Can’t Sleep?
                                                          --Causes, Cures, and Treatments for Insomnia


Do you struggle to get to sleep no matter how tired you are? Or do you wake up in the middle of the night and lie awake for hours,

anxiously watching the clock? Insomnia is a common problem that takes a toll on your energy, mood, health, and ability to function

during the day. Chronic insomnia can even contribute to serious health problems. Simple changes to your lifestyle and daily habits

can put a stop to sleepless nights.

Can’t sleep? Understanding insomnia and its symptoms

Insomnia is the inability to get the amount of sleep you need to wake up feeling rested and refreshed. Because different people need

different amounts of sleep, insomnia is defined by the quality of your sleep and how you feel after sleeping—not the number of hours

you sleep or how quickly you doze off. Even if you’re spending eight hours a night in bed, if you feel drowsy and fatigued during the

day, you may be experiencing insomnia.

Although insomnia is the most common sleep complaint, it is not a single sleep disorder. It’s more accurate to think of insomnia as a

symptom of another problem, which differs from person to person. It could be something as simple as drinking too much caffeine during

the day or a more complex issue like an underlying medical condition or feeling overloaded with responsibilities.

The good news is that most cases of insomnia can be cured with changes you can make on your own—without relying on sleep specialists

or turning to prescription or over-the-counter sleeping pills.


Symptoms of insomnia:

• Difficulty falling asleep despite being tired

• Waking up frequently during the night

• Trouble getting back to sleep when awakened

• Exhausting sleep

• Relying on sleeping pills or alcohol to fall asleep

• Waking up too early in the morning

• Daytime drowsiness, fatigue, or irritability

• Difficulty concentrating during the day


Causes of insomnia: Figuring out why you can’t sleep

In order to properly treat and cure your insomnia, you need to become a sleep detective. Emotional issues such as stress, anxiety,

and depression cause half of all insomnia cases. But your daytime habits, sleep routine, and physical health may also play a role.

Try to identify all possible causes of your insomnia. Once you figure out the root cause, you can tailor treatment accordingly.

• Are you under a lot of stress?

• Are you depressed or feel emotionally flat or hopeless?

• Do you struggle with chronic feelings of anxiety or worry?

• Have you recently gone through a traumatic experience?

• Are you taking any medications that might be affecting your sleep?

• Do you have any health problems that may be interfering with sleep?

• Is your sleep environment quiet and comfortable?

• Are you spending enough time in sunlight during the day and in darkness at night?

• Do you try to go to bed and get up around the same time every day?


Common mental and physical causes of insomnia:

Sometimes, insomnia only lasts a few days and goes away on its own, especially when the insomnia is tied to an obvious temporary

cause, such as stress over an upcoming presentation, a painful breakup, or jet lag. Other times, insomnia is stubbornly persistent.

Chronic insomnia is usually tied to an underlying mental or physical issue.

• Psychological problems that can cause insomnia: depression, anxiety, chronic stress, bipolar disorder, post-traumatic stress disorder.

• Medications that can cause insomnia: antidepressants; cold and flu medications that contain alcohol; pain relievers that contain caffeine

(Midol, Excedrin); diuretics, corticosteroids, thyroid hormone, high blood pressure medications.

• Medical problems that can cause insomnia: asthma, allergies, Parkinson’s disease, hyperthyroidism, acid reflux, kidney disease, cancer,

chronic pain.

• Sleep disorders that can cause insomnia: sleep apnea, narcolepsy, restless legs syndrome.

Insomnia cures and treatments: Changing habits that disrupt sleep

Some of the things you’re doing to cope with insomnia may actually be making the problem worse. For example, if you’re using sleeping

pills or alcohol to fall asleep, this will disrupt your sleep even more over the long-term. Or if you drink excessive amounts of coffee during

the day, it will be more difficult to fall asleep later. Often, changing the habits that are reinforcing sleeplessness is enough to overcome

insomnia altogether. It may take a few days for your body to get used to the change, but once you do, you will sleep better.


Using a sleep diary to identify insomnia-inducing habits

Some habits are so ingrained that you may overlook them as a possible contributor to your insomnia. Maybe your daily Starbucks habit

affects your sleep more than you realize. Or maybe you’ve never made the connection between your late-night TV viewing or Internet

surfing and your sleep difficulties. Keeping a sleep diary is a helpful way to pinpoint habits and behaviors contributing to your insomnia.

All you have to do is jot down daily details about your daytime habits, sleep routine, and insomnia symptoms. For example, you can keep

track of when you go to sleep and when you wake up, where you fall asleep, what you eat and drink, and any stressful events that occur

during the day.

Adopting new habits to help you sleep

• Make sure your bedroom is quiet, dark, and cool. Noise, light, and heat can interfere with sleep. Try using a sound machine or earplugs

to hide outside noise, an open window or fan to keep the room cool, and blackout curtains or a sleep mask to block out light.

• Stick to a regular sleep schedule. Support your biological clock by going to bed and getting up at the same time every day, including weekends,

even if you’re tired. This will help you get back in a regular sleep rhythm.

• Avoid naps. Napping during the day can make it more difficult to sleep at night. If you feel like you have to take a nap, limit it to 30 minutes before

3 p.m.

