What Should I Do If I Can't Sleep?
According to the Centers for Disease Control and Prevention (CDC), in 2020, 14.5% of adults reported experiencing difficulty falling asleep in the past 30 days. With a significant number of individuals experiencing sleep disturbances, thinking “I can’t sleep” can be a common occurrence. Finding ways to address sleeplessness can be important, as sleep deprivation could have a variety of health consequences. In addition to finding ways to treat sleep disturbances, it may also be beneficial to learn about specific sleep disorders, such as insomnia. Therapy is usually an effective treatment for insomnia and other mental health-related sleep difficulties.
What is insomnia?
Insomnia is a sleep disorder typically involving challenges falling asleep, staying asleep, or achieving sufficient sleep quality or duration. While some only struggle with insomnia briefly, others can experience it for extended periods of time.
If a person’s sleep struggles only last for a few days or weeks, it could be considered short-term insomnia. This is often associated with the stress that can come with major events or illnesses in one’s life.
However, if this condition lasts for more than three months and occurs for three or more nights a week, it may be considered chronic insomnia, which can have a more significant impact on a person’s mental and physical health.
Insomnia symptoms
Insomnia symptoms can vary, depending on an individual’s personal circumstances and the severity of their condition. These symptoms may include the following:
- Waking up at different points during the night
- Symptoms of anxiety or depression
- Fatigue or sleepiness during the day
- Waking up early and being unable to get back to sleep
- Difficulty falling asleep
- Unhealthy focus on the subject of sleep
- Difficulty focusing on and completing tasks
- Memory-related challenges
The symptoms of insomnia can make it difficult to function in a variety of environments, including at work, school, and home. Insomnia can also have a negative impact on relationships, as the condition can contribute to irritability, aggression, and forgetfulness. In addition to these consequences, insomnia and a lack of sleep could have a negative impact on a person’s mental and physical health.
How can insomnia affect your health?
Although updated evidence may be needed, research suggests that insomnia and a lack of sleep can affect a person’s health in multiple ways, impacting the immune, endocrine, cardiovascular, and nervous systems. These impacts may include those discussed below:
- Adult and childhood obesity: Sleep deprivation can lower levels of leptin, a hormone that can suppress the appetite, and raise levels of ghrelin, which can increase hunger signals in the brain. Overall, researchers found that the less sleep a person got, the higher their BMI tended to be.
- Anxiety, depressed mood, and substance use: Loss of sleep can also lead to mental distress, as well as anxiety and depression symptoms. Inadequate sleep may also contribute to the increased use of certain substances, such as alcohol. This may be a way for a person to cope with sleep disturbances, but substance misuse can increase insomnia over time.
- Impaired glucose tolerance and diabetes: Sleep loss could lead to impaired glucose tolerance, which can cause glucose levels to rise to higher-than-normal levels and stay at higher levels after glucose injections. This intolerance, which can be a precursor to diabetes, may be more likely to occur in those who sleep five or fewer hours a night.
- Hypertension and cardiovascular disease: Complaints about sleep and sleep loss may be associated with an increased rate of heart attack and stroke. Sleeplessness can also raise blood pressure, even after a single night of poor sleep.
To avoid these negative consequences, it can be beneficial to understand the reasons that lack of sleep and insomnia happen. While each person’s situation is unique, there can be several common reasons a person may struggle to get proper sleep.
What causes insomnia?
The reasons a person develops insomnia can depend on several factors, including their physical and mental health. Below are several potential causes of insomnia.
- Failing to maintain a regular sleep schedule: Maintaining a consistent sleep schedule can regulate an individual’s circadian rhythms. These rhythms typically function as a type of internal clock, helping your body line up its sleep and wake patterns with the cycle of night and day. However, some may struggle to avoid an irregular sleep schedule, whether that be due to work, travel, or any other reason. This can disrupt their circadian rhythms and subsequently lead to insomnia.
- Short-term or chronic stress: The body’s stress response usually involves releasing hormones like cortisol, which could affect whether someone experiences sleep disturbances. Short-term stressors may include struggles at work or school, the termination of a relationship, or difficulties at home. Chronic stress, on the other hand, may stem from traumatic events, such as natural disasters, war, abuse, or the death of a loved one. Understanding and addressing these situations could be crucial for managing sleep disturbances.
- Mental health disorders: Certain mental health conditions can contribute to insomnia, such as bipolar disorder, depression, and anxiety. These disorders sometimes involve symptoms that disturb their sleep, including rapid thoughts, difficulty relaxing, hyperarousal, and shifting moods. In addition, a lack of sleep may exacerbate mental health conditions. Over time, this can create a negative feedback loop that could increase sleeplessness and mental health symptoms.
- Sleep hygiene and lifestyle: The behavior in which a person engages may have a significant impact on their sleep quality and duration. Potentially unhelpful behaviors can include the following:
- Drinking excessive amounts of alcohol or coffee, particularly right before a person goes to bed
- Engaging in other activities in bed besides sleep, such as working or watching TV
- Using electronic devices later in the day, as these can emit blue light and stimulate the brain
- Sleeping during the day or late afternoon, or sleeping in on the weekends
- Eating large meals before bed
To avoid potential consequences, it may be necessary to seek treatment. While the precise treatments used can depend on the cause of one’s insomnia, certain treatments, such as those that involve therapy, may be beneficial for numerous individuals.
What to do if you are experiencing insomnia
These sessions may involve several distinct types of intervention:
- Psychoeducational: Psychoeducational interventions can provide individuals with the information they need to understand the symptoms of insomnia and the process of CBT-I. Mental health professionals may also show their clients the connection between their thoughts and behaviors and how they may relate to their sleep disturbances.
- Behavioral: Behavioral interventions can show a person which behaviors may be leading them to experience insomnia and enable them to change these behaviors. This may involve multiple techniques, including controlling any stimuli near bedtime, such as using electronic devices or completing work tasks. Another technique can involve sleep restriction and compression, which generally limits the amount of time someone spends in bed without sleeping. CBT-I providers may also share relaxation techniques to ease a person into a state that may make it easier to get to sleep.
- Cognitive: Cognitive interventions typically involve a process known as cognitive restructuring. This CBT-I technique can allow someone to focus on the potential stressors or causes of their insomnia, while also determining whether the thoughts surrounding these situations are true. After that, a CBT-I provider can help a client restructure their thoughts about these situations in a way that may be considered more positive or constructive.
While CBT-I can be beneficial, in-person forms of therapy may not be available to everyone. Some individuals may not have access to reliable transportation, or they may not be comfortable driving while struggling with insomnia. Others may struggle to schedule face-to-face sessions or could prefer to communicate via video chat, online chat, or phone call. In these situations, exploring effective alternatives (such as online therapy) may be necessary.
Research suggests that online therapy can not only treat insomnia, but it may also be as effective as in-person therapy. In one meta-analysis published in 2023, researchers compared several studies on the efficacy of in-person and online therapy for the treatment of insomnia. Out of 3,597 participants across seven studies, they found the effect of online CBT-I was comparable to in-person CBT-I—results that were maintained during the following six weeks to six months after treatment. Researchers also found that online CBT-I could reduce the severity of short-term insomnia while also decreasing the severity of long-term insomnia.
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