The Ultimate Guide to Sleep
By Rory Coulter
Can't sleep? Then you’ve come to the right place! This article will answer all your sleep questions and provide simple solutions.
WHY CAN’T I SLEEP?
Do you often find yourself lying awake at night, you’re tired but can’t sleep, wondering “why can’t I sleep?” There are many different reasons why you might be exhausted and can’t sleep. Some are simple and easy to pinpoint, like that extra cup of coffee after 3pm or the discomfort from being 38 weeks pregnant! Some are more complex and might point to a more serious sleep condition. Either way, it’s important to get to the bottom of what’s causing you not to be able to sleep, because getting enough of the right kind of sleep is critical to your health. As we say, good health starts with good sleep.
WHAT DOES IT MEAN WHEN YOU CAN’T SLEEP?
Simply put, if you can’t sleep at night, it means there’s a problem you need to solve or a change you need to make or a temporary situation you need to ride out.
WHAT ARE SLEEP CONDITIONS?
There are many different types of sleeping disorders. Common sleep disorders and sleep conditions like insomnia, sleep apnea (both obstructive sleep apnea and central sleep apnea), restless leg syndrome, delayed sleep phase syndrome, night sweats, and narcolepsy can affect every aspect of your life including your mental health, your self esteem, your relationships, your job performance, your safety (e.g.driving while tired) and can leave you at greater risk for the development of chronic diseases and conditions like type 2 diabetes, heart disease, obesity and depression. If you can’t sleep or don’t get enough sleep at night, it’s important to take it seriously.
According to the CDC, approximately 70 million Americans suffer from sleep problems including major sleep disorders like insomnia, narcolepsy, restless leg syndrome, and sleep apnea. Lack of sleep is associated with injuries, chronic diseases, mental illnesses, poor quality of life and well-being, increased health care costs, and lost work productivity.
Even though sleep problems and insufficient sleep are major contributors to some chronic conditions, including type 2 diabetes, cardiovascular disease, obesity, and depression, they are rarely addressed. Below, we outline some of the sleep problems that may be affecting you.
What is insomnia?
The inability to fall asleep or stay asleep is called insomnia. Up to 50% of adults experience acute insomnia; that is, short-term insomnia that lasts anywhere from a few days to a few weeks. Up to 15% of adults experience chronic insomnia; that is, long-term insomnia, which means trouble falling asleep and staying asleep at least three nights a week for three months or longer. There are two types of chronic insomnia: primary and secondary. We outline the difference below.
What are insomnia causes?
Common causes of acute insomnia include stress, an irregular sleep schedule such as caused by rotating shift work, poor sleeping habits like consuming too much caffeine or alcohol before bed, physical illnesses and pain, and mental health issues like anxiety and depression. Other causes of short-term insomnia include jet lag, an uncomfortable bed, a room that’s too hot, and loud noises.
Chronic primary insomnia is not linked to any other medical conditions and its causes are largely unknown but might have something to do with changing levels of certain brain chemicals. Not much is understood about primary insomnia and what causes it, but research is ongoing.
Chronic secondary insomnia is caused by other health issues and could be considered a symptom of other medical problems. Chronic insomnia of the secondary kind can be caused by a number of long-term health problems, such as respiratory issues like asthma or sleep apnea, acid reflux, fibromyalgia, restless leg syndrome, hypothyroidism, anxiety, depression and more.
What are insomnia symptoms?
Insomnia causes symptoms at night that have a knock-on effect during the day. Nighttime insomnia symptoms may include: trouble falling asleep, trouble staying asleep, waking up throughout the night, waking up too early, and not being able to get back to sleep. This results in feeling tired and groggy throughout the day, feeling irritable and short tempered, having low energy and mood, and having trouble concentrating and focussing. Insomnia can also cause anxiety and depression and a host of other health problems due to a weakened immune system from lack of sleep.
There are two main types of sleep apnea: obstructive sleep apnea, which is the most common, and central sleep apnea.
What is obstructive sleep apnea?
Obstructive sleep apnea is quite common and the most common sleep-related respiratory disorder. It’s a potentially very serious disorder that causes you to repeatedly stop and start breathing while you’re sleeping. This is due to the muscles in your throat relaxing and narrowing during sleep, causing the blockage of airways. It’s called apnea when there is a total blockage of your airway for 10 seconds or more. When your airway closes, your brain senses it and briefly wakes you up to reopen your airway and your breathing quickly adjusts. This can happen up to 30 times an hour all throughout the night. These continual disruptions disturb your sleep and prevent you from reaching restful deep sleep, which is when your body repairs itself. Many people with obstructive sleep apnea don’t realize they have it and wonder why they feel tired all day.
What is central sleep apnea?
Central sleep apnea is less common than obstructive sleep apnea. Central sleep apnea happens when your brain doesn’t send the right signals during sleep to the muscles that control your breathing. Similar to obstructive sleep apnea, central sleep apnea causes you to stop and start breathing during sleep.
