Most people experience nighttime wakefulness from time to time. However, if you’re waking up at 3 A.M. every night, you’re likely living with insomnia, which can involve difficulty staying asleep, as well as long periods of wakefulness each night. Stress, physical and mental health conditions, age, and lifestyle factors can all play a role in insomnia. You may find it helpful to exercise regularly, keep a regular sleep schedule, and do something relaxing before bed to manage insomnia. It can also be beneficial to see your doctor and speak with a therapist about your sleep-related challenges.
What Is Insomnia?
The CDC typically recommends that adults get an average of seven to nine hours of sleep at night. Adolescents usually need eight to 10, and school-aged children may need nine to 12 hours within a 24-hour period. As age increases, the recommended hourly numbers tend to decrease.
Symptoms of insomnia can include the following:
- Long periods of wakefulness at night
- Difficulty falling asleep and staying asleep
- Excessive feelings of grogginess or sluggishness upon waking
- Irritability and difficulty concentrating during the day
- Difficulty napping despite extreme fatigue
There can be several potential contributing factors to insomnia, such as stress, health conditions, substance use, poor sleeping environment, mental health conditions, and more. For some, insomnia may have no clear cause.
Factors That May Contribute To Insomnia
Read more about several potential contributing factors below.
Stress may be one reason that some individuals have difficulty falling asleep, wake in the middle of the night, or are unable to return to sleep. Insomnia may emerge after a singular stressful event, like the loss of a loved one, a job, or a home. Continuous stress from financial, health, family, or work challenges can cause insomnia as well.
One of the difficulties of experiencing insomnia due to stress can be that often, people worry over the fact that they can’t sleep because they’re stressed. This can then create another source of stress, potentially resulting in additional insomnia.
Physical health problems, like heart and respiratory conditions, neurological conditions, and hormonal problems, can cause insomnia in some cases. People experiencing chronic pain and joint or muscle problems can be affected as well.
There may be a bi-directional link between obesity and insomnia. Sleep studies generally show that adults who sleep five hours or less may be more likely to become obese, and conditions associated with obesity, like sleep apnea and acid reflux, can be common causes of insomnia.
Mental Health Disorders
Post-traumatic stress disorder and other anxiety disorders can have an adverse impact on sleep, as can depression. Trouble sleeping can also be associated with a long list of other mental health conditions like bipolar disorder, schizophrenia, and more.
People of different ages usually need varying hours of sleep to stay well-rested, and while older adults typically need far less sleep than school-aged children, it appears that aging can be a contributor to insomnia. Contributing factors may include a reduction in activity, changes in health associated with aging, and increased prescription medication use. Changes in our natural circadian rhythms as we age may also cause sleep disturbances.
Lifestyle factors like nicotine, alcohol and substance use, stimulating exercise, what and when you eat in the evening, work or travel schedules, and more may all be contributors to insomnia and poor sleep quality. Caffeinated beverages can disrupt sleep, as can medicines for blood pressure, asthma, and some antidepressants. Habits like using smartphones, tablets, laptops, and other electronics just before bed can adversely affect sleep, as can keeping an irregular bedtime schedule.
Tips For Better Sleep
There may be many things you can do to improve your sleep quality and increase the hours you stay asleep at night.
Get Regular Physical Activity
As long as you exercise at least one to two hours before bedtime, regular physical activity can significantly improve sleep quality. This may be especially true if you exercise outdoors, as exposure to daylight during outdoor exercise can establish your body’s natural circadian rhythms. Physical movement may also relieve the stress and anxiety that may keep you awake at night.
Keep A Regular Sleep Schedule
Try to resist the temptation to stay up late and sleep in on weekends. Maintaining the same daily sleep schedule may help your body know when it’s time to go to sleep.
Do Something Relaxing Before Bed
Creating a regular bedtime ritual can signal to the body that it’s time to wind down. It can also help to keep your bedroom cool, dark, and comfortable, and try to refrain from using your bed for anything but sleeping and sex.
Avoid Unhealthy Consumption Habits
Try to limit caffeine and alcohol or avoid them altogether before bed. It can also be beneficial to avoid large meals and smoking around bedtime.
Getting Professional Help
People often underestimate how vital it can be to get enough high-quality sleep, and the consequences of insomnia on physical and mental health can be far-reaching. But it isn’t always easy to uncover the causes of sleep disturbances, and if that’s the case for you, a visit to your primary care physician (PCP) may be recommended.
Your PCP will likely conduct physical and lab tests, as well as review your medical history to isolate or rule out the causes of your insomnia. They may also review any medications you take and adjust them as needed. If necessary, your doctor may refer you to a sleep specialist who can conduct a sleep study.
