Understanding The Science Behind Poor Sleep Quality

There are many reasons why you might not be sleeping well until morning. These range from lifestyle factors such as consuming caffeine and alcohol, to underlying health conditions including anxiety, depression, and chronic pain. Sleep issues can also be caused by medication, age, and poor sleep habits.

Lifestyle factors such as alcohol, caffeine, and screen time

Alcohol

Drinking alcohol before bed can negatively affect your sleep, even if it initially makes you feel sleepy. Alcohol is rapidly absorbed into your bloodstream and takes about an hour for your body to process one serving. It is recommended to avoid consuming alcohol within the last three to four hours before bedtime. Finishing your last drink several hours before sleeping is especially important if you've had multiple drinks. Alcohol can enhance the brain's levels of adenosine, a chemical that induces sleepiness. However, as alcohol wears off during sleep, it can lead to frequent, short awakenings and interrupt your REM sleep, which is crucial for dreaming, learning, and memory processing. Additionally, alcohol can relax your airway, worsening snoring and sleep apnea.

Caffeine

Caffeine is a stimulant that promotes wakefulness by blocking adenosine, a sleep-inducing chemical. Its effects can last for hours, even after the initial stimulating sensation fades. To ensure better sleep quality, it is generally recommended to avoid caffeine at least eight hours before bedtime. This guideline may vary depending on individual sensitivity to caffeine and consumption habits. If you experience insomnia, anxiety, or headaches, consider reducing your daily caffeine intake.

Screen Time

While not directly mentioned in the search results, screen time, especially close to bedtime, can negatively impact your sleep. The blue light emitted by electronic devices can delay the release of melatonin, the hormone that regulates sleep. Additionally, engaging with stimulating content or activities on screens can make it harder to fall asleep. To improve your sleep, it is advisable to limit screen time before bed and opt for relaxing activities that promote sleepiness.

Circadian rhythm disorders, including jet lag and shift work adjustments

Circadian rhythm disorders are disruptions to the body's internal clock, which regulates the sleep-wake cycle. This can be caused by travelling across multiple time zones, known as jet lag, or by working irregular shifts, known as shift work adjustment.

Jet Lag

Jet lag is a common sleep problem that occurs after travelling across more than three time zones, resulting in an abrupt change to the body's internal clock or circadian rhythm. Symptoms include insomnia, daytime drowsiness, lack of focus, extreme fatigue, mood changes, and a general feeling of being "off". The severity of jet lag depends on the direction and number of time zones crossed, with eastward travel typically resulting in more severe symptoms. The body's internal clock needs time to adjust to the new sleep and wake cycles at the destination, and this adjustment period can cause sleep disturbances.

To manage jet lag, it is recommended to get exposure to sunlight during the day, adjust your sleep-wake schedule to the new time zone, focus on getting quality sleep, maintain a consistent meal schedule, and avoid caffeine and alcohol.

Shift Work Adjustment

Shift workers, particularly those working night shifts, experience long-term disruptions to their circadian rhythm, which can have social and physiological implications. Night shift workers must adapt to sleeping during the day when their internal clock is usually set to be awake, and staying awake during the night when their urge to sleep is strong. This misalignment between internal circadian rhythms and external environmental cues can lead to insomnia and excessive sleepiness, increasing the potential for impaired judgement and accidents.

To help manage shift work adjustments, it is recommended for shift workers to maintain a consistent sleep schedule, enhance lighting in the workplace to simulate daylight, and use caffeine strategically in small, regular doses.

Sleep disorders like insomnia, sleep apnea, and restless legs syndrome

Insomnia

Insomnia is often caused by long-ingrained behaviours, such as staying up too late or engaging in stimulating activities before bed. To combat insomnia, it is recommended to follow basic sleep hygiene strategies. This includes going to bed and waking up at the same times each day, keeping the bedroom cool, dark, and comfortable, and using the bed only for sleep and sex. If you can't fall asleep within 15 minutes, it is suggested to get up, leave the bedroom, and engage in a quiet activity until you feel sleepy.

Sleep apnea

Sleep apnea is a serious sleep disorder characterised by repeated pauses in breathing during sleep, resulting in loud snoring, daytime tiredness, and potentially more severe problems like heart issues or high blood pressure. It occurs when the airways become partially or completely blocked, often due to obesity, enlarged tonsils or adenoids, or a thick neck. Sleep apnea can be managed through lifestyle changes, such as weight loss, smoking cessation, and treating nasal allergies. In more severe cases, continuous positive airway pressure (CPAP) machines may be recommended to help keep the airways open during sleep.

Restless legs syndrome

Restless legs syndrome (RLS) is a neurological disorder causing unpleasant sensations in the legs, along with a compelling urge to move them. It is more common in women and tends to worsen with age. While there is no cure for RLS, symptoms can be managed through medication and lifestyle modifications. Home remedies such as regular exercise, leg massages, hot baths, and reducing caffeine, alcohol, and tobacco intake may help alleviate symptoms.

Medical conditions, including depression, anxiety, and chronic pain

Sleep problems are common among people with depression, anxiety, and chronic pain.

Depression

Depression and sleep issues have a bidirectional relationship, meaning that poor sleep can contribute to the development of depression, and having depression makes a person more likely to experience sleep troubles. A majority of people with depression experience sleep issues.

People with depression may find it difficult to fall asleep and stay asleep during the night or experience periods of excessive daytime sleepiness. They may also experience early wakening, difficulty falling asleep at night, or switch back and forth between insomnia and hypersomnia during a single period of depression.

Depression is marked by persistent bouts of sadness, disappointment, and hopelessness, as well as other emotional, mental, and physical changes that lead to difficulties with daily activities. Symptoms may include a persistent sad, low, or irritable mood, feelings of hopelessness, worthlessness, or guilt, decreased energy and fatigue, difficulty concentrating, insomnia, changes in appetite or overeating, and thoughts of death or suicide.

Anxiety

Sleep deprivation can negatively affect mental health, making it harder to manage and process emotions. People with sleep deprivation are more likely to feel symptoms of anxiety.

Chronic Pain

Sleep is important for the body to recover and maintain itself. Sleep deprivation can lead to higher pain sensitivity, causing people to feel pain more easily and making the pain more intense.

Medication side effects, including antidepressants and corticosteroids

Additionally, corticosteroids like prednisone, commonly used to reduce inflammation, can also disrupt sleep patterns. Prednisone stimulates the production of cortisol, the stress hormone, which can interfere with the sleep cycle.

The impact of these medications on sleep can manifest in various ways. Some may delay sleep onset, making it difficult to fall asleep. Others may cause frequent nighttime awakenings, trigger early morning waking, or impair sleep quality, leaving individuals feeling unrefreshed in the morning. It's important to note that individuals may experience different side effects, and the effects can vary within the same class of drugs.

If you suspect that your medication is affecting your sleep, it's essential to consult your healthcare provider. They may recommend adjusting the dosage, changing the time of administration, or exploring alternative treatments.

Frequently asked questions