Why Can’t I Sleep At Night?

Why can’t I sleep at night?

You may have cried this phrase out in frustration at some point in your life. 

We have all experienced difficulties sleeping, but it may plague some more than others. 

There are few things worse than lying in bed with your eyes wide open, unable to catch some z’s. 

If you have difficulty sleeping, this is the article for you.

Signs of sleep problems

Symptoms of insomnia can differ from one person to the next. It all depends on the severity and type of sleeping disorder present. 

In general, the following are signs of sleep problems:

  • Difficulty falling asleep
  • Difficulty staying asleep
  • Fatigue during the day
  • Strong urge to take naps during the day
  • Unusual breathing patterns
  • Unusual or unpleasant urges to move while falling asleep
  • Unintentional changes to your sleep and wake cycles
  • Irritability
  • Anxiety
  • Impaired performance at school or work
  • Lack of concentration
  • Depression
  • Gaining weight

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Why can’t I sleep?

Medical and psychiatric disorders can lead to difficulty sleeping, as well as the other conditions listed below.

Age-related conditions

Age-related conditions include dementia, dependence, and living in an institution. All these conditions can worsen sleep disturbances. 

Research shows that sleep quality declines with age. It is also strongly affected by any medical conditions you might have. 

Respiratory problems

Breathing problems such as allergies, colds, and upper respiratory tract infections make it harder to breathe at night. 

We all know what it’s like when you have trouble breathing out of your nose. That can make it really hard to fall asleep! In fact, sleep-disordered breathing is a major cause of sleep disturbances.

Frequent urination

Whatever the cause, needing to urinate during the night can keep you from getting proper sleep. Hormonal imbalances and urinary tract infections and conditions can lead to frequent urination that keeps you up at night.

Chronic pain

It can certainly be hard to fall asleep in chronic pain. Unfortunately, chronic pain can also get worse when you have difficulty sleeping. 

The following conditions are some of the common causes of chronic pain that can keep you up at night:

  • Arthritis
  • Chronic fatigue syndrome
  • Fibromyalgia
  • Irritable Bowel Disease (IBD)
  • Headaches
  • Back pain 

Stress and anxiety

Stress and anxiety can certainly contribute to sleep difficulties. They can also lead to nightmares, sleep talking, and sleepwalking, which can further disrupt your sleep.

Why can’t I sleep through the night?

Respiratory problems

If you have sleep apnea, asthma, or other similar breathing problems, it can be difficult to stay asleep. In fact, if anything disrupts your breathing for just one second, it can wake you up. It can also make it more difficult to fall back asleep.

Pain

If you have a chronic pain condition such as arthritis or fibromyalgia, your pain can flare up at night and wake you up. Even if you have a pain or injury that is only triggered by movement, turning over in bed can hurt and wake you up.

Illness

Some of the illnesses that can wake you up in the middle of the night include the following:

  • Cardiovascular conditions
  • Diabetes
  • Neurological conditions such as Alzheimer’s disease and Parkinson’s disease
  • Other sleep disorders such as Restless Leg Syndrome (RLS)

Mental health conditions

Mental health conditions include disorders such as depression and schizophrenia. Insomnia can often co-occur with mental health conditions. 

Difficulty staying asleep is a common side effect of mental health conditions like anxiety, depression, and schizophrenia. It can also become a bit of a vicious cycle, as poor sleep can worsen symptoms of these mental health conditions. 

Medications 

Some over-the-counter (OTC) and prescription medications can cause side effects that may wake you in the middle of the night. These include excitability, frequent urination, and vivid dreams.

Some of the medications that may cause you to wake up in the night include the following:

  • Diuretics
  • Cold medications
  • Allergy medications
  • Corticosteroids
  • Anticonvulsants
  • Antidepressants
  • Beta-agonists

External issues

Worrying about your work or social life can wake you in the night. In fact, it is even possible to have nocturnal panic attacks if you are under a lot of anxiety and stress. 

Hormonal changes

If you have a uterus, you may be more prone to sleep disturbances due to hormonal changes. Hormone fluctuations occur during menstruation, pre menstrually, pregnancy, perimenopause, and menopause. 

These hormonal changes can lead to sleep-disrupting symptoms such as hot flashes, night sweats, and anxiety.

Acid reflux 

Lying on your back can trigger acid reflux or make it worse. It can even potentially lead to choking. 

Jet lag

Jet lag occurs when your circadian rhythm and the time of day don’t match up. If you travel or work shift work, your body’s clock may be anchored to a different time zone than the one you are in. This can cause difficulty staying asleep.

Your sleep environment

Environmental factors can also play a role in disrupting your sleep. Bright lights or disruptive noises can impact your ability to stay asleep. 

Blue light

Screens emit blue light. This type of light suppresses the secretion of melatonin, the sleep hormone. Blue light can also increase alertness. 

Age

As we age, our sleeping patterns change. In the elderly, waking at night becomes more common. You may also get shorter periods of deep sleep in older age. Fragmented sleep can also become more common. 

Also, remember that as we age, our propensity for chronic conditions becomes stronger. This can make it even harder to stay asleep.

Impact of lack of sleep 

Not getting enough sleep can have the following effects:

  • Decreased physical health overall
  • Decreased emotional development
  • Inability to concentrate
  • Decreased cognitive development
  • Decreased social development
  • Poor academic and work performance
  • Poor growth and development
  • Cardiovascular effects

One study showed that children with decreased Rapid Eye Movement (REM) sleep had more severe externalizing and total behavioral problems. 

In fact, the study group with abnormal behaviors had significantly shorter total sleep time and REM sleep than the normal behavior group. The authors of this study concluded that behavioral problems could be aggravated by insufficient total sleep.