What are obstructive sleep apnea symptoms?
Signs and symptoms of obstructive sleep apnea include loud snoring, waking up suddenly gasping for air or choking, and awakening with a dry mouth (also known as xerostomia), sore throat, or headache.
What are central sleep apnea symptoms?
The signs and symptoms of central sleep apnea are similar to obstructive sleep apnea, but the snoring may not be quite so loud. Other symptoms may include: abrupt awakenings with shortness of breath and difficulty staying asleep.
What is sleep deprivation?
Sleep deprivation is a term used to mean you are not getting enough sleep, which for adults is 7-9 hours a night. We live in a chronically sleep-deprived society and it’s estimated that around 30% of people aren’t getting enough sleep. When you’re sleep deprived, your body doesn’t go into deep sleep, which is when your immune system produces and releases cytokines to heal whatever needs healing and fight off whatever needs fighting off. This is why sleep deprivation can lead to a host of illnesses.
There are three types of sleep deprivation: acute sleep deprivation, chronic sleep deprivation, and chronic sleep insufficiency.
Acute sleep deprivations refers to a short period of time upto a few days when you experience a significant reduction in your sleep.
Chronic sleep deprivation means not getting enough sleep for three months or longer.
Chronic sleep insufficiency is ongoing sleep deprivation that is long-term. It also refers to long-term poor quality of sleep, such as caused by chronic sleep apnea or other sleep disruptions.
Sleep plays a very important role in the healthy functioning of your body and chronic sleep deprivation and chronic sleep insufficiency can lead to a host of medical problems, including heart disease, diabetes, obesity, a compromised immune system, and hormonal imbalances. Studies have found that the risk of diabetes is 2.5x greater for those that consistently sleep less than 7 hours a night.
Is sleep deprivation different from insomnia?
Sleep deprivation and insomnia both deal with not getting enough sleep, but the causes are different. When it comes to insomnia, you usually have plenty of time to sleep but just can’t. When it comes to sleep deprivation, you usually don’t have enough time allotted for sleep. A lot of parents are sleep deprived because 7-9 hours of uninterrupted sleep is just not an option for them. A lot of people are sleep deprived because of the choices they make, like binging Netflix until 2am even when you have work the next day. We’ve all done that!
What causes sleep deprivation?
Sleep deprivation is often caused by not giving yourself enough time to sleep, such as staying up too late when you have to wake up early. Other sleep disorders, such as sleep apnea, can cause sleep deprivation by interrupting your sleep throughout the night. Other physical health problems like pain and mental health problems like general anxiety disorder can negatively impact the quality and quantity of your sleep as well.
What are sleep deprivation symptoms?
We’ve all experienced acute sleep deprivation at one point or another, so you’re probably familiar with the symptoms. These include: feeling extremely tired throughout the day, having less energy than usual and a lower mood, and slower thinking and reduced attention span.
What are night sweats?
Night sweats are when you sweat so much in your sleep it soaks through your pajamas and makes your sheets wet, despite your bedroom being at a normal temperature.
What causes night sweats? What could night sweats indicate?
There are many causes of night sweats, including menopause (hot flashes), anxiety, medications (including some antidepressants, steroids, and pain relievers), hypoglycemia or low blood sugar, alcohol and drug use, other sleep disorders like obstructive sleep apnea, and other medical issues like hyperthyroidism. If you frequently experience night sweats, consult your doctor.
What is snoring?
Snoring is the sound that your body makes while sleeping when air flows past relaxed tissue in your throat. Mild snoring is very common and not usually a cause for concern, but loud long-term snoring can indicate a bigger problem, such as obstructive sleep apnea, and increase your risk of heart attack, stroke, and other health problems. Studies show men are more likely to snore than women and men are also more likely to have sleep apnea.
What are the causes of snoring?
Snoring can be caused by a number of different things. Snoring can be caused by nasal congestion from allergies, a cold and can usually go away when your sinus problems clear up. Snoring can be caused by sleeping on your back and can usually stop when you roll over and sleep on your side. Snoring can be caused by alcohol consumption before bed, which can relax your throat muscles and constrict your air passageway. Snoring can be caused by your mouth anatomy. People who are overweight may have extra tissue in the back of their throats that can constrict airflow.
RESTLESS LEGS SYNDROME
What is restless legs syndrome?
Restless legs syndrome, or Willis-Ekbom disease, is a common condition of the nervous system that usually triggers at nighttime when you lie down and causes an uncontrollable urge to move your legs due to uncomfortable sensations in your legs. While it’s called Restless legs syndrome and mainly affects the legs, more rarely it can be experienced in the arms, chest, and face.
What causes restless legs syndrome?
