5 Reasons You Aren't Sleeping

Do you wake up grumpy from a hard day’s night of trying to get enough sleep? Lack of quality sleep can drag down your mood, deplete your energy, and dull your thinking. It can also have negative effects on your memory, immunity, blood sugar, blood pressure, and hormonal balance, disrupting your health in ways that can have serious consequences over time.1

If you persistently have trouble sleeping, it’s important to identify the root cause. Sleep loss is a pretty common problem, and the reasons for it are well-known. Here are 5 of the most likely reasons you are having trouble sleeping, and some approaches to help get your sleep back on track. 

1. Sleep Apnea

Sleep apnea is a sleep disorder in which your throat muscles relax too much during sleep and block your airways, inhibiting your breathing. As a result, there are stops and starts in your breathing that may repeatedly interrupt your sleep throughout the night. Though you may not remember these nighttime interruptions, you’ll feel sleepy and foggy the next day, as if you didn’t really sleep. 

Sleep apnea is most common in heavier people, who tend to have more soft tissue around the throat, but anyone with a narrow jaw, a thicker neck, or a change in muscle tone may also be prone to sleep apnea.2,3 Sleep apnea is commonly characterized by loud snoring, though not always. If you think you may have sleep apnea, you should see a sleep specialist, who may recommend some lifestyle adjustments or a nighttime breathing device to help.

2. Evening Lifestyle Choices

Your body can’t switch into sleep mode as quickly as you switch off the lights; it needs time to transition by slowing down your metabolism and turning on its relaxation response. What you choose to eat, drink, and do in the hours before bedtime will naturally influence this transition process and have an impact on your sleep. 

For instance, eating a heavy meal late in the evening puts a burden on your digestive system that keeps your metabolism in active mode. Drinking alcohol will make you drowsy at first, but it’s a trick: once your body metabolizes that drink a few hours later, your brain will wake up again, often disrupting your sleep.4 It’s better to limit food and alcohol intake in the three hours before bedtime. Try a hot, non-caffeinated tea or golden milk as a relaxing bedtime ritual.

Many of the things we do for recreation in the evening may also not be very relaxing. Watching a dramatic show, playing video games, catching up on the news, or even scrolling through social media can trigger rushes of adrenaline, anxiety, or emotion that make it harder for your brain to shut off for sleep. Make sure to give yourself at least an hour of wind-down time before bed where you can turn off all the electronics and let your mind settle down. Read a book, do some gentle yoga, take a bath, journal, or get some lovin’ to trigger those relaxation hormones.

3. Stress & Worry

This is a big one. According to the American Psychological Association’s “Stress in America” survey, as many as 43% of adults said that stress had caused them to lie awake in the past month.5 Stress keeps the body, mind, and nervous system in a state of hyperarousal, which is the opposite of the relaxation response you need for sleep.6 Unfortunately, this triggers a vicious cycle, as not sleeping well increases stress hormones and anxiety levels7,8 and diminishes the mind’s ability to regulate moods and thoughts.9,10

Getting good sleep can help reduce your stress, but you also need to manage your stress better in order to get good sleep. Sometimes our worries come to us at night because that’s the only quiet time we give ourselves to reflect on our inner lives. If you find yourself flooded with troubled thoughts when you turn out the light, try setting aside some time during the day to take a quiet walk, journal, or talk to a friend about what’s bothering you. In the evening, practice a relaxation technique such as meditation or deep breathing to help settle the mind and nerves. 

4. Physical Discomfort

A sore, achy body is a perpetual distraction and a frequent sleep disruptor. According to the National Sleep Foundation’s Sleep in America poll, one in five Americans experiences recurring or long-term pain, and most of them also experience poor sleep. Likewise, 50% of those with insomnia also have chronic pain.11 The relationship between pain and sleep loss goes both ways: not only does pain interfere with sleep, lack of sleep also appears to heighten sensitivity to pain.12

It can be hard to find a comfortable sleeping position when you have pain, so experiment with using pillows as props to help relieve pressure in the right places. Try taking a warm bath with epsom salts before bed; epsom salts are a good source of magnesium, which helps muscles and nerves relax and supports better sleep. Yoga can also help relieve joint, back, and other kinds of pain by helping to stretch and strengthen different muscles and reduce stress.13 Work with a yoga teacher who can help you find the right kinds of poses for your condition.

