If you've ever had a long, sleepless night, you've suffered from insomnia. A relatively common occurrence, insomnia affects most people at some time in their life. Insomnia is simply trouble sleeping at night. Being unable to fall asleep or stay asleep, or waking multiple times during the night, are symptoms of insomnia.
Many different things can cause a person to suffer from insomnia. Things you eat or drink, such as caffeine or alcohol, are common causes of insomnia. It isn't just stimulants or depressants that can cause insomnia. Eating rich or spicy food before bed is another common trigger.
Some medications can cause insomnia as well. Any type of stimulant is likely to make sleeping difficult. Somewhat surprisingly, some drugs that cause drowsiness can actually cause insomnia as well. A person may feel tired, but be unable to stay asleep due to restlessness, or may just doze off for short periods of time without getting a full night's sleep.
Stress, worry, anxiety, and pain are common causes of insomnia. A person who is worried at bedtime may have trouble falling asleep. Many people know the frustration of being particularly anxious about something that will happen the next day, only to have trouble getting enough sleep to be ready for it. Children sometimes have insomnia before an exciting trip because they are looking forward to it so much.
Developing poor sleep habits is another leading cause of insomnia. Spending a lot of time in bed doing activities, reading or drawing or even working, can make it difficult for a person to change gears when it's time to sleep. Going to sleep and waking up at different times each day can also contribute to insomnia.
If you suffer from insomnia, there are a lot of things you can do to try and get to sleep. Practicing regular sleeping habits, such as going to bed at the same time every night and not taking naps during the day, can help. Abstaining from caffeine or alcohol before bed may also help you get a good night's sleep.
If you suffer from insomnia frequently, or it interferes with your life, it's best to consult with a doctor. Your doctor can help you pinpoint the causes of your insomnia and treat those, and may also be able to prescribe medications to help you fall asleep.
Common causes of insomnia include:
Concerns about work, school, health or family can keep your mind active at night, making it difficult to sleep. Stressful life events, such as the death or illness of a loved one, or a job loss, may lead to insomnia.
Everyday anxieties as well as more-serious anxiety disorders may disrupt your asleep.
You might either sleep too much or have trouble sleeping if you're depressed. This may be due to chemical imbalances in your brain or because worries that accompany depression may keep you from relaxing enough to fall asleep. Insomnia often accompanies other mental health disorders as well.
Many prescription drugs can interfere with sleep, including some antidepressants, heart and blood pressure medications, allergy medications, stimulants (such as Ritalin) and corticosteroids. Many over-the-counter (OTC) medications, including some pain medication combinations, decongestants and weight-loss products, contain caffeine and other stimulants. Antihistamines may initially make you groggy, but they can worsen urinary problems, causing you to get up to urinate more during the night.
Coffee, tea, cola and other caffeine-containing drinks are well-known stimulants. Drinking coffee in the late afternoon and later can keep you from falling asleep at night. Nicotine in tobacco products is another stimulant that can cause insomnia. Alcohol is a sedative that may help you fall asleep, but it prevents deeper stages of sleep and often causes you to awaken in the middle of the night.
If you have chronic pain, breathing difficulties or a need to urinate frequently, you might develop insomnia. Conditions linked with insomnia include arthritis, cancer, heart failure, lung disease, gastroesophageal reflux disease (GERD), overactive thyroid, stroke, Parkinson's disease and Alzheimer's disease. Making sure that your medical conditions are well treated may help with your insomnia. If you have arthritis, for example, taking a pain reliever before bed may help you sleep better.
Travel or working a late or early shift can disrupt your body's circadian rhythms, making it difficult to sleep. Your circadian rhythms act as internal clocks, guiding such things as your sleep-wake cycle, metabolism and body temperature.
Habits that help promote good sleep are called sleep hygiene. Poor sleep hygiene includes an irregular sleep schedule, stimulating activities before bed, an uncomfortable sleep environment and use of your bed for activities other than sleep, like working.
This may occur when you worry excessively about not being able to sleep well and try too hard to fall asleep. Most people with this condition sleep better when they're away from their usual sleep environment or when they don't try to sleep, such as when they're reading.
Having a light snack before bedtime is OK, but eating too much may cause you to feel physically uncomfortable while lying down, making it difficult to get to sleep. Many people also experience heartburn, a backflow of acid and food from the stomach into the esophagus after eating. This uncomfortable feeling may keep you awake.
Insomnia becomes more common with age. As you get older, changes can occur that may affect your sleep. You may experience:
A change in sleep patterns. Sleep often becomes less restful as you age, and you may find that noise or other changes in your environment are more likely to wake you as you get older. With age, your internal clock often advances, which means you get tired earlier in the evening and wake up earlier in the morning. But older people generally still need the same amount of sleep as younger people do.
A change in activity. You may be less physically or socially active. Activity helps promote a good night's sleep. You may also be more likely to take a daily nap, which also can interfere with sleep at night.
