Battling Insomnia: Why Can't I Fall Asleep?

There are many reasons why you might not want to sleep. One phenomenon is known as revenge bedtime procrastination, where you put off sleep in favour of personal time or leisure activities. This might be because you feel overscheduled or that you don't have enough free time during the day. However, this can lead to sleep deprivation, which can have serious consequences for your health and well-being. Other reasons for not wanting to sleep include anxiety, stress, poor sleep hygiene, and underlying health issues.

Revenge bedtime procrastination

The term "revenge" was first added in China in the late 2010s, possibly relating to the 996 working-hour system (72 hours per week), as people felt it was the only way to gain control over their daytime lives. The English term emerged from a Chinese expression "baofuxing aoye", which roughly translates to "revenge bedtime procrastination".

Who is affected?

Women, students, and "night owls" (people with a later chronotype) are most likely to experience bedtime procrastination. People with high daytime stress levels are also more prone to it.

Causes

Effects

Bedtime procrastination can lead to sleep deprivation, which can cause:

• Slow thinking
• Low attention levels
• Poor memory
• Poor decision-making
• Stress
• Anxiety
• Irritation

If not addressed, long-term consequences can include:

• Heart disease
• Diabetes
• Obesity
• Weakened immune system
• Pain
• Hormone issues
• Mental health issues

Prevention

• Turn off electronic devices at least one hour before bed.
• Take a hot shower or bath to reduce stress.
• Write down thoughts, feelings, and experiences from the day.
• Maintain a regular bedtime and wake-up time, even on non-working days.
• Set a bedtime routine.
• Avoid alcohol or caffeine late in the afternoon or evening.
• Take melatonin supplements (with caution).
• Set boundaries at work.
• Reduce internet use.
• Practise time management and priority-setting skills.

Circadian misalignment

• Inappropriately timed sleep and wake cycles
• Misalignment of feeding rhythms with the sleep-wake or light-dark cycle
• Internal misalignment of central and peripheral rhythms
• Sleep disturbances and daytime sleepiness
• Changes in feeding behaviours and appetite-stimulating hormones
• Altered glucose metabolism and mood

To mitigate the effects of circadian misalignment, it is important to maintain a consistent sleep schedule, time sleep with the body's melatonin production, and properly time light exposure.

Sleep anxiety

• Creating a healthy sleep schedule
• Engaging in regular exercise
• Maintaining a dark, cool, quiet, and comfortable sleeping environment
• Practising relaxation techniques like reading, meditating, and avoiding screens before bed
• Avoiding caffeine, alcohol, and heavy meals close to bedtime
• Writing down worries before bed

In addition to improving sleep and lifestyle habits, treatment for sleep anxiety may include therapy, medication, or a combination of both. Cognitive Behaviour Therapy (CBT) is a form of therapy that helps reduce sleep anxiety by identifying and modifying behaviours and thought patterns that trigger it. Medications, such as over-the-counter antihistamines or prescription drugs, can also help calm sleep anxiety, but it is important to monitor their effects and be cautious of potential side effects or habit-forming tendencies.

Poor sleep hygiene

Additionally, poor sleep hygiene can lead to sleep problems, including insomnia, and impact your mental health. It can also result in daytime sleepiness, which can affect your overall productivity and well-being.

To improve your sleep hygiene, it is recommended to maintain a consistent sleep schedule, follow a bedtime routine, cultivate healthy daily habits, and optimise your bedroom environment. This includes limiting naps, avoiding bright lights and electronic devices before bed, and creating a comfortable and calm sleeping environment.

By addressing these factors and making positive changes, you can improve your sleep quality and overall health.

Medication side effects

Sleeping pills can also lead to tolerance development, where the body becomes accustomed to their effects, necessitating higher doses over time. Additionally, they may cause a "rebound effect" when discontinued, resulting in a worsening of insomnia. This is due to the body's dependence on the medication for sleep. Other side effects include memory problems, changes in appetite, headaches, shaking, and stomach upset.

It is important to note that sleeping pills are typically recommended for short-term relief and should be used responsibly by adhering to prescribed dosages and durations. They should also be used in conjunction with other treatments, such as cognitive behavioural therapy, lifestyle changes, and addressing any underlying health conditions.

Frequently asked questions