5. Circadian Disruption

Your circadian rhythms are biological cycles that regulate the timing of your body’s processes to coordinate with the cycles of day and night. They use cues such as light to tell the body when to shift into active daytime mode or restful nighttime mode, maintaining a healthy and stable sleep-wake cycle. 

The problem is that our modern lifestyles no longer closely follow the cycles of nature, including those of night and day. Thanks to electric light, we are more active at night than our ancestors were, and we spend much of the day indoors, away from the natural light. Because of this, it’s easy for our circadian rhythms to get thrown off, disrupting our sleep-wake cycle. 

To reset your body’s clock, first you have to establish a regular sleep schedule. Your body likes consistency so that it can prepare for a graceful transition to the next phase. Make a point of going to sleep and getting up at roughly the same time each day, even on weekends. Get outside for a walk each day to expose yourself to natural light and get some exercise. 

In the evening, turn off your tv and phone for a couple hours before bed. The bright blue light from electronic screens mimics sunlight and confuses your circadian rhythms, delaying the release of melatonin, the hormone that prepares you for sleep.14 If your sleepy-time feeling isn’t coming, you can try taking a melatonin supplement 30 minutes to 2 hours before bed to help trigger sleep mode.

Once you know why you aren’t sleeping, you can start taking steps to improve your sleep. For most people, addressing one or more of these common sleep problems will help you sleep better. If you still have trouble sleeping, talk to a doctor or a sleep specialist who can help identify the root problem and work with you to find a solution.

References:

1. “The Effects of Sleep Deprivation on Your Body.” Healthline, May 2020.

2. “8 Reasons Why You’re Not Sleeping.” Harvard Health Publishing, Feb 2014.

3. “Causes of Obstructive Sleep Apnea.” WebMD, May 2019.

4. Paddock, Catharine. “Alcohol disrupts body’s sleep regulator.” Medical News Today, December 2014.

5. “Stress and Sleep.” American Psychological Association.

6. Kalmbach, David A et al. “Hyperarousal and sleep reactivity in insomnia: current insights.” Nature and science of sleep vol. 10 193-201. 17 Jul. 2018, doi:10.2147/NSS.S138823

7. Rachel Leproult, Georges Copinschi, Orfeu Buxton, Eve Van Cauter, Sleep Loss Results in an Elevation of Cortisol Levels the Next Evening, Sleep, Volume 20, Issue 10, October 1997, Pages 865–870, https://doi.org/10.1093/sleep/20.10.865

8. Gabriel Natan Pires, Andreia Gomes Bezerra, Sergio Tufik, Monica Levy Andersen, Effects of acute sleep deprivation on state anxiety levels: a systematic review and meta-analysis, Sleep Medicine, Volume 24, 2016, Pages 109-118, ISSN 1389-9457, https://doi.org/10.1016/j.sleep.2016.07.019.

9. Dinges DF, Pack F, Williams K, Gillen KA, Powell JW, Ott GE, Aptowicz C, Pack AI. Cumulative sleepiness, mood disturbance, and psychomotor vigilance performance decrements during a week of sleep restricted to 4-5 hours per night. Sleep. 1997 Apr;20(4):267-77. PMID: 9231952.

10. Soomi Lee, Orfeu M. Buxton, Ross Andel, David M. Almeida, Bidirectional associations of sleep with cognitive interference in employees' work days, Sleep Health, Volume 5, Issue 3, 2019, Pages 298-308, ISSN 2352-7218, https://doi.org/10.1016/j.sleh.2019.01.007.

11. Taylor DJ, Mallory LJ, Lichstein KL, Durrence HH, Riedel BW, Bush AJ. Comorbidity of chronic insomnia with medical problems. Sleep. 2007 Feb; 30(2):213-8.

12. Tang NK, Goodchild CE, Sanborn AN, Howard J, Salkovskis PM. Deciphering the temporal link between pain and sleep in a heterogeneous chronic pain patient sample: a multilevel daily process study. Sleep. 2012 May 1;35(5):675-87A. doi: 10.5665/sleep.1830. PMID: 22547894; PMCID: PMC3321427.

13.  “Yoga for Pain Relief.” Harvard Health Publishing, April 2015.

14. “Blue Light Has a Dark Side.” Harvard Health Publishing, July 2020.