Why can’t I sleep? You ask yourself as you toss and turn at 4 a.m. for the third night in a row. If quality sleep eludes you, it could be stress and poor habits sabotaging a healthy sleep-wake cycle.
And you’re not alone. In 2008, the Centers for Disease Control (CDC) reported that 70% of American adults get insufficient sleep (less than 7 hours) at least one night a month, and 11% of us get insufficient sleep every night. Given the incredible stress of the COVID pandemic, it’s probably safe to assume these numbers have gone up, not down.
Below are some reasons why you’re tired and can’t sleep and how to get more (and better quality) sleep. But first, let’s review why sleep is important.
Why is Sleep Important?
Aside from some of the more obvious and annoying consequences of lack of sleep like feeling tired and having trouble concentrating, there are some more wide-ranging effects on the cardiovascular, endocrine, immune, and nervous systems, including the following:
The less sleep you get, the greater your odds of gaining weight. According to two studies by the Institute of Medicine (US) Committee on Sleep Medicine and Research, lack of sleep was associated with lower levels of leptin, a hormone that suppresses appetite, and higher levels of ghrelin, a peptide that stimulates appetite. Getting less than 7 hours of sleep each night led to an increase in appetite and weight gain.
Diabetes and Impaired Glucose Tolerance
A Sleep Heart Health study reported that adults who get 5 hours of sleep or less were 2.5 times more likely to have diabetes, compared with those who slept 7 to 8 hours per night. Adults reporting 6 hours per night were about 1.7 times more likely to have diabetes. Both groups were also more likely to display impaired glucose tolerance, a precursor to diabetes.
Lack of sleep can also have negative effects on the heart and cause cardiovascular issues, like increased blood pressure. The studies above showed that 5 hours of sleep or less was associated with a 45% increase in risk of heart attack.
Here’s where it gets interesting. Oversleeping is just as bad for you. These same studies showed that more than 9 hours of sleep led to higher BMIs, diabetes and heart attack risks. So, how much sleep do you need? It seems that getting too much sleep can have the same effects as not getting enough, and the sweet spot is 7-8 hours a night.
Anxiety, Depression and Mental Health
Sleep loss not only has negative effects on your body physically—it can also affect mood and mental health. This article from the Sleep Foundation explains the link between sleep problems and depression, anxiety and other mental health conditions.
If you’re experiencing any of these issues from not getting enough shuteye, it may be time to re-evaluate your sleep hygiene, including your bedroom environment.
If you’re a student with a demanding schedule, a parent of young children, a shift worker, or have jet lag or one of several sleep disorders like sleep apnea, it’s more likely you’re suffering from sleep deprivation; you’re losing slumber due to outside forces (mainly) beyond your control. Here’s an article on how to regain a little control over your sleep when you’re bound to someone else’s schedule.
For those of us who have the opportunity to sleep 7 hours but can’t, we’re looking at insomnia, or the inability to fall and stay asleep.
Reasons Why You Can’t Fall Asleep and Stay Asleep
Nutrition is key to getting a good night’s sleep. In most cases, it’s about what you don’t eat or drink before bed that plays the biggest role in sleep quality.
We love to drink coffee and tea in the morning to help wake us up, but those same stimulating effects are good to avoid before bed. Conventional wisdom says to stop drinking caffeine 8 hours before bedtime, but anyone who feels the afternoon slump knows that sometimes a caffeinated pick-me-up is in order. Everyone’s different, so it’s important to know your limit. Observe the effects afternoon coffee have on you and try to set a boundary so as not to disturb your sleep that night.
Sugar can mess with your body in so many ways. Have you ever seen a child eat candy and get that immediate sugar rush, suddenly bouncing off the walls? It’s no surprise then that sugar can impair sleep. If you’re one to indulge in a late-night sweet and then find yourself tossing and turning, it could be that the sugar is working against you.
If you’re like me, genetics and years of build-up on the gallbladder and liver mean it’s no longer possible to eat a heavy meal past 6 p.m. And we’re not just talking about typical heavy foods like ribs and pork chops. Even nuts, seeds, or salmon on a salad can make me uncomfortable well into the night. As with caffeine, know your limits. Maybe it’s spicy food. Maybe you’re simply eating too much. Do your body a favor and eat a light, early, easy-to-digest dinner. This not only enables sleep, but also helps prevent you from packing on weight over time.
