Gina Johnson
Sleep is a vital part of our lives, and getting a good night's rest is essential for our health and well-being. However, many people struggle with falling asleep or maintaining sleep throughout the night, a condition known as insomnia. Insomnia can be acute (short-term) or chronic (long-term), and it affects approximately one-third of adults worldwide. There are numerous factors that can contribute to insomnia, including lifestyle habits such as excessive caffeine consumption, drinking alcohol, napping too much, and poor sleep hygiene. Additionally, stress, certain medications, negative thinking, and underlying health conditions can also play a role in sleep disturbances. The good news is that there are techniques to improve sleep, such as relaxation methods, deep breathing, guided imagery, and mindfulness meditation. Maintaining a consistent sleep schedule and improving sleep hygiene are also crucial steps in promoting better sleep. If sleep difficulties persist, it is important to consult a healthcare professional for further guidance and treatment options.
| Characteristics | Values |
|---|---|
| Type of issue | Insomnia, Circadian Rhythm Disorder, Sleep Apnea, Restless Legs Syndrome, Delayed Sleep Phase Syndrome, Narcolepsy, Night Terrors, Sleepwalking |
| Causes | Stress, Illness, Medication, Caffeine, Alcohol, Anxiety, Depression, Age, Chronic Pain, Neuropathy, Sleep Environment, Jet Lag, Shift Work, Napping, Light Exposure, Exercise, Genetics, Vitamin and Iron Deficiencies, Pregnancy, Fear, Sleep Associations |
| Treatment | Cognitive Behavioural Therapy, Relaxation Techniques, Meditation, Deep Breathing, Autogenic Training, Melatonin, Antihistamines, Herbs and Supplements, Sleep Study, Lifestyle Changes |
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What You'll Learn
Sleep maintenance insomnia
If you are experiencing sleep maintenance insomnia, it is important to seek help and not assume that disrupted sleep is something you must live with. Your doctor may recommend sleep therapy, specifically cognitive behavioural therapy for insomnia (CBT-i), which is considered the most effective treatment for all forms of insomnia. CBT-i can help change unhelpful thoughts and behaviours around sleep and teach you techniques to relax, manage anxiety about sleep, and build a healthier sleep routine. Maintaining good sleep habits, such as a regular sleep schedule and avoiding caffeine, nicotine, and alcohol before bed, can also help improve sleep maintenance insomnia.
In some cases, your doctor may recommend short-term use of sleep medications if CBT-i is not effective. However, it is important to talk to your doctor before taking any sleep aids, including over-the-counter antihistamine-containing products. Other techniques to improve sleep include progressive muscle relaxation, deep breathing, guided imagery, mindfulness meditation, and autogenic training, which uses self-hypnosis to promote sleep.
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Circadian rhythm disorders
Circadian rhythm sleep disorders (CRSD), also known as circadian rhythm sleep–wake disorders (CRSWD), are a family of sleep disorders that affect the timing of sleep. CRSDs cause a persistent pattern of sleep/wake disturbances that arise either by dysfunction in one's biological clock system or by misalignment between one's endogenous oscillator and externally imposed cues.
There are four main types of CRSD: delayed sleep phase disorder, advanced sleep phase disorder, non-24-hour sleep–wake disorder, and irregular sleep–wake rhythm disorder. Delayed sleep phase disorder (DSPD) is when individuals have sleep–wake times that are delayed compared to normal functioning individuals. People with DSPD have very long periods of sleep latency when they attempt to sleep during conventional sleeping times and have trouble waking up at conventional times. Advanced sleep phase disorder is when the major sleep episode is advanced in relation to the desired clock time, resulting in evening sleepiness, an early sleep onset, and waking up earlier than desired. In non-24-hour sleep–wake rhythm disorder, sleep times may gradually become more delayed, often occurring when light exposure is very limited. Irregular sleep–wake rhythm disorder occurs when there is a misalignment between the timing of the circadian oscillator and the surrounding environment or a failure in the clock entrainment pathway.
Other types of circadian rhythm disorders include advanced or delayed sleep-wake phase disorder, irregular or non-24-hour sleep-wake rhythm disorder, and shift work or jet lag disorder. Advanced sleep-wake phase disorder (ASWPD) can make it difficult to stay awake in the early evening and cause individuals to wake up too early in the morning. Delayed sleep-wake phase disorder (DSWPD) causes individuals to fall asleep later than they would like and makes it difficult to wake up on time in the morning. Jet lag disorder occurs when there is a misalignment between one's internal circadian system and external or environmental cues, typically associated with rapid travel across multiple time zones. Shift work disorder affects those who work during the night or on a rotating schedule, causing insomnia, extreme tiredness, and sleepiness while working at night.