• Avoid stimulating activity and stressful situations before bedtime. This includes vigorous exercise; big discussions or arguments; and TV, computer,

or video game use. Instead, focus on quiet, soothing activities, such as reading, knitting, or listening to soft music, while keeping lights low.

• Don’t read from a backlit device (such as an iPad).  If you use an eReader, opt for one that is not backlit, i.e. one that requires an additional light


• Limit caffeine, alcohol, and nicotine. Stop drinking caffeinated beverages at least eight hours before bed. Avoid drinking alcohol in the evening;

while alcohol can make you feel sleepy, it interferes with the quality of your sleep. Quit smoking or avoid it at night, as nicotine is a stimulant.


Preparing your brain for sleep

Your brain produces the hormone melatonin to help regulate your sleep-wake cycle. As melatonin is controlled by light exposure, not enough

natural light during the day can make your brain feel sleepy, while too much artificial light at night can suppress production of melatonin and

make it harder to sleep.


To help naturally regulate your sleep-wake cycle and prepare your brain for sleep:

• Increase light exposure during the day. Take breaks outside in sunlight, remove sunglasses when it’s safe to do so, and open blinds and

curtains during the day.

• Limit artificial light at night. To boost melatonin production, use low-wattage bulbs, cover windows and electrical displays in your bedroom,

avoid bright light and turn off television, smartphone, and computer screens at least one hour before bed. If you can’t make your bedroom

dark enough, try using a sleep mask.

Insomnia cures and treatments: Neutralizing anxiety when you can’t sleep

The more trouble you have with sleep, the more it starts to invade your thoughts. You may dread going to sleep because you just know that

you’re going to toss and turn for hours or be up at 2 a.m. again. Or maybe you’re worried because you have a big day tomorrow, and if you

don’t get a solid eight hours, you’re sure you’ll blow your presentation. But agonizing and expecting sleep difficulties only makes insomnia

worse; worrying floods your body with adrenaline, and before you know it, you’re wide-awake.


Learning to associate your bed with sleeping, not sleeplessness

If sleep worries are getting in the way of your ability to unwind at night, the following strategies may help. The goal is to train your body to

associate the bed with sleep, sex, and nothing else—especially not frustration and anxiety.

• Use the bedroom only for sleeping and sex. Don’t work, watch TV, or use your computer or smartphone. The goal is to associate the

bedroom with sleep and sex, so that when you get in bed your brain and body get a strong signal that it’s time to nod off or be romantic.

• Get out of bed when you can’t sleep. Don’t try to force yourself to sleep. Tossing and turning only amps up the anxiety. Get up, leave the

bedroom, and do something relaxing, such as reading, drinking a warm cup of caffeine-free tea, taking a bath, or listening to soothing music.

When you’re sleepy, go back to bed.

• Move bedroom clocks out of view. Anxiously watching the minutes tick by when you can’t sleep—knowing that you’re going to be exhausted

when the alarm goes off—is a surefire recipe for insomnia. You can use an alarm, but make sure you can’t see the time when you’re in bed.

Insomnia cures and treatments: Harnessing your body’s relaxation response

Relaxation techniques such as deep breathing, meditation, yoga, and tai chi can help quiet your mind and relieve tension. They can also

help you fall asleep faster and get back to sleep more quickly if you awaken in the middle of the night. And all without the side effects of sleep


Relaxation techniques that can help you sleep

It takes regular practice to master relaxation techniques but the benefits can be huge. You can do them as part of your bedtime routine, when

you are lying down preparing for sleep, and if you wake up in the middle of the night.

• Abdominal breathing. Most of us don’t breathe as deeply as we should. When we breathe deeply and fully, involving not only the chest, but

also the belly, lower back, and ribcage, it can help relaxation. Close your eyes and take deep, slow breaths, making each breath even deeper

than the last. Breathe in through your nose and out through your mouth.

• Progressive muscle relaxation. Lie down or make yourself comfortable. Starting with your feet, tense the muscles as tightly as you can. Hold

for a count of 10, and then relax. Continue to do this for every muscle group in your body, working your way up from your feet to the top of your


Resources and references:
What is Insomnia? – A series of articles covering different types of insomnia, the causes of transient and chronic insomnia, self-help cures, and professional treatment. (University of Maryland Medical Center)
Facts About Insomnia (PDF) – Fact sheet describes the symptoms and common causes of insomnia, as well as proven treatments and cures. (National Institutes of Health)
Can't Sleep? What to Know About Insomnia – An overview of insomnia including common causes, signs, symptoms, and what to do (National Sleep Foundation)
Insomnia – Discusses insomnia symptoms, types, causes, and treatments, including what you can do to stop sleepless nights. (University of Cambridge)
insomnia treatments and cures
Insomnia Treatment: Cognitive Behavioral Therapy Instead of Sleeping Pills – Your attitudes about sleep and certain behaviors are often the root cause of insomnia. (The Mayo Clinic)
Ten Natural Sleep Tips – Describes ten natural remedies for insomnia, including lifestyle changes, herbal supplements, and relaxation strategies. (Dr. Weil)
Sleep Restriction Therapy: When Nothing Else Works – Step-by-step guide to sleep restriction therapy, an effective insomnia treatment that involves limiting time spent in bed. (Talk About Sleep)
Cognitive Behavioral Therapy for Insomnia – Describes how cognitive behavioral therapy works treating insomnia, and provides a case study as an example. (National Sleep Foundation)

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