Ashwin Lewis
Sleep is essential for a healthy life, yet many people suffer from a lack of it. Insomnia is a common problem that can have a significant impact on energy levels, mood, and daily functioning. While the recommended amount of sleep is 7-9 hours, sleeping less than 8 hours is perfectly normal and may not lead to negative health consequences. There are various factors that can contribute to insomnia, including lifestyle choices, sleep habits, stress, medical conditions, and sleep disorders. Understanding and addressing these underlying causes can help improve sleep quality.
| Characteristics | Values |
|---|---|
| Alcohol | Drinking alcohol before bed can cause fragmented and unrefreshing sleep. |
| Caffeine | Caffeine can make it harder to fall asleep and reduce total sleep time and quality. |
| Diet | Eating a large amount of fat or protein, or a spicy meal, before bed can cause heartburn and indigestion, disrupting sleep. |
| Exercise | Exercising too late in the evening can make it harder to fall asleep due to increased body temperature and heart rate. |
| Light exposure | Light exposure at bedtime, including from electronic devices, impairs sleep quality. |
| Mental health | Conditions such as anxiety, stress, and depression can cause insomnia, and vice versa. |
| Medication | Certain medications can interfere with sleep, including antidepressants, ADHD stimulants, and cold and flu remedies. |
| Sleep disorders | Conditions such as sleep apnea, restless legs syndrome, and narcolepsy can cause insomnia. |
| Sleep environment | A bedroom that is too hot, cold, noisy, or bright can disrupt sleep. |
| Sleep habits | Poor sleep habits, such as an irregular sleep schedule, napping, and screen use before bed, can contribute to insomnia. |
What You'll Learn
Sleep disorders
Insomnia
Insomnia is a common sleep disorder characterized by difficulty falling or staying asleep, resulting in non-restorative sleep. It can be caused by various factors, including stress, anxiety, depression, traumatic experiences, medications, medical conditions such as asthma or allergies, and poor sleep habits like an irregular sleep schedule or excessive caffeine consumption. Chronic insomnia can have serious health consequences and impact one's energy, mood, and daily functioning.
Sleep Apnea
Sleep apnea is a physiological sleep disorder where a person's breathing temporarily stops during sleep due to the tongue falling back and blocking the throat. It is more common in men than women and can lead to frequent sleep interruptions throughout the night. Sleep apnea can increase the risk of cardiovascular disease and premature death. Lifestyle changes, such as weight loss, and devices like CPAP machines can help manage this condition.
Restless Legs Syndrome (RLS)
RLS causes uncomfortable sensations and uncontrollable movements in the legs at night, affecting sleep. It is more common in women and has been linked to an increased risk of heart disease and depression. Simple interventions such as regular exercise, hot baths, leg massages, and reducing caffeine and tobacco intake can help manage RLS. In more severe cases, medication may be prescribed.
Narcolepsy
Narcolepsy is a rare sleep disorder characterized by sudden and uncontrollable sleep episodes during the day. It is caused by a lack of the peptide that keeps people awake. People with narcolepsy may also experience cataplexy, sudden collapses due to a loss of muscle tone triggered by strong emotions. Medication and psychotherapy are often used to manage narcolepsy.
Other Factors
Other factors that can contribute to sleep disorders include sharing a bed with others or pets, an uncomfortable bedroom temperature, excessive screen time before bed, work schedule disruptions, jet lag, and mental health conditions such as depression. Addressing these factors and improving sleep hygiene can help improve sleep quality.
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Poor sleep habits
To improve sleep hygiene, it is recommended to establish a consistent sleep schedule, maintain a comfortable bedroom environment, and avoid stimulating activities and substances close to bedtime. This includes limiting screen time, caffeine, and alcohol intake several hours before bed. Engaging in relaxing activities, such as reading or listening to soft music, can also promote better sleep habits.
Additionally, regular exercise can improve sleep quality, but it is important to avoid strenuous workouts too close to bedtime as it may have the opposite effect. Instead, a gentle yoga stretch or meditation practice before bed may aid in relaxation and prepare the body for sleep.
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Stress and anxiety
Sleep Disruption
Anxiety is a common human response to stress, and it can manifest as a feeling of worry, unease, or fear. While it is normal to experience occasional anxiety, when it becomes excessive or persistent, it can lead to sleep disruption. People with anxiety may find it difficult to fall asleep or stay asleep throughout the night. This sleep disruption can then contribute to feelings of stress and worry, creating a cycle that reinforces sleep problems.
Mental and Emotional Impact
Sleep Anxiety
In some cases, individuals may develop sleep anxiety, which is a fear or worry specifically about falling asleep or staying asleep. They may think something bad will happen if they fall asleep or that they need to stay alert. This sleep anxiety can create a sense of dread around bedtime, further disrupting sleep schedules and routines.
Sleep Reactivity
People with anxiety disorders tend to have higher sleep reactivity, meaning they are more likely to experience sleeping problems when facing stress. This reactivity can contribute to insomnia and other sleep disturbances, making it challenging for them to get the rest they need.
