Do you struggle to get to sleep no matter how tired you are? Or do you wake up in the middle of the night and lie awake for hours, anxiously watching the clock? Insomnia is a common problem that takes a toll on your energy, mood, health, and ability to function during the day.
Chronic insomnia can even contribute to serious health problems. Simple changes to your lifestyle and daily habits can put a stop to sleepless nights.
What Is Insomnia?
Insomnia can be a short-term or chronic condition, but it always involves problems with falling asleep or staying asleep. Short-term (transient) insomnia can be caused by illness, stress, travel, or environmental factors.
Long-term (chronic) insomnia may be due to underlying psychological or physical conditions.
Who Is at Risk?
Anyone can get insomnia, but it is generally more common in women than in men. The elderly are particularly at risk for insomnia.
Causes of insomnia: Figuring out why you can’t sleep
In order to properly treat and cure your insomnia, you need to become a sleep detective. Emotional issues such as stress, anxiety, and depression cause half of all insomnia cases.
But your daytime habits, sleep routine, and physical health may also play a role. Try to identify all possible causes of your insomnia. Once you figure out the root cause, you can tailor treatment accordingly.
- Are you under a lot of stress?
- Are you depressed or feel emotionally flat or hopeless?
- Do you struggle with chronic feelings of anxiety or worry?
- Have you recently gone through a traumatic experience?
- Are you taking any medications that might be affecting your sleep?
- Do you have any health problems that may be interfering with sleep?
- Is your sleep environment quiet and comfortable?
- Are you spending enough time in sunlight during the day and in darkness at night?
- Do you try to go to bed and get up around the same time every day?
Insomnia is the inability to get the amount of sleep you need to wake up feeling rested and refreshed. Because different people need different amounts of sleep, insomnia is defined by the quality of your sleep and how you feel after sleeping—not the number of hours you sleep or how quickly you doze off.
Even if you’re spending eight hours a night in bed, if you feel drowsy and fatigued during the day, you may be experiencing insomnia.
Although insomnia is the most common sleep complaint, it is not a single sleep disorder. It’s more accurate to think of insomnia as a symptom of another problem, which differs from person to person. It could be something as simple as drinking too much caffeine during the day or a more complex issue like an underlying medical condition or feeling overloaded with responsibilities.
The good news is that most cases of insomnia can be cured with changes you can make on your own—without relying on sleep specialists or turning to prescription or over-the-counter sleeping pills.
A doctor will make a diagnosis of insomnia based on information about your sleep patterns. Your doctor may ask:
- How long does it take you to fall asleep at night?
- How many times during the night do you wake up?
- Do you experience daytime fatigue?
- Do you have a medical condition that may interfere with sleep?
- What medications do you take (including prescription drugs, over-the counter drugs, and herbs or supplements?)
- Do you drink alcohol or smoke?
- Your doctor may also ask you to keep a sleep diary to record specific sleep-related information.
Sleep hygiene is an important first step for controlling insomnia. These simple self-help measures include establishing a regular bedtime routine, regulating mealtimes and fluid consumption, and limiting caffeine consumption.
Behavioral therapy methods include various approaches for training new sleep behaviors and helping patients relax and sleep well. Behavioral therapy can help treat insomnia in people of all ages.
If self-help or behavioral therapy do not solve the problem, a doctor may prescribe medications for use on a short-term basis.
Non-benzodiazepine sedative hypnotics are usually the preferred type of drugs. They include zolpidem (Ambien, generic), zaleplon (Sonata, generic), eszopiclone (Lunesta), and ramelteon (Rozerem).
These drugs can cause side effects, and it is important that your doctor explains the risks of these drugs and the precautions you need to take.
In sleep studies, subjects spend about one-third of their time asleep, suggesting that most people need about 8 hours of sleep each day.
Individual adults differ in the amount of sleep they need to feel well rested, however. (Infants may sleep as many as 16 hours a day.)
The daily cycle of life, which includes sleeping and waking, is called a circadian (meaning “about a day”) rhythm, commonly referred to as the biologic clock.
Hundreds of bodily functions follow biologic clocks, but sleeping and waking comprise the most prominent circadian rhythm. The sleeping and waking cycle is about 24 hours. It usually takes the following daily patterns:
Humans are designed for daytime activity and nighttime rest.
Additionally, there is a natural peak in sleepiness at mid-day, the traditional siesta time.
In addition, daily rhythms intermesh with other factors that may interfere or change individual patterns:
The monthly menstrual cycle in women can shift the pattern.
Light signals coming through the eyes reset the circadian cycles each day, so changes in season or various exposures to light and dark can unsettle the pattern.
Sunlight is an important regulator of circadian rhythms. People who are blind commonly suffer from trouble sleeping and other circadian rhythm disruptions.
Adopting new habits to help you sleep
- Make sure your bedroom is quiet, dark, and cool. Noise, light, and heat can interfere with sleep. Try using a sound machine or earplugs to hide outside noise, an open window or fan to keep the room cool, and blackout curtains or a sleep mask to block out light.
- Stick to a regular sleep schedule. Support your biological clock by going to bed and getting up at the same time every day, including weekends, even if you’re tired. This will help you get back in a regular sleep rhythm.
- Avoid naps. Napping during the day can make it more difficult to sleep at night. If you feel like you have to take a nap, limit it to 30 minutes before 3 p.m.
- Avoid stimulating activity and stressful situations before bedtime. This includes vigorous exercise; big discussions or arguments; and TV, computer, or video game use. Instead, focus on quiet, soothing activities, such as reading, knitting, or listening to soft music, while keeping lights low.
- Don’t read from a backlit device (such as an iPad). If you use an eReader, opt for one that is not backlit, i.e. one that requires an additional light source.
- Limit caffeine, alcohol, and nicotine. Stop drinking caffeinated beverages at least eight hours before bed. Avoid drinking alcohol in the evening; while alcohol can make you feel sleepy, it interferes with the quality of your sleep. Quit smoking or avoid it at night, as nicotine is a stimulant.
Preparing your brain for sleep
Your brain produces the hormone melatonin to help regulate your sleep-wake cycle. As melatonin is controlled by light exposure, not enough natural light during the day can make your brain feel sleepy, while too much artificial light at night can suppress production of melatonin and make it harder to sleep.
To help naturally regulate your sleep-wake cycle and prepare your brain for sleep:
Increase light exposure during the day. Take breaks outside in sunlight, remove sunglasses when it’s safe to do so, and open blinds and curtains during the day.
Limit artificial light at night. To boost melatonin production, use low-wattage bulbs, cover windows and electrical displays in your bedroom, avoid bright light and turn off television, smartphone, and computer screens at least one hour before bed.
If you can’t make your bedroom dark enough, try using a sleep mask.