medical conditions. OSA is caused by anatomical factors (excess tissue in the throat, obesity) that cause airway collapse during sleep. Both conditions are bidirectional with mental health — each makes the other worse.

Diagnosis

Insomnia is diagnosed based on symptoms and sleep history. Your GP may use a sleep diary or questionnaires like the Epworth Sleepiness Scale (for OSA) or Insomnia Severity Index. OSA diagnosis requires a sleep study — your GP can refer you to a sleep clinic. Some home-based sleep tests are available privately.

NZ-Specific Information

CPAP machines for OSA are subsidised through ACC and various government schemes in NZ for eligible patients. Pharmac funds zopiclone for short-term insomnia. Sleep clinics are available in most major NZ centres. The Sleep Disorders NZ foundation provides support. Many Māori and Pacific peoples have higher rates of OSA due to higher rates of obesity and specific anatomical risk factors.

Frequently Asked Questions

Are sleeping tablets safe long-term? No — sleeping tablets lose effectiveness over time and carry risks of dependence and daytime sedation. CBT-I is the preferred long-term treatment. Will I always need CPAP? Most people with moderate to severe OSA need long-term CPAP. Weight loss can improve OSA significantly. Can children have sleep apnoea? Yes — often related to enlarged tonsils/adenoids. Treatment is usually surgical (tonsillectomy).

Supplements That May Support Management

⚠️ Important: The supplements listed below have varying levels of clinical evidence. They are not a substitute for prescribed medications and should only be considered as adjunctive support under the guidance of a qualified healthcare professional. Always inform your GP or pharmacist before commencing any supplement, as interactions with prescribed medicines are possible.

• Melatonin — Melatonin regulates the sleep-wake cycle. Low-dose melatonin (0.5–5 mg, 30–60 minutes before target bedtime) is evidence-supported for sleep onset insomnia, circadian rhythm disorders, and jet lag, with an excellent safety profile.
• Magnesium Glycinate or Threonate — Magnesium activates GABA receptors and regulates melatonin synthesis. Supplementation at 200–400 mg before bed may improve sleep onset latency and subjective sleep quality, particularly in deficient individuals or older adults.
• L-Theanine — L-Theanine promotes relaxation via alpha-wave induction without sedation. At 200 mg taken 30–60 minutes before bed, it may reduce sleep onset latency, particularly in those with anxiety-related insomnia.
• Valerian Root — Valerian has weak GABA-modulatory activity. Clinical evidence supports modest improvements in sleep latency. Standardised extracts (400–600 mg) taken 30–60 minutes before sleep are the most studied formulations.
• Phosphatidylserine — In those with elevated evening cortisol contributing to sleep difficulty, phosphatidylserine (100–400 mg) has demonstrated blunting of the cortisol stress response, potentially supporting sleep in stress-related insomnia.

Relevant Vaccinations

Individuals living with sleep disorders may benefit from the following vaccinations. Please discuss your vaccination status with your GP or practice nurse, as eligibility and funding through the New Zealand National Immunisation Schedule may apply.

• Influenza (annual) — Illness significantly disrupts sleep quality and quantity. Annual influenza vaccination reduces illness-related sleep disruption.
• COVID-19 — Post-COVID insomnia is frequently reported. Maintaining COVID-19 vaccination may reduce the risk of post-acute sleep complications.

Dietary Guidance

Evidence-based dietary modifications play a meaningful role in the management of sleep disorders. The following foods are generally recommended as part of a balanced, condition-appropriate diet. A referral to a registered dietitian may be beneficial for personalised nutritional planning.

• Tart cherry juice — Among the richest dietary melatonin sources. Clinical trials demonstrate improvements in sleep duration and quality with twice-daily consumption. Also contains tryptophan and anti-inflammatory anthocyanins.
• Kiwifruit — New Zealand-grown and sleep-evidenced — two kiwifruits eaten 1 hour before bed demonstrated significant improvements in sleep onset (35% reduction in latency), total sleep time, and quality in a randomised study, via serotonin and antioxidant mechanisms.
• Oily fish and walnuts — Omega-3 fatty acids and vitamin D from fatty fish are associated with better sleep quality. Walnuts are also a natural melatonin source.
• Warm milk or chamomile tea — Milk contains tryptophan (a melatonin precursor). Chamomile contains apigenin, which binds GABA-A receptors to promote relaxation.
• Avoid: caffeine after 2 pm, alcohol, large evening meals — Caffeine has an 8–10 hour half-life delaying sleep onset. Alcohol reduces sleep quality and suppresses REM sleep. Large evening meals increase core temperature, disrupting sleep onset.

Related Conditions & Medications

Related medications: Zopiclone, Melatonin. Related conditions: Depression, Anxiety.