A change in health. The chronic pain of conditions such as arthritis or back problems as well as depression, anxiety and stress can interfere with sleep. Older men often develop noncancerous enlargement of the prostate gland (benign prostatic hyperplasia), which can cause the need to urinate frequently, interrupting sleep. In women, hot flashes that accompany menopause can be equally disruptive.
Other sleep-related disorders, such as sleep apnea and restless legs syndrome, also become more common with age. Sleep apnea causes you to stop breathing periodically throughout the night. Restless legs syndrome causes unpleasant sensations in your legs and an almost irresistible desire to move them, which may prevent you from falling asleep.
Increased use of medications. Older people use more prescription drugs than younger people do, which increases the chance of insomnia caused by a medication.
Sleep problems may be a concern for children and teenagers as well. Some children and teenagers simply have trouble getting to sleep or resist a regular bedtime because their internal clocks are more delayed. They want to go to bed later and sleep later in the morning.
The symptoms of insomnia depend on the type of sleeping problem that you have. A lack of sleep can affect your mood and cause tiredness and fatigue during the day. It's thought that up to a third of people in the UK have symptoms of insomnia at some point in the year, which can include:
lying awake for a long time at night before falling asleep
waking up several times in the middle of the night
waking up early in the morning and not being able to get back to sleep
feeling tired and not refreshed by sleep
not being able to function properly during the day and finding it difficult to concentrate
being irritable
As every individual is different, it's difficult to define what ‘normal sleep’ is. Factors that influence the amount of sleep you need include your age, lifestyle, diet and environment. For example, newborn babies can sleep for 16 hours a day, while school-age children need to have an average of 10 hours sleep. Most healthy adults sleep for an average of seven to nine hours a night. As you get older, it's normal to find sleep more difficult to maintain, although you still need the same amount of sleep.
While treating underlying physical and mental issues is a good first step, it may not be enough to cure your insomnia. You also need to look at your daily habits. Some of the things you’re doing to cope with insomnia may actually be making the problem worse. For example, maybe you’re using sleeping pills or alcohol to fall asleep, which disrupts sleep even more over the long-term. Or maybe you drink excessive amounts of coffee during the day, making it harder to fall asleep later. Oftentimes, changing the habits that are reinforcing sleeplessness is enough to overcome the insomnia altogether. It may take a few days for your body to get used to the change, but once you do, you will sleep better.
Habits that make insomnia worse:
drinking a lot of caffeine
drinking or smoking before bed
taking naps during the day
an irregular sleep schedule
Some habits are so ingrained that you may overlook them as a possible contributor to your insomnia. Maybe your daily coffee habit affects your sleep more than you realize. Or maybe you’ve never made the connection between your late-night Internet surfing and your sleep difficulties. Keeping a sleep diary is a helpful way to pinpoint habits and behaviors contributing to your insomnia.
All you have to do is jot down daily details about your daytime habits, sleep routine, and insomnia symptoms. For example, you can keep track of when you go to sleep and when you wake up, where you fall asleep, what you eat and drink, and any stressful events that occur during the day.
Make sure your bedroom is quiet, dark, and cool. Noise, light, and heat can interfere with sleep. Try using earplugs to mask outside noise, an open window or fan to keep the room cool, and blackout curtains or an eye 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. Get up at your usual time in the morning 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 and computer use.
Limit caffeine, alcohol, and nicotine. Stop drinking caffeinated beverages at least 8 hours before bed. Avoid drinking 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.
The more trouble you have with sleep, the more it starts to invade your thoughts. You may dread going to sleep because you just know that you’re going to toss and turn for hours or be up at 2 a.m. again. But agonizing and expecting sleep difficulties only makes insomnia worse. Worrying about getting to sleep or how tired you’re going to be floods your body with adrenaline, and before you know it, you’re wide-awake.
If sleep worries are getting in the way of your ability to unwind at night, the following strategies may help. The goal is to train your body to associate the bed with sleep and nothing else—especially not frustration and anxiety.
Use the bedroom only for sleeping. Don’t work, read, watch TV, or use your computer in bed or the bedroom. The goal is to associate the bedroom with sleep alone, so that your brain and body get a strong signal that it’s time to nod off when you get in bed.
Get out of bed when you can’t sleep. Don’t try to force yourself to sleep. Tossing and turning only amps up the anxiety. Get up, leave the bedroom, and do something relaxing, such as reading or drinking a warm cup of caffeine-free tea. When you’re sleepy, go back to bed.
Move bedroom clocks out of view. Anxiously watching the minutes tick by when you can’t sleep—knowing that you’re going to be exhausted when the alarm goes off—is a surefire recipe for insomnia. You can use an alarm, but make sure you can’t see the time when you’re in bed.
It’s also helpful to challenge the negative attitudes about sleep and your insomnia problem that you’ve developed over time. The key is to recognize self-defeating thoughts and replace them with more realistic ones.