Do you have trouble sleeping no matter how tired you are? Or do you wake up in the middle of the night and stay awake for hours, looking anxiously at the clock? Insomnia is a very common problem that takes a toll on your energy, humor and ability to work during the day. Chronic insomnia can even contribute to serious health problems. But you do not have to resign yourself to sleepless nights. Address the underlying causes and make changes in your lifestyle, daily habits and the environment before sleep can put an end to the frustration of insomnia and help you finally get a good night’s sleep.
What you can do
- Recognize the different types of insomnia
- Identify the causes of your insomnia and its role in the problem
- Take steps to improve your daytime habits and the environment preceding sleep
- Learn how to deal with a problem to fall asleep
- Discover ways to go back to sleep when you wake up at night
- Coping with daytime stress and worries
WHAT IS INSOMNIA?
Insomnia is the inability to fall asleep or stay asleep at night, which results in something not helpful when going to sleep. Anyone who is awake at night knows how frustrating and annoying it can be to spend hours in bed waiting for sleep to come … and to know how bad it will feel in the morning if it does not. Insomnia can negatively affect all aspects of your health and well-being, what makes you feel fatigued, drowsy and low in energy during the day, affecting your mood and concentration levels and damaging your productivity at work or at school. Insomnia can also pressure you to start to rely on sleeping pills, sleeping aids or alcohol, which in the long run only makes sleep problems worse. Chronic insomnia can even seriously affect your physical and mental health, increasing your risk of suffering health problems such as stroke, diabetes, obesity, high blood pressure, heart disease, Alzheimer’s disease and certain types of cancer.
No matter how long you have been suffering from insomnia or how often you struggle to sleep, do not despair. Although it may take time to correct the habits that contribute to your sleep problems, there are a lot of things you can do to help you overcome insomnia and enjoy the dream of a full and restful night. The first step is to identify the type of insomnia you are struggling with.
TYPES OF INSOMNIA
Short-term or acute insomnia is a temporary problem caused by changes in your normal routine due to diseases, travel, pain, hormonal fluctuations or stress. Most of us experience this type of insomnia at some point in our lives and while it usually resolves when your routine returns to normal, addressing the problem early can ensure that insomnia does not persist.
Long-term or chronic insomnia occurs when you regularly experience sleep problems (three or more nights a week) for a prolonged period of time (three months or more). Since chronic insomnia has been ingrained for months, changing the unhealthy habits or thought patterns that fuel your insomnia can sometimes take time, perseverance and a willingness to experiment with different solutions.
Insomnia can also be categorized as:
Sleep onset insomnia – This is when you have difficulty falling asleep despite feeling tired. While good sleepers can fall asleep with 15 to 20 minutes of going to bed, If you have sleep onset insomnia it can take hours before the dream finally arrives.
Sleep maintenance insomnia – A condition in which you find it difficult to remain asleep. While it’s normal to wake up briefly during the night, good sleepers usually don’t remember it. But if you have sleep maintenance insomnia, you can stay awake for hours in the middle of the night fighting to go back to sleep, or you wake up too early in the morning. The result is the same: you wake up without feeling rested.
WHY I CAN’T SLEEP?
While short-term insomnia is usually due to a temporary interruption of your routine, chronic or long-lasting insomnia is most likely caused by unhealthy habits during the day and at bedtime, shift work, psychological problems and medical or a combination of these factors.
Psychological and medical causes of insomnia
Anxiety, stress and depression are some of the most common causes of chronic insomnia. Having difficulty sleeping can also make anxiety, stress, and depression symptoms worse. Other common emotional and psychological causes include anger, worry, pain, bipolar disorder and trauma. Treating these underlying problems is essential to solve insomnia.
Medical problems or diseases. Many medical conditions and diseases can contribute to insomnia, including asthma, allergies, Parkinson’s disease, hyperthyroidism, acid reflux, kidney disease and cancer. Chronic pain is also a common cause of insomnia.
Medicines. Many prescription medications can interfere with sleep, including antidepressants, stimulants for ADHD (Attention Deficit Hyperactivity Disorder), corticosteroids, thyroid hormone, medications for high blood pressure and some contraceptives. The common over-the-counter culprits include medicines for cold and flu that contain alcohol, analgesics that contain caffeine (Midol, Excedrin), diuretics and diet pills.
Sleep disorders. Insomnia is itself a sleep disorder, but it can also be a symptom of other sleep disorders, like sleep apnea, restless legs syndrome and disorders of the circadian rhythm related to jet lag or night work.
Daytime habits that cause insomnia
Have an irregular sleep schedule, take a nap, drink caffeine at the end of the day, eat sugary foods or heavy meals too close to bedtime and not doing enough exercise are all examples of diurnal habits that can affect your ability to sleep at night.