Why is salt so good? Salt is a hard one to give up—I won’t even pretend I’ve tried. You don’t have to give it up, but limit the amount you use in the evenings. The resulting thirst is sometimes enough to wake you from a dead sleep. On the other hand, if you overcompensate and drink too much water before bed, you may find yourself making multiple trips to the bathroom. It’s a fine balance, and I’d suggest observing how salt affects you, limiting your salty afternoon/evening snacks, and finishing consuming your daily water intake before dinner.
Incidentally, sugar, oil, and salt (S.O.S.) are known as the “pleasure trap,” and some people who have found a way to eliminate them all completely have managed to lose weight and feel amazing. Look to Dr. Douglas Lisle on TEDx and Chef A.J. for fascinating stories about the pleasure trap, eating S.O.S. free, and the benefits of eating a whole-foods, plant-based diet.
Alcohol is a sedative, but it doesn’t necessarily afford a deep, restful sleep. Many of us enjoy a glass of wine at night, and it helps us drift off. But alcohol tends to result in lower quality sleep, causing us to wake up around 2 or 3 a.m., or toss and turn. If you’re in the category that can fall asleep after drinking and stay asleep, lucky you! If you’re noticing disjointed sleep on nights you drink before bed, consider that alcohol may be the problem.
This is where one begins to feel like the princess and the pea. The bedroom, where all the blissful sleep goes down, is a sacred space that deserves serious care and attention. If sleep is important to you, this is where you’ll want to spend some time and money to ensure you get your 7-8 hours.
Light is important because it affects your body clock’s 24-hour repeating rhythm (called the circadian rhythm). As part of this process, your internal body clock takes cues from the environment, whether that be natural light outdoors or artificial light indoors. Light and darkness can determine when you feel awake and when you feel drowsy.
When it gets dark, your body releases a hormone called melatonin, which signals to your body that it's time to prepare for sleep, and helps you feel drowsy. On the other hand, light signals that it’s daytime and causes your body to release cortisol to help prepare you to wake up. This is why it’s important to try and maintain a consistent sleep schedule that aligns with daylight. If you’re a shift worker trying to sleep through the day, treat yourself to black-out blinds. If that’s not possible, a very comfy silk or bamboo sleep eye mask could work.
Daylight isn’t the only culprit that can disrupt this sleep cycle. Bright artificial light in the late evening can make it hard to fall asleep. That’s why it’s best to minimize or eliminate the light from TV, computer, phone screens, and alarm clocks. Some sources recommend shutting down screens an hour before bed for better sleep. If you must be on your screen in the evening, consider blue light blocker glasses, which also ease eye strain and fatigue.
Unfortunately, even low lights like those from power buttons, can affect sleep. Block it all out as best you can. If you have a humidifier or air purifier, you likely have ambient light in your room. Try to cover each one.
Like light, sound can hinder sleep. Our HVAC system by our bedroom door could not be louder. Our fridge rattles on and off throughout the night. So, we usually sleep with the bedroom door closed. If you also have a noisy house or you live in the city and don’t love traffic, consider a noise machine, ear plugs, or air purifier, which does double duty by both cleaning the air and providing a soft white noise.
The Sleep Foundation says that the best bedroom temperature for sleep is approximately 65 degrees Fahrenheit (18.3 degrees Celsius). Since some people run warmer or colder, keeping the room cooler with different blanket options for layering is ideal.
Dust and odors are more impactful on sleep than you’d think. If you sleep with your door closed and can’t open a window, consider getting an air purifier. And if you have time to dust/vacuum only one room this week, make it your bedroom. It’s amazing how much better you’ll sleep if you’re breathing in fresh air all night.
Maybe you’ve lived your whole life in the same type of climate or maybe you’ve recently made a switch from the humid coast to the dry desert. If you’re feeling the effects of a dry climate (like nose bleeds or cracked skin), add a little moisture to your air with a humidifier—it’ll help with breathing and overall comfort at night. On the opposite spectrum, a dehumidifier can help adjust to a more moist climate so you don’t spend the night sweating through your sheets.
A good mattress is expensive and can be a tough buying decision. But it's one of the biggest factors affecting the quality of your sleep. Go to a store where you can actually try out many types; maybe you’ve always thought you loved sleeping on soft memory foam when really you needed something firmer. If you’re suffering through bad sleep after bad sleep (and potentially a sore back), please consider getting a new mattress.