Sleep studies typically use technology to track the brain and body’s activity during sleep, including oxygen levels, arm and leg movements, and sleep stages. Through sleep studies, doctors can diagnose a host of sleep disorders beyond insomnia, such as sleep apnea and restless leg syndrome.
Depending on the results of the study, your PCP can make recommendations and prescribe medications if needed. They may also refer you to a psychotherapist to manage stress, anxiety, depression, and any other underlying psychological causes for your sleep disturbances.
Benefits Of Online Therapy
Online therapy can be an excellent choice for those living with insomnia as it usually allows for quite a bit of flexibility. You might choose to schedule your sessions close to bedtime so that you can work through relaxation exercises with your therapist before going to sleep for the night. In addition, if you’re feeling tired due to insomnia, attending therapy from home may be more convenient than traveling to a therapist’s office.
Effectiveness Of Online Therapy
Studies indicate that online therapy generally has a high rate of success in treating insomnia and depressive symptoms, as well as many other mental health conditions. If you believe you may benefit from working with a licensed mental health professional, online therapy may be a valid option.
What do I do if I need to sleep?
If you're struggling to fall asleep most nights, work on having a regular sleep routine. The National Sleep Foundation recommends creating a quiet sleep environment, making sure the room is dark, and avoiding caffeine before bedtime. Try relaxation techniques like deep breathing or meditation. If you still have trouble sleeping, consult a sleep medicine professional for guidance on improving your sleep habits and overall sleep health.
What are the 5 stages of sleep deprivation?
The five stages of sleep deprivation vary in severity and symptoms as time without sleep increases. Stage 1, after 24 hours, includes symptoms like drowsiness and irritability. During Stage 2, after 36 hours, an individual might experience impaired memory and decision-making. By Stage 3, at 48 hours, hallucinations and extreme fatigue may occur. Stage 4, after 72 hours, leads to more complex hallucinations and disordered thinking, and Stage 5, after 96 hours, can result in sleep deprivation psychosis, a severe distortion of reality.
Should I go to the ER if I haven't slept in 3 days?
If you haven't slept for three days, it's recommended to seek medical attention. While it may not always require a visit to the ER, you may want to consult a healthcare provider or a clinical sleep medicine expert as soon as possible. Prolonged sleep deprivation can lead to severe physical and mental health problems.
Why am I so tired but can't sleep?
You may be tired but unable to sleep because of different factors, including stress, sleep disorders, or poor sleep habits. The Academy of Sleep Medicine suggests keeping a consistent sleep schedule and a calming pre-sleep routine. If the problem persists, consider consulting a healthcare provider to determine potential causes.
Should I just stay awake if I can't sleep?
Staying awake if you can't sleep isn't recommended. Instead, try relaxation techniques to help you fall asleep. If you're awake for more than 20 minutes after trying to sleep, you can do quiet, non-stimulating activities, such as reading or journaling, until you feel sleepy.
How long can you go without sleep?
The amount of time you can go without sleep varies, but after 48 hours, major cognitive deficits and health risks increase. The Sleep Research Society confirms that chronic sleep deprivation can lead to severe health risks, such as poor mood, decreased cognitive skills, and an increased risk for accidents. Therefore, it’s not recommended to go for long periods without sleep.
What to do after a night of no sleep?
After a night of no sleep, you may want to avoid heavy physical or mental tasks. If you can, do light activities and try to take short naps if possible. Avoid caffeine late in the day, as it can further disrupt your sleep patterns, and try to return to your normal sleep schedule as soon as possible. In many cases, you may need more sleep the next day to make up for the lost sleep the night before.
Is 4hrs of sleep enough?
A sleep duration of four hours is generally not enough for people in most age groups, particularly for a healthy adult. Most adults require seven to nine hours of sleep per night for optimal health. Adolescents typically need eight to 10 hours, while school-aged children generally need nine to 12 hours of sleep.
How much sleep debt am I in?
Sleep debt accumulates when you get less sleep than your body needs. To calculate it, subtract the amount of sleep you’ve been getting from the amount recommended for your age group. Over time, sleep debt can affect your overall health, increasing the risk of diabetes, heart disease, and high blood pressure.
Will your body eventually force you to sleep?
Yes, the body has a natural drive for sleep, and staying awake for long periods typically leads to involuntary sleep or microsleeps. However, forcing the body into such a state can interfere with normal sleep patterns and disrupt your health. With good sleep habits, you can make sure you get enough sleep regularly.
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