Battling Sleep: Why I Refuse To Let Myself Rest

Sleep is a necessity for humans, yet many people struggle to fall asleep at night. There are numerous reasons why someone may have trouble sleeping, such as lifestyle habits, medications, or physical or mental health conditions. For example, consuming caffeine or alcohol close to bedtime can make it difficult to fall asleep. Additionally, mental health issues like depression, anxiety, and stress can also lead to sleep problems. Furthermore, fear, bad habits, hormones, or grief can also play a role in disrupting sleep patterns. To combat these issues, individuals can try relaxation techniques, improve their sleep hygiene, seek talk therapy, or consult a healthcare professional for advice and treatment options.

Fear and grief can prevent sleep

Fear and grief are powerful emotions that can significantly impact our sleep. Here are some ways in which these emotions can affect our sleep and some strategies to help you manage them:

Fear

Somniphobia, or the fear of falling asleep, is a common reason why many people struggle to fall asleep when alone. This fear can stem from the anticipation of nightmares or health events during the night. Having a co-sleeper can provide reassurance and help individuals with somniphobia feel more relaxed. If you experience fear-induced insomnia, consider the following strategies:

• Talk therapy: This can help you identify and confront your fears, developing healthier sleep patterns over time.
• Relaxation techniques: Try deep breathing exercises, progressive muscle relaxation, or meditation to calm your mind and body.
• Positive thinking: Challenge negative thoughts and replace them with positive ones to reduce fear and anxiety.

Grief

The loss of a loved one or a breakup can disrupt your sleep patterns and evoke intense emotions that make it difficult to fall asleep. Grief can leave you grappling with sadness and a lack of feel-good hormones to help you cope. Here are some strategies to help you manage grief-induced insomnia:

• Cuddle with a pet: Sleeping with a pet can increase oxytocin levels and provide comfort similar to that of a human partner.
• Talk therapy: Therapy can help you process your grief and develop healthier sleep patterns.
• Relaxation techniques: Try deep breathing, meditation, yoga, or tai chi to calm your mind and body.

While it is normal to experience sleep disturbances during difficult emotional periods, it is important to prioritize your sleep. Practicing good sleep hygiene and adopting relaxation techniques can help you manage fear and grief, improving your sleep quality over time.

Hormones and oxytocin release

Hormones play a significant role in sleep patterns. A lack of sleep can increase the stress hormone, cortisol, in the body, which negatively impacts sleep quality. In contrast, oxytocin, often referred to as the "love hormone," has been shown to decrease cortisol levels and promote better sleep.

Oxytocin is a neuropeptide synthesised in the mammalian hypothalamus, particularly within the paraventricular nucleus and supraoptic nucleus. It is well known for its role in social behaviours, such as attachment, bonding, and social interaction, but it also plays a crucial role in stress relief and pain reduction.

Oxytocin has been found to:

• Improve physical and mental health
• Enhance sleep quality
• Decrease blood pressure
• Reduce the stress hormone, cortisol
• Boost the immune system
• Relieve pain and anxiety

Oxytocin is released in the body during intimate moments with loved ones, such as cuddling, skin-to-skin contact, and eye contact. It is also released during labour and breastfeeding, playing a vital role in uterine contractions and stimulating milk letdown.

In terms of sleep, oxytocin has been shown to have a wake-promoting influence at higher doses in preclinical studies. However, clinical studies suggest that oxytocin may have a minor sleep-promoting effect or no effect on sleep-wake outcomes. This discrepancy could be due to differences in species, doses, and methods of administration.

Additionally, the impact of oxytocin on sleep may be influenced by sex hormones. For example, endogenous and exogenous oestrogen has been found to increase oxytocin levels, and oral contraceptives have been shown to impact oxytocin release.

While the relationship between oxytocin and sleep is complex and not yet fully understood, the available evidence suggests that oxytocin may play a role in modulating sleep-wake behaviour and could be a potential target for sleep-related therapeutics.

Stress and the stress hormone cortisol

Stress is a condition caused by various factors and characterised by an imbalance in body functioning, an impaired nervous system, and tension. The human body is continually responding to internal and external stressors. The body processes the stressful information and elicits a response depending on the degree of threat. The body's autonomic nervous system is broken down into the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). In times of stress, the SNS gets activated. The SNS is responsible for the fight or flight response, which causes a cascade of hormonal and physiological responses. The amygdala is responsible for processing fear, arousal, and emotional stimuli to determine the appropriate response. If necessary, the amygdala sends a stress signal to the hypothalamus. The hypothalamus subsequently activates the SNS, and the adrenal glands release a surge of catecholamines, such as epinephrine. This results in effects such as increased heart rate and respiratory rate. As the body continues to perceive the stimuli as a threat, the hypothalamus activates the HPA axis. Cortisol is released from the adrenal cortex and allows the body to continue to stay on high alert. Acutely, cortisol's catabolic mechanisms provide energy to the body.