Little is understood about restless legs syndrome and there are no known causes of RLS. Scientists think it might have something to do with an imbalance of dopamine in the brain, which controls your muscles and muscle movement. Being a condition of the nervous system, it might have something to do with problems there. Pregnancy and hormonal changes are known to trigger it temporarily. It is thought to be genetic and tends to run in families.
What are the symptoms of restless legs syndrome?
People with restless legs syndrome have described the sensation as burning, itching, tingling, throbbing, and generally painful. The only relief comes from rubbing or moving your legs, which is why it’s called restless legs syndrome.
What is narcolepsy?
Narcolepsy is a rare chronic sleep disorder that causes people to experience extreme drowsiness during the day and suddenly fall asleep at unusual times.
What causes narcolepsy?
The exact cause of narcolepsy is unconfirmed, but is thought to be caused by an imbalance of hypocretin, the brain chemical responsible for regulating wakefulness. With narcolepsy, the brain is not able to regulate the sleeping and waking patterns properly.
What are the symptoms of narcolepsy?
The symptoms of narcolepsy include: excessive daytime drowsiness, falling asleep all of a sudden, loss of muscle control, and sleep paralysis.
WHAT HAPPENS IF YOU DON’T SLEEP OR DON’T GET ENOUGH SLEEP?
People need sleep to survive. During deep sleep, your body slows down and goes into recovery mode. It repairs your cells, muscles, and organic and strengthens your immune system. That’s why when you are sick, sleeping is one of the best things you can do.
HOW MUCH SLEEP DOES AN ADULT NEED?
How many hours do you need of sleep? Well, adults need 7-9 hours of quality sleep a night. (babies, children and teenagers need even more!) Less sleep than this has been linked to a whole host of health problems, including heart disease, diabetes, obesity, a compromised immune system, and hormonal imbalances. Studies have found that the risk of diabetes is 2.5x greater for those that consistently sleep less than 7 hours a night. Interestingly, getting too much sleep has been linked to the same health problems. While it’s nice to sleep in on the weekends, it’s important not to make a habit of oversleeping. Try to stay in the 7-9 hour zone every night.
WHAT HAPPENS IF YOU DON’T GET ENOUGH SLEEP?
In the short-term, like a few days, probably not too much. You will probably be excessively tired and not be operating on full cylinders. Any longer than this, and it starts to cause real problems with your mental and physical health. Getting enough quality sleep is one of the best things you can do for your health.
WHAT ARE THE SIDE EFFECTS OF SLEEPING PILLS?
According to the CDC (2013), ~4% of American adults (that’s over 10 million people) used prescription sleep aids in the past month. One in six adults with a diagnosed sleep disorder and one in eight adults with trouble sleeping reported using prescription sleep medicine. 
A Scripps study led by Dr. Daniel F. Kripke, MD, linked the 8 most commonly prescribed sleeping pills to a 4.6 times higher risk of death and a significant increase in cancer (35% higher among patients prescribed 135+ sleeping pills a year). Even among patients prescribed 1-18 pills per year, the risk of death was 3.6 times higher. Essentially, no amount of sleeping pills should be considered safe. 
According to the makers of Ambien, “Ambien may cause serious side effects including complex sleep behaviors that have caused serious injury and death.” The most common side effects of Ambien include: diarrhea, dizziness, drowsiness, grogginess, and feeling like you’ve been drugged. More serious side effects include: abnormal thoughts and behavior, memory loss, anxiety, and getting out of bed while not fully awake and engaging in activities while not fully aware.
The side effects of Lunesta and other prescription sleeping pills are similar and the FDA has issued warnings about next day impairment with the pharmaceutical sleeping aid Lunesta.
IS MELATONIN SAFE?
The hormone melatonin is considered safe for very short-term use, but because melatonin is a hormone, it’s possible melatonin supplements can mess with your hormone balances, which comes with its own host of problems. For this reason, you should not take melatonin if you are on medication that affects your hormones like contraceptive birth control. Melatonin is also not safe for pregnancy or breastfeeding. As well, mixing melatonin and alcohol should be avoided. Common side effects of melatonin include dizziness, drowsiness, headaches and nausea. People with chronic insomnia, restless leg syndrome, or dementia are cautioned to steer clear of melatonin completely.
WHAT ABOUT TAKING BENADRYL TO SLEEP?
Although some antihistamines and cold medicines can make you drowsy, the American Academy of Sleep does not recommend taking Benadryl to sleep or taking Tylenol PM or NyQuil to sleep. While these over the counter medicines can help you fall asleep, they can negatively affect your sleep quality and how you feel the next day. They also quickly become less and less effective as your body gets used to them and you may stop experiencing any benefits if you take them too often.
WHAT TO DO WHEN YOU CAN’T SLEEP
If you can’t sleep, check out these articles for natural ways to fall asleep: 5 Natural Sleep Remedies That Actually Work and How to Fall Asleep Fast and Naturally.
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