Anemia and Sleep: What’s the Connection?

Sleep is a complex process. There are so many factors that can play a role in how well you’re able to sleep—and, as a result, how energized (or exhausted) you feel the next day. One of those factors? Anemia.

Yep, there’s a connection between anemia and sleep—and that connection can have a major influence on the quality of your rest.

But what role does anemia play in sleep? How do they influence each other? For example, can lack of sleep cause anemia—or can anemia cause sleep apnea or other issues?

Let’s take a look at everything you need to know about anemia and trouble sleeping.

What is anemia?

First things first. Before we jump into the anemia/sleep connection, let’s quickly touch on what, exactly, anemia is.

Anemia happens when there’s a reduction in the amount of healthy red blood cells or hemoglobin in the blood, according to the Mayo Clinic.

As the Cleveland Clinic explains, hemoglobin is a protein in your red blood cells, and it’s responsible for transporting oxygen from your lungs to other organs.

When you’re anemic, that oxygen delivery is compromised. This can lead to anemia symptoms like fatigue, weakness, dizziness, and pale skin.

What causes anemia?

There are a few different things that can cause anemia, according to the Mayo Clinic. These include:

Iron deficiency. One of the most common culprits behind anemia is iron deficiency. You might experience iron deficiency if you don’t get enough of it through your diet or your body can’t absorb it adequately.
Vitamin B12 deficiency. It’s not just iron deficiency that can cause anemia. Vitamin B12 deficiency can also cause anemia since your body needs this vitamin to make enough healthy red blood cells.
Blood loss. When you lose blood, you also lose red blood cells and hemoglobin—which, in turn, could lead to anemia. Blood loss can result from injuries, childbirth, or gastrointestinal issues like ulcers.
Chronic conditions. There are also certain conditions or diseases (like autoimmune disorders, cancer, or kidney disease) that can cause anemia. Sickle cell anemia, meanwhile, is an inherited condition that can cause a shortage of healthy red blood cells.

What are the symptoms of anemia?

Anemia can manifest in several different symptoms. Per the Mayo Clinic, these include:

Extreme fatigue
Feelings of exhaustion
Dizziness
Weakness
Pale skin
Cold extremities (hands and feet)
Shortness of breath
Headaches

Over time, anemia can also lead to more serious symptoms and issues—like heart problems (including an irregular heartbeat, an enlarged heart, or heart failure) or pregnancy complications.

Anemia and sleep: What’s the connection?

Clearly, anemia can cause a lot of symptoms. But how does it impact sleep specifically?

“Anemia can affect sleep in a variety of ways,” says Raj Dasgupta, MD, chief medical advisor for Sleepopolis.

For example, “There are associations between anemia and insomnia as well as anemia and restless legs syndrome,” says Dasgupta. “Anemia can cause symptoms that may make it difficult to sleep, like headaches.”

There’s a definite connection between iron deficiency and sleep; if your anemia is caused by an iron deficiency, it could influence your neurotransmitters in a way that negatively impacts sleep.

Even if your anemia isn’t caused by iron deficiency, you could still experience other sleep-related issues, such as fatigue.

“Fatigue…may lead to insomnia because it makes it more difficult to get physical activity during the day,” explains Dasgupta.

Common questions about the connection between sleep and anemia include:

Can lack of sleep cause anemia? Lack of sleep doesn’t cause anemia, per se—but it also doesn’t help. “Poor sleep doesn’t directly cause anemia but can make anemia symptoms worse, like increasing daytime tiredness and fatigue,” says Dasgupta.
Can sleep apnea cause anemia—and can anemia cause sleep apnea? There’s a link between anemia and sleep apnea. Low iron levels (which can indicate anemia) have been associated with a variety of sleep disorders, including sleep apnea. The shallow breathing that can often accompany sleep apnea can cause oxygen in the blood to drop, impacting red blood cells and hemoglobin.
Does anemia make you sleepy? One of anemia’s main symptoms is fatigue—so if you’re anemic, it can definitely make you feel more sleepy during the day.

How do you treat anemia?

So, how do you treat anemia and get your sleep back on track?

“To treat anemia, you must address the underlying cause,” says Dasgupta—and that means going to the doctor. Your doctor can run tests to help determine if you have anemia—and, if so, what’s causing it.

Then they can help you create a treatment plan that addresses the root cause of your anemia—and get you feeling better.

Depending on the type of anemia you have, treatments may include:

Taking iron supplements. If your anemia is due to iron deficiency, replacing that iron via supplements may help. However, always consult a medical specialist before adding iron supplements to your routine.
Changing your diet. Similarly, dietary changes can help treat anemia. “Eat iron-rich foods and get enough vitamins B12 and folic acid,” says Dasgupta. Follow your doctor’s advice and take any prescribed supplements.
Managing sleep disorders. As mentioned, sleep disorders like sleep apnea can contribute to anemia. As such, part of treatment should be to “address any primary sleep disorder such as obstructive sleep apnea,” says Dasgupta.
Practicing good sleep hygiene. While practicing good sleep hygiene won’t necessarily treat your anemia, it could help improve sleep—and help you manage sleep-related anemia symptoms like fatigue. “Go to bed at the same time each night, make your bedroom cozy, and manage stress to sleep better,” says Dasgupta.
Working with your doctor. Anemia requires ongoing maintenance—so, if you want to treat your anemia (and get better sleep in the process!), it’s important to work with your doctor on an ongoing basis. “Regular check-ups will help keep your anemia under control and support better sleep,” says Dasgupta.

FAQs

Does anemia cause sleep problems?

Yes, anemia can play a part in a variety of sleep problems—including insomnia, restless legs syndrome, and fatigue.

What does anemia fatigue feel like?

Anemia fatigue can feel like you’re exhausted or depleted. You don’t have much energy and you don’t feel well-rested.

How much sleep does an anemic person need?

An anemic person needs to work on treating their anemia and getting their symptoms under control so they can not only get the recommended amount of sleep (which, depending on the person, can range from seven to nine hours per night) but also improve the quality of sleep—which can lead to increased energy and decreased fatigue.