CRSDs can be categorized into two groups based on their underlying mechanisms: intrinsic type disorders and extrinsic type CRSDs. Intrinsic type disorders are composed of disorders where the endogenous oscillator has been altered. Extrinsic type CRSDs consist of disorders in which the external environment and the endogenous circadian clock are misaligned.
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Sleep apnea
There are many reasons why you may not be able to sleep as long as you used to. Sleep maintenance insomnia is when you cannot stay asleep at night, and it may be caused by health conditions, medications, or stress. Sleep issues could also be related to long-lasting COVID symptoms, with a 2022 study finding that over 40% of 1,321 people with long-lasting COVID symptoms experienced moderate to severe sleep difficulties. Sleep apnea is a sleep disorder that could be a reason why you are unable to sleep as long as you used to.
If you suspect you have sleep apnea, you should consult a healthcare provider. They may recommend a sleep study, which can help diagnose sleep apnea and rule out other conditions. Treatment options include the use of breathing devices such as continuous positive air pressure (CPAP) machines, lifestyle changes, and in some cases, surgery.
While you await professional advice, there are some techniques you can try to help you sleep. These include progressive muscle relaxation, deep breathing, guided imagery, mindfulness meditation, and autogenic training. You should also consider limiting your caffeine intake and reducing screen time before bed.
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Restless leg syndrome
RLS typically affects individuals when they are inactive and sitting for extended periods, such as during a plane trip or while watching a movie. People with RLS may need to constantly move their legs while sitting or pace the floor to find relief from the uncomfortable sensations. Symptoms often worsen at night, making it difficult to fall asleep and stay asleep. Leg movement or walking typically provides temporary relief, but the sensations return when movement stops.
RLS can severely interrupt sleep and cause problems with functioning during the day. It can occur at any age but usually begins in middle age and is more common in women. While the exact cause of RLS is often unknown, it is believed to have a genetic component, with specific gene variants associated with the condition. Low levels of iron in the brain and dysfunction in the basal ganglia, a part of the brain that controls movement, may also contribute to RLS.
If you suspect you have RLS, it is recommended to consult a healthcare professional to explore treatment options. Treatment for RLS-related sleep issues often starts with cognitive-behavioral therapy (CBT-I), which helps change unhelpful thoughts and behaviors around sleep. CBT-I can teach relaxation techniques, anxiety management, and the building of a healthier sleep routine. In some cases, short-term use of sleep medications may be considered. Additionally, certain lifestyle changes, such as reducing caffeine intake and limiting screen time before bed, can also help improve sleep quality.
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Stress, depression, or anxiety
Stress, depression, and anxiety can all have a significant impact on sleep. A bidirectional relationship exists between anxiety and sleep deprivation, where worrying causes poor sleep, and further sleep difficulties increase anxiety. This can lead to a cycle of worsening anxiety and insomnia.
Anxiety disorders are the most common mental health problem in the United States, and insufficient sleep negatively affects overall health. Research has shown that people prone to anxiety are especially sensitive to the effects of sleep deprivation on mood and emotional health. Sleep deprivation can also instigate or worsen anxiety disorders.
Similarly, stress can interfere with sleep. The COVID-19 pandemic, for example, caused increased stress and uncertainty, contributing to sleep issues labelled as "Coronasomnia".
Depression is also closely linked to sleep issues. Serious sleep disturbances, including insomnia, are common symptoms of depression. Sleep deprivation can contribute to the onset and worsening of depression.
If you are experiencing sleep issues due to stress, depression, or anxiety, there are several techniques you can try. Progressive muscle relaxation, deep breathing, guided imagery, and mindfulness meditation are simple, safe methods that can help induce relaxation and sleep. Cognitive behavioral therapy for insomnia (CBT-I) is a proven approach that helps change unhelpful thoughts and behaviors around sleep, teaching techniques to manage anxiety and build a healthier sleep routine. In some cases, short-term use of sleep medication may be considered.
If you are struggling with sleep, it is important to seek help. Talk to a healthcare professional to understand the underlying causes and explore treatment options.
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Frequently asked questions
There are many reasons why you might not be able to sleep as long as you used to. Some common causes include age, lifestyle habits such as drinking alcohol or consuming caffeine close to bedtime, medication side effects, or an underlying condition.
Signs of sleep deprivation include drowsiness, forgetfulness, and moodiness. If you regularly sleep less than five hours a night and experience these symptoms, it could be a sign of sleep deprivation or a sleep disorder.
Here are some evidence-backed techniques to help you fall asleep:
- Progressive muscle relaxation
- Deep breathing
- Guided imagery
- Mindfulness meditation
- Autogenic training
- Reading a book
- Listening to relaxing music
If you are still having trouble sleeping, consider talking to a healthcare professional to understand the underlying causes of your sleep challenges and explore treatment options. Treatment for insomnia often starts with cognitive behavioural therapy (CBT-I) and lifestyle adjustments.
