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Why Can’t I Sleep?

Malena Piper

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Some nights, sleep comes easily. Others, you might have a hard time drifting off for even a few minutes. Restlessness nights aren’t uncommon, and you don’t have to have a sleep disorder to experience the occasional bout of poor sleep. That said, sleep deprivation has become so severe, it was even declared a national pandemic by the CDC. And the CDC reports nearly 35% of adults consistently struggle with achieving a full night’s rest.

Sleep struggles can stem from a variety of causes, whether it be recent hormonal changes—such as menopause—or stress or mental illnesses. You may even have a sleeping disorder. Regardless of the cause, your sleep problems can likely be addressed.

Common Reasons You Can’t Sleep

Sleep Disorders

Sleep disorders are an obvious cause of poor sleep. That said, it’s possible to have a sleep disorder and be unaware. If you’re taking all the steps to improve your night’s sleep and not seeing results, you could be struggling with an undiagnosed sleep disorder.

Common sleep disorders are insomnia, sleep apnea, and narcolepsy. If you feel you may have a sleep disorder, we recommend talking with your doctor about your symptoms and concerns. Only a medical professional can truly diagnose a sleep disorder, and your doctor will be able to lend the best advice for getting better rest.

Let’s talk in more detail about the most prevalent sleep disorders.

Insomnia

Insomnia is most commonly defined as difficulty sleeping. People with insomnia can have difficulty falling asleep, staying asleep, or waking up too early. Acute insomnia is temporary and merely a condition of sleeplessness. Occasionally, insomnia becomes a chronic disorder. People with chronic insomnia have struggled with sleep for at least a month and have trouble sleeping at least three nights each week.

Sleep Apnea

Sleep apnea is another common sleep disorder. The most common form of sleep apnea is obstructive sleep apnea, meaning something blocks your breathing while you’re asleep. Although often associated with being overweight, sleep apnea has many other causes including large tonsils and genetic syndromes. Obesity is a common cause of sleep apnea because of the increased fat deposits around the airway. Similarly, large tonsils and certain genetic syndromes can narrow the airway and make breathing during sleep more difficult. These episodes of difficulty breathing can cause restless sleep.

Narcolepsy

Narcolepsy is a chronic neurological disorder that affects the sleep/wake cycle in the brain. People with narcolepsy often wake frequently and experience uneven sleep during the night. The next day, they may wake up refreshed, only to crash later during the day.  In addition to their tiredness from poor sleep, narcolepsy often causes excessive daytime sleepiness. People can fall asleep while driving or in the middle of a conversation. Symptoms often start between ages 7 and 25 and can occur for the rest of your life.

Restless Legs Syndrome

Restless Legs Syndrome (RLS) causes an unpleasant feeling and an irresistible urge to move your legs. The sensations often become worse at night and act up while resting or even staying in one place for too long. As the sensations worsen at night and while resting, RLS can often interfere with sleep. Moving can provide temporary relief, but often start up again when you rest. RLS can begin at any age and affects both men and women.

Solution: Moving your legs may provide some relief. RLS is often correlated with another medical condition (such as anemia and diabetes), so treating the underlying condition can often relieve RLS. Exercising more and massaging your legs may also help.

Diet

Studies suggest a link between certain diets and sleep. People who sleep poorly tend to snack more while people who sleep greater than 7 hours tend to snack less. Conversely, eating more carbs, particularly refined sugars, can disrupt sleep while a healthy diet of proteins, whole grains, fruits, veggies, and healthy fats can improve sleep. We get our energy from the food we eat and the sleep we get. Sugar can make our energy temporarily rise, and thus interfere with falling asleep.

Solutions: Limiting refined sugars, particularly before bedtime, and eating more sleep-inducing foods can greatly improve your quality of rest.

Exercise

Exercise is commonly associated with better sleep. A day without physical activity can make it harder to fall asleep. According to a  randomized controlled trial affiliated with Northwestern University’s Department of Neurology, regular physical activity helps you sleep longer and more efficiently. The study examined the sleep quality of 17 older adults with insomnia. In conjunction with sleep hygiene education, these 17 adults began aerobic exercise. The combination improved their quality of sleep.

However, vigorous exercise too close to bedtime can make it take longer for you to sleep. There are two reasons for this. Exercise can release endorphins and raise your body temperature. Both endorphins and a higher body temperature can make it harder to fall asleep.

Solutions: Sometimes sleeplessness comes from inactivity. Spend at least 30 minutes a day exercising and you’ll see a long-term improvement in your sleep. There isn’t one best time of day to exercise. So, pay attention to what time of day exercising best helps you.