Cortisol is a steroid hormone, synthesized from cholesterol. It is synthesized in the zona fasciculata layer of the adrenal cortex. Adrenocorticotropic hormone (ACTH), released from the anterior pituitary, functions to increase LDL receptors and increase the activity of cholesterol desmolase, which converts cholesterol to pregnenolone and is the rate-limiting step of cortisol synthesis. Glucocorticoid receptors are present in almost all tissues in the body. Therefore, cortisol is able to affect nearly every organ system. Cortisol has many functions in the human body, such as mediating the stress response, regulating metabolism, the inflammatory response, and immune function. The release of cortisol is under control of the hypothalamus-pituitary-adrenal (HPA) axis. Corticotropin-releasing hormone (CRH) is released by the paraventricular nucleus (PVN) of the hypothalamus. It then acts on the anterior pituitary to release ACTH, which subsequently acts on the adrenal cortex. In a negative feedback loop, sufficient cortisol inhibits the release of both ACTH and CRH. The HPA axis follows a circadian rhythm. Thus, cortisol levels will be high in the morning and low at night.

Chronic stress and lack of control over life experiences when outcomes fail to meet expectations may manifest as a sense of helplessness or hopelessness. After repeated disappointments and failures to achieve success, humans are likely to give up when they feel a loss of control. Although chronic fears, challenges, and unexpected events define anxiety, repeated failures, giving up, helplessness, and hopelessness are all characteristics of depression. Similarly, chronic pain and repeated failures in pain management are likely to be perceived as a loss of control over health and may manifest as depression. In either case, the transition to depressive symptoms should be addressed and prevented by modifying the way pain or non-pain-related stressors are perceived and managed.

Snuggling with loved ones can reduce the stress hormone cortisol, thereby helping one get a peaceful night's sleep.

Screen time and blue light

The screens of electronic devices such as smartphones, computers, tablets, and televisions emit blue light that disrupts our natural sleep cycles. Research shows that a majority of Americans use electronic devices within an hour of going to bed, which can lead to unsatisfactory sleep. Exposure to blue light in the hours leading up to bedtime can hinder sleep by suppressing the body's release of melatonin, a hormone that makes us feel drowsy. Blue light can trick our brains into thinking it is still daytime, disrupting our circadian rhythms and leaving us feeling alert instead of tired.

Teens are more sensitive to the effects of blue light than adults. To improve sleep, it is recommended to avoid looking at bright screens beginning two to three hours before bed. If you must use electronic devices at night, consider wearing blue-light-blocking glasses or using a night mode feature found on some devices to reduce blue light exposure.

In addition to the type of light, the content consumed on screens can also impact sleep. Engaging in activities that increase your heart rate or stimulate your brain, such as video games or stressful texts, can kick your body into wake-up mode. It is best to shut off alerts and keep devices that emit light out of your bedroom when sleeping.

Overall, limiting screen time and blue light exposure before bed can help improve sleep quality and ensure you get the rest you need.

Sleep disorders and mental health issues

Sleep is crucial for good mental health, but sleep issues can worsen mental health conditions, and mental health problems can lead to poor sleep. Sleep and mental health are closely connected and have demonstrated links to depression, anxiety, bipolar disorder, and other conditions.

The Bidirectional Relationship Between Sleep and Mental Health

The relationship between sleep and mental health is bidirectional, meaning that sleeping problems may be both a cause and consequence of mental health problems. For example, insomnia has been recognised as a risk factor for depression, and people with insomnia are twice as likely to develop depression. However, it was previously believed that depression caused insomnia, but now it is understood that the relationship is more complex and circular.

Sleep Disorders and Mental Health Disorders

Several mental health disorders are associated with insomnia and other sleep disorders, including:

• Anxiety disorders, such as post-traumatic stress disorder (PTSD)
• Attention-deficit/hyperactivity disorder (ADHD)
• Depressive disorders, including seasonal affective disorder
• Schizophrenia
• Bipolar disorder
• Substance use disorders

Sleep Disorders and Trauma

Trauma can also cause sleep disorders. People who have experienced trauma may have flashbacks, nightmares, or night terrors that disturb their sleep. They may also feel unsafe or uncomfortable in bed or in the dark.

Sleep Disorders and Stress

Stress and worry can also contribute to sleep disorders. Hyperarousal, a state of increased alertness and tension, is considered a central contributor to insomnia. Sleep problems may become an additional source of worry, creating anticipatory anxiety that makes it harder to fall asleep.

Sleep Disorders and Grief

Sudden loss or a breakup can also impact sleep patterns. Grief can bring up uneasy feelings of sadness that make it difficult to fall asleep, especially if the person is dealing with a lack of feel-good hormones.

Frequently asked questions