I Can't Sleep!

How many of us have tossed and turned and have been aggravated by an inability to sleep? Looking at the clock only to realize another hour has passed can break the spirit of anyone. Most people need at least seven or eight hours of sleep, but many get less than that and some need more than that. Children and adolescents need more than that.

What are some of the causes? Most often it's stress, or a medical condition. Stress hormones triggered throughout the day can leave you feeling tired during the day but awake at night. Dwelling on problems may be also be caused by depression or anxiety, and can leave you feeling even more depressed or anxious. Managing emotions during the day may be key to a good night’s sleep.

Ask yourself three questions about your sleep at night:

Am I in pain? (Talk to your doctor!)
Am I comfortable, or restless?
Am I relaxed, or distracted?

Medical Conditions
Sleep apnea, Restless Leg Syndrome, hyperthyroidism, and other medical conditions should be addressed by your physician. Sleep apnea may be marked by loud snoring, gaps in breathing, a collar size over sixteen inches, high blood pressure, falling asleep during sedentary activity or while driving. Sleep apnea is treatable by Positive Airway Pressure or minor surgical procedures. Snoring or disrupted sleep could also be caused by allergies, being overweight, alcohol, smoking, or sleeping on one's back. Restless Leg Syndrome may be caused by overexertion, prolonged positioning during the day, electrolyte imbalances, or other medical conditions. Exercise, gentle stretching, or over-the-counter pain relievers may help, but your physician should be consulted first.

After addressing medical conditions, if you can't sleep, your body can get the rest it needs if you at least attain comfort plus relaxation. This sets the stage for sleep, but worrying about sleep leads to even less sleep. The more you chase it, the more it eludes you.

Comfort
How can you get more comfortable? Mattresses can be replaced every ten years. What about changing the type of pillows, sheets, or the room temperature? Is it at least dark and quiet? Perhaps the low hum of a fan may help. What did you recently eat or drink? Certain foods or medications may be affecting you. If you ingested caffeine, nicotine, or alcohol, even during the day, it can affect your sleep cycles at night. Maybe instead a warm glass of milk, herbal tea, or a warm bath may help.

Relaxation
Difficulties abound when we generate stress hormones all day and wish they would not affect you at night. You may have to practice relaxation during the day. How can you get more relaxed? Relaxation requires no distractions. While some of our best problem-solving occurs when relaxed, maybe bedtime is not the time to solve problems. Can you give yourself a break, and then retackle the problem in the morning? Write it down, let it go, and let your subconscious mind work on it (which science says does happen). Gently bring your mind back to pleasant sensations, using all five senses. Don’t judge, react, or fix negativity. That reinforces it. Often awareness of your breathing and muscle tension can help relax you.

Perhaps a bedtime routine may help, one that gradually moves your focus from your stressful day to more enjoyable but non-exciting thoughts or activities, like certain reading, or relaxing to music, or pleasant aromas. While physical exertion or exercise during the day can prepare you for a good night's sleep, nighttime is no time to get adrenaline moving around the body. It is not a good time to do anything stressful. Instead, some gentle stretches may help. Also, no naps during the day!  Lastly, if you are not comfortable or relaxed, don't stay in bed unless you can fall asleep. Pretend it is time to get up in the morning, or tackle that project you have been putting off. If that does not help you sleep instead, you may have to try an advanced approach listed below. Keep in mind the three considerations: managing medical conditions, comfort, and the ability to relax day and night.

More advanced approaches include reconditioning that requires consistency and a strict sleep routine. The idea is that uninterrupted sleep that allows one to experience all the stages of sleep matters more than how long one sleeps. Quality of sleep matters. So if one estimates that the total time of sleep at night now is about five or six hours, reconditioning involves waking at the same early time in the morning, but going to bed at five or six hours before that time. So, if one wakes at 5:30 am, one would start by waiting until 12:30 or 1:30 am to go to bed. Once quality sleep is achieved, the next step is to gradually go to bed earlier in half-hour increments, while always waking at the same time. Again, naps will disrupt this process. This approach is not the easiest, but may be necessary.