Not only diurnal bad habits contribute to insomnia, but a bad night’s sleep can make these habits more difficult to correct, creating a vicious circle of restless sleep:
- You sleep badly at night
- You feel fatigued and stressed during the day
- You compensate with unhealthy habits
- These habits affect your ability to fall asleep or stay asleep
- And the insomnia cycle gets worse and worse
Another common habit associated with insomnia is overstimulating the brain during the day, so it’s harder to clarify your head at night. Many of us exaggerate with our brain during the day repeatedly interrupting tasks to check the phone, email or social media. The brain becomes so conditioned to constantly seek fresh stimulation that when it’s time to relax at night your brain keeps looking for the next information.
In addition to avoiding the screens in the hours before bedtime, try to set aside specific times, during the day, the review of messages and social networks, allowing your brain to spend more time focusing on one task at a time. Taking short breaks of technology during the day and doing non-stimulating activities can also help recondition your brain’s habit of constantly seeking a new stimulus.
If you have trouble identifying the habits that induce insomnia
Some habits are so ingrained that you can overlook them as a possible contributor to your insomnia. Maybe your Starbucks habit affects your sleep more than you realize. Or maybe you’ve never made the connection between that last-minute glass of wine and your sleeping difficulties. Keeping a sleep diary is a useful way to identify the habits and behaviors that contribute to your insomnia.
Sleep environment and routines that cause insomnia
The noise, the light that filters through the window, a bedroom that is too hot or cold, or an uncomfortable mattress or pillow can contribute to insomnia. To make sure the sleeping environment is quiet, dark and comfortable, try to mask the noise with a fan or a sound machine, use low tones or wear an eye mask, and experiment with different levels of firmness of the mattress, pillows, etc.
Creating a peaceful bedtime routine sends a powerful signal to your brain that it’s time to relax and let go of the stresses of the day. The electronic screens emit a blue light that interrupts the production of melatonin in your body which helps you regulate your sleep-wake cycle. Therefore, instead of watching television in bed or using a computer, a tablet or a phone in the two hours before bed, try listening to soft music or a podcast / audiobook, take a warm bath or practice a technique of relaxation like deep breathing or meditation.
WHAT TO DO WHEN YOU CAN’T SLEEP
One of the most common causes of sleep onset insomnia is anxiety or chronic worry. You get into bed at night, but you can’t sleep because your mind is competing with anxious thoughts about what you didn’t do today, about what could last tomorrow or just feeling overwhelmed by daily responsibilities.
In addition to addressing daytime habits that contribute to sleep onset insomnia (as avoiding caffeine late in the day and exercise in the morning or afternoon) there are steps you can take to learn to stop worrying at bedtime and look at life from a positive perspective. To calm your mind and prepare you for sleep, you can also try:
Use the bedroom only for sleeping. Do not work, or watch TV, or use your computer on the bed or in the bedroom. The objective is to associate the bedroom only with sleep, so your brain and body get a strong signal that it’s time to snuggle when you get to bed.
Turn off all screens at least one hour before bedtime, Dim the lights and concentrate on calm and soothing activities, like reading, knitting or listening to soothing music.
Avoid stimulating activity and stressful situations before you go to bed. This includes great arguments with your spouse or family,or catch up on work. Postpone these things until the next morning.
Change the bedroom clocks to another room. Watching anxiously how the minutes pass one by one on the clock, when you can not sleep, knowing that you will be exhausted when the alarm sounds, it’s a recipe for insomnia. You can use an alarm but make sure you don’t see what time it is when you are in bed.
Get out of bed when you can’t sleep. Do not try to force yourself to sleep. Turning on yourself, trying to fall asleep, can only increase your anxiety. Get up, leave the bedroom and do something relaxing, like reading, drinking a cup of herbal tea or taking a bath. When you are sleepy, go back to bed.
Take advantage of the relaxation response of your body. Relaxation techniques such as meditation and deep breathing not only help you calm your mind and relieve tension in the body, they also help you fall asleep faster. Regular practice is needed to learn these techniques and harness the power they have to relieve stress. But the benefits can be enormous. You can do it as part of your routine when you lie down or when you are lying down preparing to sleep. A variety of smartphone applications can guide you through different relaxation methods, or you can follow these techniques:
- Abdominal breathing. Breathe deeply and completely, involving not only the chest, but also the abdomen, the lower back and the rib cage, can help you relax. Close your eyes and breathe deeply and slowly, making each breath even deeper than the previous one. Inhale through the nose and exhales through the mouth.
- Progressive muscle relaxation. Be comfortable. Starting with your feet, tense your muscles as tightly as you can. Hold them like this for 10 seconds and then relax. Continue doing this for each muscle group in your body, working from the tip of your feet to the head.