Chronic Pain

Sleep and pain are interrelated. When you’re in pain, sleep becomes harder to reach. Conversely, poor sleep leads to worse pain. According to a study by UC Berkeley scientists Matthew Walker and Adam Krause, sleep deprivation increases pain sensitivity and inhibits the area of the brain that releases dopamine. As dopamine is a natural pain-reliever, this means poor sleep increases your sensitivity while removing your ability to fight pain.

Depression or Anxiety

Mental health and sleep are related. Scientists have discovered that sleep deprivation affects levels of neurotransmitters and impairs emotional regulation. Therefore, insomnia may worsen the effects of a mental illness. Conversely, mental illnesses such as anxiety or depression make you more likely to struggle with sleep. About 65% to 90% of adults with depression struggle with sleep, and about 50% of adults with generalized anxiety disorder suffer from sleep problems. This forms a cycle of mental health and sleep struggles affecting the quality of your sleep.

Solution: Mental health problems can get better, but it takes work. Work with a professional to find a way to manage your troubles, and you may be able to help your sleeplessness as well.

Poor Sleep Hygiene

Sleep hygiene simply refers to sleep habits. Good habits, such as a consistent bedtime and wake time, can help you fall asleep faster. Poor habits may make it harder for you to fall asleep.

Solution: Implement better sleep habits:

  • Keep a consistent bedtime and wake time. Consistency can help train your brain to recognize bedtime as sleep time.
  • Use your bed just for sleep. Just as consistency is important, using your bed just for sleep can train your brain to recognize where you should sleep.
  • Avoid large meals and caffeine before bedtime. Heavy meals and caffeine can keep you awake when you’re struggling to sleep.
  • Take time to exercise as it can help you fall asleep more easily.

Stress

Stress can cause sleepiness because the hormones it releases can keep you awake and lead to poorer quality sleep. Evolutionary, this response to stress makes sense. It was useful to remain awake when running from a predator. Now, our stress comes from more mundane places, like approaching deadlines, and this natural response can actually make life more difficult.

Solution: As previously mentioned, we sleep better when we exercise.  Additionally, exercise uses some of the hormones induced by stress.

Light

Artificial light can influence your circadian rhythm. Our natural sleep/wake rhythm is influenced by light cycles. As the sun goes down and the light dims, our brains release more melatonin and we start to get sleepy. Bright lights at night can influence our natural circadian rhythms by suppressing melatonin production.

Blue light can be particularly disruptive. Though beneficial to both attention and mood during the day, it can disrupt sleep at night. Blue light from phone screens can actually interrupt melatonin production, even more than other artificial light.

Solution: Dim the lights before bedtime. If you keep the lights dim an hour or so before bed, then the light won’t suppress your melatonin production as you’re preparing for bed. Don’t use screens as you’re falling asleep and even avoid using them two hours before bedtime. If necessary, consider using blue-light blocking glasses.

Too Much Caffeine

For obvious reasons, drinking too much coffee can keep you awake. As a stimulant, caffeine keeps us alert and can even make us hyper. While caffeine can help you feel awake during the day, an afternoon cup of coffee may keep you staring at the ceiling wishing you were asleep. According to Drake et al.’s study published in The Journal of Clinical Sleep Medicine, coffee consumed as much as six hours before bedtime can keep you from getting enough sleep.

Solution: Cut the afternoon caffeine. It makes sense to drink coffee as your energy levels dip around three or four in the afternoon; however, that cup of coffee could make you even more tired the next morning.

Late Night Solutions

The bad news is most of these sleep problems require more than just a quick fix. So, what can you do as the minutes tick closer to your alarm and you just can’t sleep?

If sleep won’t come and it’s a little late to exercise or change your bedtime, don’t give up hope. You can try a couple of tricks to lull your brain to sleep:

  1. Try not to sleep. It sounds counterintuitive, but trying to sleep can make you more stressed about getting enough sleep.  A Russian study found that the extra stress will help keep you awake and worsen the quality of any sleep you do get. Instead of counting sheep or your breaths, try reading a book or folding laundry. Doing something mindless or relaxing can help you fall asleep faster and even improve your sleep.
  2. Purposefully daydream. According to sleep experts at the University of California, Irvine, anxious or deep thinking can keep you awake longer. Picturing yourself at the beach can help you relax and focus on something other than everything that you need to get done tomorrow. When you’re relaxed, you’ll fall asleep faster.

Conclusion

Most sleep problems don’t have an easy solution. The most appropriate treatments for poor quality of sleep require habitual changes. This takes effort and time. Regardless of the cause behind your sleepless nights, most sleep problems can be addressed. Some require lifestyle changes, such as cutting afternoon caffeine, eating healthier, and exercising regularly. Establishing healthy sleep hygiene will likely lessen your sleep problems and even improve your quality of sleep. Sweet dreams!

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