What’s Causing Your Insomnia?
Eight Things To Look Out For
In many cases, insomnia can be thought of not so much as a disorder, but as a symptom — the result of some underlying problem that’s actually responsible for fouling up your sleep. The key to fixing any problem is to uproot its cause. It usually just comes down to a matter of good old-fashioned troubleshooting. That’s why we’ve put together this list of often-seen causes of sleeplessness. We want you to be able to see past the intimidating specter of insomnia and look head-on at what’s really preventing you from getting a good night’s sleep.
- An Uneasy Mind. Have you ever had one of those nights? Lying awake in bed, with your mind racing over some nagging problem or personal crisis? Tossing and turning, growing more stressed with each hour, dreading the arrival of morning? We’ve all been there. Sleep specialists sometimes refer to this as “hyperarousal” and it’s probably behind more cases of insomnia than any other cause. The human body is designed to strike a balance between two basic needs: the need to be alert, active, and awake, and the need for sleep. When troubles and emergencies bear down on us, the mind tries to hold off sleep — this is probably part of our evolutionary defense mechanisms. But like a lot of ancient, hard-wired instincts, this response isn’t really well adapted to modern life. After all, what chance have you got of dealing with your problems if you haven’t slept? Fortunately, there are ways to overcome this. We’ll be looking at some relaxation techniques and mental tricks designed to help calm the mind and open the door for sound sleep. You can start by reading this article on sleep hygiene.
- A Disrupted Schedule. Our bodies are governed by a very precise internal timing mechanism called the circadian rhythm. This 24-hour rhythm sets the pace of our daily lives, carefully orchestrating our patterns of activity, including most notably our sleep/wake cycles. Whenever you’re forced to keep to an unpredictable schedule, these cycles are thrown off, so that your body is never quite sure if it’s day or night, time to be alert or time to go to sleep. Shift work and jetlag are the two most notorious culprits in this. But you don’t have to be a frequent flyer or work the graveyard shift to get your rhythm out of whack. We are all creatures of our times, living in a frenetic, always-on society. With the advent of artificial lighting and relentless late-night activity, the age-old patterns of night and day have been all but obliterated. Scientists say this screws with our circadian rhythms in subtle but significant ways and insomnia is very often the result. Keeping to a consistent schedule and working to minimize the disorienting effects of shift work and jetlag will do wonders for your sleep.
- Noisy, Hot, and Uncomfortable. You’re not surprised to learn that your surroundings — what experts call your “sleep environment” — plays a strong role in how well or how badly you sleep. When things go wrong here, it can be miserable. We’ve all fallen victim to the really obvious problems like noise disturbances: barking dogs, midnight car door slammers, neighborhood party animals, and (closer to home) snoring bed partners. But other environmental factors are much more subtle and often overlooked: If the temperature in your house at night is too hot or too cold to sleep comfortably… If your bedroom is cluttered up with distracting reminders of daytime concerns (bills, paperwork, laptop, iPhone, etc.)… If your pillows don’t give you adequate head support and your sheets don’t feel good against your skin… If your mattress and box spring are relics from the turn of the century… Well, you get the idea. It really pays to think hard about this stuff — your sleep and your well being depend on it! Click here for more on how to make a sleep environment that’s virtually insomnia-proof.
- Aches and Pains. Researchers have uncovered a strange link between chronic pain and insomnia. It’s easy enough to see why the torment of aches and pains can make for a rough night’s sleep. But what’s interesting is how this cause and effect relationship sometimes gets reversed: disrupted sleep can actually make pain worse. In a recent study, subjects who were deprived of deep sleep showed increased nerve sensitivity and a lower tolerance of pain as a result. You can see how a vicious cycle could get started this way: pain leads to insomnia, which makes the pain worse, which in turn leads to more lost sleep, etc. We are told that in some cases it becomes tricky to figure out which came first, the pain or the sleeplessness. This is particularly the case when it comes to problems like fibromyalgia for example. But understanding how this complex relationship works may just guide us to a solution, both for reducing pain and improving sleep. About 15% of adults in the general population report having chronic pain, with 2/3 of those suffering from bad sleep.
