Battling Insomnia: Why Don't I Feel Like Sleeping?

There are many reasons why you might not feel like sleeping. Insomnia, which is when you regularly have problems sleeping, can be caused by stress, anxiety, depression, alcohol, caffeine, nicotine, or illegal drugs. It can also be caused by physical health conditions, such as acid reflux or Parkinson's disease, or mental health conditions like schizophrenia or bipolar disorder. Additionally, your sleep habits, such as napping during the day, screen time before bed, or consuming caffeine close to bedtime, can affect your sleep. Other factors include your sleep environment, diet, and physical activity levels. If you're having trouble sleeping, it's important to evaluate your lifestyle and make changes to improve your sleep hygiene.

Anxiety and stress

Anxiety is a hard-wired response in the nervous system, designed to alert us to threats in our environment. When we feel anxious, our body responds through ancient fight-or-flight pathways, releasing hormones such as cortisol and adrenaline. This can cause an increased heart rate, quickened breathing, and flushed skin. However, in modern society, we rarely need to physically fight or flee from threats, so this anxiety can persist for days, weeks, or longer, disrupting our sleep schedules.

Anxiety can affect our thoughts, emotions, and physical state. Cognitively, we may experience trouble thinking clearly, doubts, racing thoughts, or anticipate bad outcomes. Emotionally, we may feel fear, uncertainty, uneasiness, or a sense of being trapped. Physically, we may experience sweaty palms, muscle tension, rapid heartbeat, an upset stomach, and difficulty sleeping.

Research has shown that sleep deprivation can cause poorer thinking skills and altered perception, which can lead to further anxiety. Sleep is when the body repairs itself, relaxing muscle tension and reducing physical issues caused by stress. Without this recovery time, stress can build up, making it harder to cope with the next day. Sleep deprivation can also affect the regulation of hormones, which can impact our overall anxiety levels.

Additionally, the stress of not getting enough sleep can contribute to further sleep issues, creating a vicious cycle of sleep deprivation and anxiety. This can be particularly problematic for those with anxiety disorders, who may already struggle with sleep.

To improve sleep when experiencing anxiety, it is important to practice good "sleep hygiene". This includes maintaining a consistent sleep schedule, getting regular exercise (but not too close to bedtime), limiting caffeine and alcohol intake, and creating a comfortable, cool, dark, and quiet bedroom environment. Relaxation techniques such as deep breathing, meditation, and listening to relaxing music can also help reduce anxiety and improve sleep.

If anxiety and stress are impacting your sleep, it may be helpful to seek professional help, such as cognitive-behavioral therapy (CBT) or medication.

Caffeine consumption

Caffeine is a stimulant that promotes wakefulness by blocking adenosine, a sleep-inducing chemical. Adenosine is a crucial part of the sleep/wake cycle, which increases the time one is awake and decreases the time one is asleep. Caffeine blocks adenosine receptors in the brain, which prevents adenosine from causing sleepiness. Over time, the body increases its sensitivity to adenosine, and once caffeine is metabolized, it can cause excessive tiredness.

The time it takes for caffeine to be metabolized varies from person to person. About 99% of caffeine is absorbed within 45 minutes of consumption. It peaks at one to two hours and has a half-life of 2.5 to 12 hours. People who regularly consume caffeine can develop a tolerance, which means they become used to its effects and may need more to achieve their desired level of alertness. This can negatively impact sleep, leading to tiredness despite drinking coffee.

To improve sleep quality, it is recommended to avoid caffeine at least eight hours before bedtime. Additionally, reducing daily caffeine intake can help if you experience insomnia, anxiety, or headaches. If you are struggling with sleep, it may be helpful to keep track of your caffeine consumption and sleep patterns to identify any correlations.

Caffeine withdrawal can also lead to sleep disturbances. Decreasing caffeine intake can result in symptoms such as drowsiness, headaches, trouble concentrating, and irritability. To minimize these symptoms, it is advisable to gradually reduce caffeine consumption rather than quitting abruptly.

In addition to the amount and timing of caffeine intake, individual factors such as genetics and lifestyle also influence how caffeine affects sleep. For example, nicotine use can shorten the half-life of caffeine, while pregnancy can slow down its metabolism.

Sleep disorders

There are two main ways that experts classify insomnia:

• Time: acute (short-term) or chronic (long-term, also known as insomnia disorder)
• Cause: primary insomnia means it happens on its own, while secondary insomnia is a symptom of another condition or circumstance

Insomnia has several potential symptoms, which fall into a few categories:

• Trouble sleeping, including difficulty falling asleep, waking up in the middle of the night, and waking up too early
• Feeling tired, unwell, or sleepy
• Delayed responses and slow thought processes
• Trouble remembering things
• Mood disruptions, especially anxiety, depression, and irritability
• Other disruptions in your daily routine activities

Chronic insomnia is characterised by the following:

• Insomnia without circumstances that would interfere with your ability to sleep, such as changes in work schedule or life events
• Insomnia occurring at least three times per week
• Insomnia lasting for at least three months
• Insomnia that is not caused by substances, medications, or other sleep disorders, and cannot be fully explained by other medical or mental health conditions

Experts don't fully know why insomnia happens, but it can involve many factors, including family history, brain activity differences, medical conditions, mental health conditions, life circumstances, life changes, and sleep habits

If you are experiencing insomnia, there are several ways to treat it:

• Developing and practicing good sleep habits
• Medications that help you fall or stay asleep, including prescription and non-prescription drugs, mental health medications, and certain herbs and supplements
• Cognitive behavioural therapy (CBT), which can help change the thoughts and behaviours that keep you from sleeping

In addition to insomnia, other common sleep disorders include:

• Delayed sleep phase syndrome (DSPS): falling asleep 2 or more hours later than what is considered normal (10 pm to 12 am), making it difficult to wake up in the morning
• Sleep apnea: breathing repeatedly stops or becomes very shallow during sleep
• Restless legs syndrome: your legs feel uncomfortable, triggering you to want to move them

Alcohol consumption

Alcohol can make you feel sleepy, but it does not help you get a good night's rest. It can be stimulating in some cases, and it can also cause or worsen anxiety and sleep disorders. Here are some reasons why alcohol consumption might be keeping you awake:

• Alcohol is a stimulant: Despite its reputation for making people drowsy, alcohol can be stimulating as blood alcohol levels rise, typically within the first hour of drinking, especially if you consume a low dose. It can also be stimulating if you drink when your energy levels are naturally rising, such as in the early evening. This is one of alcohol's biphasic effects—it can be stimulating and sedating at different times.
• Alcohol reduces melatonin: Melatonin is the hormone that primes your body for sleep. One study found that melatonin levels were reduced by 15% two hours and 20 minutes after moderate alcohol intake and by 19% three hours and 10 minutes after.
• Alcohol and anxiety: Alcohol can cause or worsen anxiety, and this can leave you wide awake in bed. It could also trigger a vicious cycle, as sleep loss makes anxiety worse, which may then cause you to self-medicate with more alcohol to relax.
• Tolerance to sedative effects: If you drink alcohol to feel sleepy, you can quickly develop a tolerance. Research shows this could start happening in as little as three days. This might lead you to drink more alcohol to get the same effects, which can cause more sleep problems.
• Caffeine and sugar: If you're drinking caffeinated or sugary cocktails, the caffeine and sugar can keep you awake alongside the alcohol.
• Poor sleep hygiene: Alcohol can disrupt your sleep patterns, and if you've been drinking, you may also have had a large meal before bed or been exposed to too much bright light from screens or a bright environment. You might also be going to bed much later, and this change to your sleep patterns could make it harder to fall asleep.
• Frequent urination: Alcohol is a diuretic, which means you might wake up needing to use the bathroom more.
• Night sweats: Alcohol can trigger night sweats, making it harder to get back to sleep once you've woken up.
• Dehydration: Research shows that short sleep duration is linked to dehydration, and alcohol can dehydrate you.
• Sleep disorders: Alcohol can cause or worsen sleep disorders such as insomnia and sleep apnea. One study found that older adults (aged 50 and above) who engaged in binge drinking more than two days a week had a 64% increased likelihood of insomnia. If they binged two times or fewer a week, they still had a 35% greater chance of insomnia than non-binge drinkers.
• Disrupted sleep stages: Alcohol can reduce the amount of rapid eye movement (REM) sleep you get, which is the deepest stage of sleep when dreaming occurs. It can also cause you to spend more time in the lighter stages of sleep, leading to more frequent wakings and fragmented, low-quality sleep.
• Dependence: If you drink a lot, you may have a problem with alcohol dependence, which is linked to short sleep duration and sleep disorders like insomnia and obstructive sleep apnea.

Screen time

Blue Light Exposure

Screens emit blue light, which is known to suppress melatonin production. Melatonin is a crucial hormone that regulates sleep. Exposure to blue light within two hours of bedtime can disrupt the sleep cycle by stimulating the brain and reducing feelings of sleepiness. Blue light promotes wakefulness and can affect the natural sleep-wake cycle, which is one of the essential circadian rhythms governing our body processes. Circadian rhythms are the 24-hour cycle of hormones and chemicals in the body that help dictate when you sleep and when you're awake.

Overstimulation of the Brain

When you're scrolling through social media or watching exciting videos, your brain is stimulated and engaged. This makes it difficult to relax and prepare for sleep, potentially delaying sleep and reducing overall sleep duration. The internet and interactive games can be highly stimulating and make it challenging to wind down.

Disruption of Sleep-Wake Cycle

Excessive screen use can disrupt the body's natural sleep-wake cycle or circadian rhythm. Over time, this can lead to insomnia and other sleep disturbances. Studies have found that smartphone use, in particular, can decrease both sleep duration and quality.

Emotional Stimulation

Engaging with social media or other emotionally stimulating content before bed can induce intense emotions, such as stress and anxiety, which are often associated with sleep disruption. Even positive emotions triggered by exciting or funny content can prolong the time it takes to fall asleep.

Time Displacement

Screen media use can lead to a behavioural bedtime delay, as individuals may choose to postpone sleep to continue watching or playing. This displaces the time that could have been spent sleeping, resulting in shorter total sleep time and delayed sleep onset.

Addiction and Sleep

There is growing concern about technology addiction, such as internet gaming disorder, and its negative impact on sleep. Excessive use of technology can lead to sleep problems, including subjective insomnia and insufficient sleep.

Individual Differences

Some individuals may be more susceptible to the effects of screen time on sleep. For example, those with existing sleep problems or those who are more sensitive to light may experience greater sleep disturbances from screen time. Additionally, individual traits and characteristics, such as risk-taking behaviour and self-control, can influence the likelihood of screen time affecting sleep.

While screen time before bed can impact sleep, it is important to note that the content and type of screen time also play a role. Passive use of technology, such as listening to music or watching non-distressing content, may have less of an impact on sleep compared to active use, such as texting or social media scrolling.

To mitigate the potential negative effects of screen time on sleep, it is recommended to create a relaxing bedtime routine and establish healthy sleep habits. This includes limiting screen time before bed, especially within the hour before bedtime, and creating a screen-free bedroom environment. Using blue light filters or wearing blue light-blocking glasses can also help reduce the impact of blue light on sleep.

Frequently asked questions