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How much sleep do you need by age? 

So, how much sleep do you need by age?

Preschool age

Preschool children aged 3 to 5 need ten to thirteen hours of sleep per 24-hour period. This includes naps.

School age

School-age children between 6 and 12 should get nine to twelve hours of sleep per 24-hour period. 

Teens

Teens between 13 and 18 should get between eight and ten hours of sleep per 24-hour period. 

Adults

Adults between 18 and 60 should get seven or more hours of sleep per night.

Should you stay up if you can’t sleep?

If you can’t sleep, it’s best to get out of bed. This is because you want your brain to associate your bed and bedroom with sleeping.

If you are awake and unable to fall asleep, get out of bed and out of your bedroom for at least 30 minutes. Once you start to feel sleepy, you can go back to bed. If you wait until you feel tired to go to bed, you will likely fall asleep more quickly.

If you are getting out of bed, it may be helpful to decide how long you’ll stay out of bed. For example, you can choose 30, 60, 90, or 120 minutes.

There are some exceptions to this rule, however. If you are on medications that make you groggy or if you have difficulties with balance, then you may not want to get up out of bed. In these cases, it may be safer to stay in bed.

What to do when you can’t sleep

Make sure you are sleeping in a cool, dark, and comfortable room. Aim for a bedroom temperature of approximately 60 to 67 degrees Fahrenheit (that’s 15 to 19 degrees Celsius).

When you get up out of bed, do some yoga and stretching. A simple five minutes of yoga with low-intensity positions can be enough to do the trick! In fact, just a child’s pose can work wonders for sleep.

Do a visualization exercise. Choose a calm place, and visualize it in your mind. For example, if you choose a waterfall, then picture that and all the sensations that come along with a waterfall. 

You can think about the echoing, the rush of water, and the scent of damp moss. Allowing this calming image to take up space in your mind pushed out thoughts, concerns, and other worries.

You may want to try progressive muscle relaxation. In this form of meditation, you alternately tense and relax your different muscle groups. This helps to release muscle and mind tension. It also helps to promote tranquility throughout your body.

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Tips to improve your sleep

Did you know that your nutrition can help with sleep? You may want to incorporate more fish and vegetables into your diet. You’ll also want to reduce your sugar intake. Be sure to also eat smaller meals that are lower in carbs if you’re eating before bedtime.

It can also be helpful to reduce your anxiety and stress levels through exercise and meditation. You’ll also want to stick to a regular sleep schedule. Go to bed and wake up at the same time each day, whether it’s a weekday or weekend. Avoid drinking too many fluids before bedtime.

Limit your caffeine intake, especially past noon. Decrease tobacco and alcohol use. Maintain a healthy weight. If you are unsure what that is for you, speak to your doctor.

You may also want to consider cognitive behavioral therapy for insomnia (called CBT-I for short). CBT-I is sometimes the first line of treatment for insomnia in adults. There is also research showing that CBT-I has promising effects in the children and adolescent populations as well. 

CBT-I includes the following techniques:

  • Bedtime shifts
  • Sleep restriction therapy
  • Stimulus control
  • Thought challenging
  • Psychoeducation
  • Relaxation techniques

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What is the best position for sleeping?

The answer to this question does depend upon a few different factors. However, in general, sleeping on your back is best.

An exception to this is sleep apnea. If you have sleep apnea, sleeping on your side or stomach is best. 

If you have acid reflux, it may be more helpful to lie on your side, particularly your left side. And if you are pregnant, then sleeping on your side is best.

When to see a doctor for trouble sleeping 

It is important to see a doctor for your sleep difficulties if you consistently experience any of the following:

  • Difficulty falling asleep
  • Difficulty staying asleep
  • Waking up earlier than you intend to
  • Waking up feeling unrefreshed
  • Having excessive sleepiness during the day 

Conclusion 

Now that you have read this article, you should understand some of the signs that you are having sleep problems. You may have a better idea of the answer to the ever frustrating question, “Why can’t I sleep?” 

You now know how poor sleep can impact your health and your life. And you know how much sleep you should be aiming for and how to get it. 

If you can’t sleep, get out of bed and try a visualization exercise or progressive muscle relaxation. Try sleeping on your back. And if you have consistent difficulties falling and/or staying asleep, be sure to speak to your doctor.

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Sources

  1. Baweja, R; Calhoun, S; Baweja, R & Singareddy, R. (2013). Sleep problems in children. Minerva Pediatr. 65 (5), 457-72. https://pubmed.ncbi.nlm.nih.gov/24056373/ 
  2. Dewald-Kaufmann, J; de Bruin, E & Michael, G. (2019). Cognitive Behavioural Therapy for Insomnia (CBT-i) in School-Aged Children and Adolescents. Sleep Med Clin. 14 (2), 155-65. https://pubmed.ncbi.nlm.nih.gov/31029183/
  3. Nguyen-Michel, VH & Vecchierini, MF. (2016). Exploration of sleep disorders in the elderly: which particularities?. Geriatr Psychol Neuropsychiatr Vieil. 14 (4), 429-37. https://pubmed.ncbi.nlm.nih.gov/27976622/
  4. Perez, C. (2018). Obstructive sleep apnea syndrome in children. Gen Dent. 66 (6), 46-50. https://pubmed.ncbi.nlm.nih.gov/30444706/
  5. Yang, L; Zhou, Y; Zhong, J; Liu, Y; Qiu, S; Zeng, J & Liu, D. (2021). Analysis of behavioural problems in children with sleep-disordered breathing and decreased REM sleep. Int J Pediatr Otorhinolaryngol. 147 (1), 1. https://pubmed.ncbi.nlm.nih.gov/34091429/

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