Stress and Anxiety
And now for the big stuff…stress and anxiety. There are many causes of insomnia, but often it’s stress and anxiety that prevent us from falling asleep and sleeping all the way through the night.
What’s the difference between stress and anxiety? The American Psychological Association says that they’re similar in that they’re both emotional responses that can lead to insomnia, but here’s where they differ:
Stress is usually caused by an external trigger, which can be short-term (like a work deadline or fight with a loved one) or long-term (like being unable to work, discrimination or chronic illness).
Anxiety is defined by persistent, excessive worries that don’t go away even in the absence of a stressor.
Luckily, both mild stress and mild anxiety* respond well to similar coping mechanisms, like exercise, meditation, relaxation techniques, and the good sleep hygiene habits discussed above.
The five stress and anxiety busting techniques I’ve come to rely on are cognitive behavioral therapy (CBT), scheduling a time to worry, breathing deeply, self-compassion, and self-care.
A psychologist introduced me to this amazing technique many years ago, and it completely transformed the way I think about problems. It’s a method for reframing your issues to neutralize your negative thoughts and the stress that surrounds those issues or events. For more information, check out this article from Psychology Today on how to shift your thinking.
Like workshopping your distortive thinking in CBT, setting aside a time to journal about your worries can help reframe them and remove some of the power these thoughts have over your mental state. This article from Psychology Central explains how to worry more effectively. I found it revolutionary because my worries tend to spring up as my head is hitting the pillow, which can lead to rumination well into the early morning.
Ruminating is the enemy of sleep. Deciding on a time (not bedtime) to sit down and worry more effectively frees your mind from worry at bedtime. And if those same thoughts crop up again as you’re approaching sleep, it’s easier to tell yourself, “Not now. Now’s not the time for this. Now’s the time for sleep.”
In moments of extreme upset, the body needs an immediate, physical way to calm down. One of the easiest is the Navy Seals’ 4x4 or “box” breathing technique. The idea is to breathe in deeply (full-body breath) for the count of four, hold for four, breathe out for four, hold for four. Repeat.
Anxiety stems from many issues, but one is the feeling that we haven’t done well enough, or we aren’t enough. Beating yourself up is painful as is, but many of us add insult to injury by feeling ashamed about feeling bad or alone. These shame spirals are detrimental to our wellbeing, and when they happen at night, they destroy any hope of peaceful sleep.
Watch expert Dr. Kristen Neff explain the pillars of self-compassion, which are self-kindness, common humanity, and mindfulness. She says that talking sweetly to yourself as you would to a friend in distress is a good way to calm yourself down and start to ease up on yourself.
In times of stress, or even as a preventative measure, consider creating a night-time self-care ritual that involves a warm bath, cup of herbal tea, and relaxing aromatherapy oils. Plants, in the form of herbs and essential oils, are wonderfully soothing and can help diminish the effects of stress and worry before bedtime.
In terms of herbs, chamomile blossoms and lavender have long been known to calm the mind. Passionflower and skullcap are mild but mighty herbs that can ease stress and anxiety. And a pinch of lobelia can deepen breathing and help with whole-body relaxation. They all work together in to calm an overactive mind and tense muscles, and help you prepare for a restful night’s sleep.
Essential oils can interact with the body in several ways. They don’t just affect our emotions when we smell them—the oils can have physical effects (like sedation or stimulation) when they’re applied to the skin. For this reason, roll-on aromatherapy oils don’t just smell pleasing, they can also physically calm, sedate, or perform any number of actions on the body.
For example, chamomile and lavender essential oils (just like the herbs) are often used to help calm the mind. Sweet marjoram and cistus (or rock rose) essential oils help quell anxiety and dispel obsessive thoughts, which are often what keep us from falling asleep. They all work together in our Sleep essential oil blend to relax the mind and encourage restful sleep.
Deep Sleep is Attainable
Knowing how important sleep is to your health and wellness, it’s worth taking the time to assess your nutritional habits and sleep environment, and to try different approaches to managing stress and anxiety. Find the practices and products that work best for you, that help you fall asleep, stay asleep, and awake refreshed and feeling resilient.
*Serious, chronic stress and anxiety that don’t respond well to coping mechanisms are best discussed with your doctor or medical health professional. Please don’t wait to seek the help you need. If in doubt, go talk to someone.