- Trouble Breathing. It’s hard to sleep when it’s hard to breathe. Everybody knows what it’s like trying to fall asleep with a head cold or bad allergies. You have to become a mouth breather; snorting, blowing, coughing and wheezing, you lie in bed on your side with one half of your nose completely stopped up, waiting in vain for your nasal passages to drain and equalize. The simple act of breathing, usually done by your body automatically, becomes something you actually have to think about and concentrate on — breathing becomes a tedious chore, an exertion. Of course, people who have chronic respiratory problems have a much more serious, long-term challenge to deal with. If you have trouble breathing at night, talk to your doctor specifically about how this impacts your sleep; she may be able to find a way to ease things. While we’re on the subject, we need to mention obstructive sleep apnea, a disorder which causes the sufferer to actually stop breathing in their sleep several times a night. This not only disturbs sleep but constitutes a serious medical condition as well. And while it isn’t always associated with insomnia, it frequently brings about complaints of chronic daytime fatigue. Don’t fool around with this. If you think you may have sleep apnea, talk to a doctor or sleep specialist as soon as you can.
- Digestive Woes. When things go wrong with your digestion, the whole world seems to get knocked off its axis. The sour discomfort of upset stomachs, the torturous bloating from gas, the incendiary pain of heartburn and acid-reflux, the tragicomedy of constipation and diarrhea. The list is long, grim and rude. And when these things strike at night, you can throw insomnia in to the bargain as well. A couple of specific problems to focus on here: First, if you have unexplained awakenings in the night, be on the lookout for gastroesophageal reflux (GER). This is where stomach acid makes its way back up into your esophagus causing irritation and discomfort. GER is sometimes considered a suspect in cases of frequent nighttime awakenings because the reflux causes you to wake up without your ever really knowing why. And finally, we’d be remiss if we didn’t talk about irritable bowel syndrome (IBS). This is a chronic digestive disorder that’s believed to have its origins in the nervous system, bringing about extremely unpleasant cycles of intestinal pain and irregularity. IBS and insomnia are known to be linked with one another and they’ve even been found to have the same kind of interconnection we saw earlier with chronic pain (IBS causes sleeplessness, but sleeplessness makes IBS worse).
- Drug Side Effects. Wouldn’t it be nice if drugs did only what they were supposed to do and nothing more? Unfortunately, side effects are often a fact of life for people taking prescription medications. The trick, of course, is to aim toward minimizing the unwanted effects. Insomnia happens to be listed as a common side effect for a number of medications, and if you suspect that something you’re taking is adversely affecting your sleep, don’t hesitate to talk with your doctor about it. He may be able to adjust the amount and time of dosage, or substitute another drug that you can get along with better. Remember, it’s always best to talk to your doctor first before you stop taking a prescription.
- Restless Legs Syndrome (RLS). RLS is a neurological disorder that causes intense “creepy-crawly” sensations in the legs (and sometimes the arms). The feeling has been likened to the pins and needles you get when your leg goes to sleep on you. It typically comes on when you’re sitting still, relaxing, or lying down. You have to fidget, stretch, or walk around in order to get rid of it but the sensations may come back in as little as a few seconds. The symptoms are typically at their worst in the late evening and right at bedtime so RLS almost always leads to insomnia. In extreme cases, sleep deprivation can become serious. To add insult to injury, about 80-90% of RLS sufferers also have something called periodic limb movement disorder (PLMD) which attacks during sleep. It’s normal to twitch or jerk in your sleep from time to time, but PLMD actually causes you to kick your legs over and over again throughout the night. Doctors are still trying to understand what’s behind all this. Restless legs syndrome seems to be more common in people with iron deficiencies, pregnant women, and kidney dialysis patients. It afflicts something like 10% of the general population with women twice as likely to be victims. The good news is that RLS is treatable and easy to diagnose. For more information, visit the Restless Legs Syndrome Fact Sheet at the National Institutes of Health.