Health Risks
Prolonged stress and insufficient sleep can have negative implications for overall health. Sleep deprivation can affect vital brain functions, impair cognitive abilities, and contribute to irritability and depression. Additionally, chronic stress and lack of sleep can increase the risk of health issues such as high blood pressure, cardiovascular disease, and obesity.
Breaking the Cycle
To break the cycle of stress and sleep disruption, it is important to address both stress management and sleep hygiene:
- Practicing relaxation techniques such as deep breathing, meditation, or progressive muscle relaxation can help reduce stress and prepare the body for sleep.
- Improving sleep habits, such as maintaining a consistent sleep schedule, limiting screen time before bed, and creating a comfortable and relaxing sleep environment, can promote better sleep.
- Seeking professional help, such as cognitive-behavioral therapy or medication, can be effective in managing both stress and sleep issues.
By addressing stress and improving sleep hygiene, individuals can work towards breaking the cycle and achieving more restful sleep.
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Alcohol and caffeine consumption
Alcohol and caffeine are two of the most widely consumed psychoactive substances in the world. They are also the two most commonly used substances for manipulating human consciousness, most notably sleep and wakefulness.
Caffeine
Caffeine is a central nervous system stimulant. It acts to antagonise adenosine receptors, which play a key role in regulating sleep. Adenosine levels gradually rise in response to prolonged neuronal activity, leading to a reduction in neuronal activity and the induction of sleep. Caffeine blocks this process, increasing the cerebral utilisation of noradrenaline, dopamine, and serotonin, all of which augment wakefulness.
Caffeine can reduce sleep quantity, delaying the ability to fall asleep and reducing total sleep duration. It can also decrease the amount of deep non-REM (NREM) slow-wave activity, which is a critical stage of sleep for feeling refreshed the next day.
The effects of caffeine can last for many hours after consumption, and it is recommended that people avoid consuming it at least eight hours before bedtime. People who have insomnia may find it helpful to reduce or eliminate caffeine intake or only consume it early in the day.
Alcohol
Alcohol is a sedative and a neurotoxin that depresses the central nervous system. While it can help people fall asleep, it negatively impacts sleep quality and quantity. It can cause more frequent awakenings and sleep fragmentation, and it interferes with REM sleep. It can also suppress REM sleep in the early and middle portions of the sleep period, leading to a rebound effect in the latter part of the night that causes more frequent awakenings and inferior sleep quality.
Alcohol can also increase the activation of the sympathetic nervous system during sleep while inhibiting the parasympathetic nervous system, leading to higher heart rate, higher blood pressure, and lower heart rate variability.
Experts recommend avoiding alcohol at least three hours before bed.
Alcohol and Caffeine Together
When consumed in combination, alcohol and caffeine can offset each other's negative impacts on sleep. The sedating effects of alcohol can mask the stimulant effects of caffeine, and vice versa. However, this does not mean that using both substances is a healthy choice. While it may help in the short term, this practice can lead to a cycle of self-medication, with increasing amounts of caffeine and alcohol needed to balance each other's effects. This can result in poor sleep, which can harm overall health.
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Screen time
The impact of screen time on sleep is particularly notable in teenagers. An estimated two in three teenagers regularly sleep less than the recommended amount, and screen time may be responsible for this sleep deprivation. Screen time is linked to a host of insomnia symptoms in teens, including delayed release of melatonin, longer sleep onset, and less restful sleep. As most teens have strict school start times, a later bedtime due to screen time usually results in fragmented sleep and increased sleepiness the next day. Over time, this can disrupt the circadian rhythm.
In addition to suppressing melatonin, screen time may directly reduce sleep time. Exciting or stimulating content before bed can boost alertness and impede sleepiness. Passive technology, such as a television running in the background or a phone emitting sounds or vibrations, can also have this effect.
There is a debate about whether screen time causes insomnia or if those with insomnia are more likely to use screens at night. Excessive mobile phone use has been linked to symptoms of depression and anxiety, which are additional risk factors for insomnia. However, the prevailing opinion among health experts is that screen time has a greater effect on insomnia than vice versa.
To mitigate the impact of screen time on sleep, it is recommended to set boundaries for screen use, establish a relaxing bedtime routine, make the bedroom a screen-free zone, keep bedroom lights dim, use nighttime mode on devices, and invest in blue light-blocking glasses.
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Frequently asked questions
This could be due to stress, an irregular sleep schedule, poor sleep habits, mental health issues, physical illness, medications, or sleep disorders.
This could be due to ageing, medication, lifestyle choices such as drinking alcohol before bed, or an underlying condition.
You might find sleeping on your back uncomfortable if you have back pain or are used to sleeping in other positions.
This could be caused by stress, a bed partner who snores, late-day naps, or spending time on your phone or watching TV right before bed.
If you wake up in the middle of the night and find it hard to go back to sleep, it's possible that your inability to rest is due to watching the clock or thinking about things that worry you.