- Mindfulness meditation.Sit or lie quietly and focus on your natural breathing and how your body feels in the present, at the moment you are doing it. Allow thoughts and emotions to go unprocessed, always returning to focus on your breathing and your body.
WHAT TO DO WHEN YOU CAN’T STAY ASLEEP
One of the keys to counteract sleep maintenance insomnia is to find out why you wake up at night or too early in the morning. If the light of the street lamps or traffic noise, neighbors or roommates are disturbing your dream, for example, the answer could be as simple as wearing a sleeping mask / mask or earplugs. If you are awake at 2 o’clock in the morning worrying, you need to take measures to keep your anxiety under control.
Things you should avoid before going to bed:
- Drinking too much liquid at night. Waking up at night to go to the bathroom becomes a bigger problem as we get older. By not drinking anything an hour before bedtime and going to the bathroom several times as you prepare for bed, you can reduce how often you wake up to go during the night.
- The alcohol before you go to bed. While a drink can help you relax and fall asleep, it interferes with the sleep cycle once you are asleep, causing you to wake up during the night.
- Great meals at night. Try to dine earlier and avoid heavy foods with two hours before going to bed. Spicy or acidic foods can cause stomach and heartburn problems that can wake you up during the night.
What to do when you wake up at night:
- Stay out of your head. As difficult as it is, try not to emphasize your inability to fall asleep again, because stress only encourages your body to stay awake. To stay out of your head, concentrate on what your body feels or practice breathing exercises. Inspire and then exhale slowly as you say or think the word, “Ahhh.” Inspire again and repeat.
- Turn relaxation into your goal, not sleep. If you find it difficult to go back to sleep, try a relaxation technique such as visualization, progressive muscle relaxation or meditation, which can be done without even getting out of bed. Although it is not a replacement for sleep, relaxation can still help rejuvenate your mind and body.
- Do a quiet and non-stimulating activity. If you have been awake for more than 20 minutes, get out of bed and do a quiet and non-stimulating activity, such as reading a book. Keep the lighting of your room down and avoid the screens to not point to your body that it is time to wake up.
- Postpone worry and brainstorm. If you wake up at night feeling anxious about something, make a brief note of it on a piece of paper and postpone the worry until the next day, when it will be easier to solve. In the same way, if a great idea keeps you awake, take note of it on paper and go back to sleep knowing that you will be much more productive after a good night’s rest.
HEALING INSOMNIA TREATING DAY STRESS AND CONCERNS
For many of us, our sleep problems can be traced back to residual stress, the worry or anger of the day that makes it difficult to relax and sleep well at night. The worse we sleep at night, the more stressed, worried and angry we become. To break this behavior:
- Get help in stress management. If the stress of driving to work, family or school keeps you awake at night, learn to manage stress in a productive way and maintain a calm and positive attitude that can help you sleep better at night.
- Talk about your worries with a friend or loved one during the day. Talking face-to-face with someone who cares about you is one of the best ways to relieve stress and end worrying hours before bedtime. The person you are talking to does not need to be able to fix your problems, but just need to be an attentive and unprejudiced listener.
- Get enough exercise. Regular exercise not only relieves stress but improves the symptoms of insomnia, increases the amount of time you spend in the deep and restorative stages of sleep and help you feel less sleepy during the day. To maximize the benefits of sleep, try to exercise for 30 minutes most days, but not too close to bedtime.
- Look what you eat and drink. Caffeine can cause sleep problems between 10 and 12 hours after taking it, and your diet can also play a role in how well you sleep. Some people find that cutting out sugary foods, drinks and refined carbohydrates during the day makes it easier to sleep at night.
WHEN TO CONSULT A PHYSICIAN ABOUT INSOMNIA
If you have tried a variety of unsuccessful self-help techniques, schedule an appointment with a sleep specialist, especially if insomnia is having a high cost on your mood and your health. Provide the doctor with all possible support information, including information from your sleep diary.
Therapy vs. sleeping pills for insomnia
In general, sleeping pills and sleeping aids are more effective when used sparingly for short-term situations, like traveling to areas with different time zones or recovering from a medical procedure. Your insomnia won’t be cured with sleeping pills, in fact, in the long term insomnia can worsen. In fact, pills and medicines should never be consumed if we are able to prevent diseases through healthy habits, personally and socially.
Since many people complain that frustration, negative thoughts and concerns prevent them from sleeping at night, cognitive-behavioral therapy (CBT) can be much more effective in the treatment of insomnia. CBT is a form of psychotherapy that treats problems by modifying negative thoughts, emotions and behavior patterns. It can be done individually, in a group, or even through the internet. A study at the Harvard Medical School found that CBT was more effective in the treatment of chronic insomnia than prescription medication, but without the risks or side effects.