Difficulty falling asleep, frequent awakenings during the night, and waking up feeling unrefreshed are common signs of insomnia. More than 60 million adults in the US face this challenge each year. If you've tried counting sheep, reading a dull book, or adjusted your routine to eliminate afternoon naps, you're not alone. Despite these well-intentioned efforts, 10-36% of Americans continue to struggle with insomnia. Sleep problems often go unreported in medical settings, making up only 0.42% of office visits. This highlights the need for more awareness and proactive discussions about sleep health. Seeking professional advice and exploring tailored solutions can lead to more restful nights and a better overall sense of well-being.
If you have sleep problems, it's important to inform your medical provider, as they may not address it otherwise. Your medical provider might have you complete the Epworth Sleepiness Scale , which only takes 2-3 minutes. The ESS helps estimate how likely you are to doze off during everyday activities, which include:
If your sleepiness is due to insomnia or poor sleep at night, here are three key tips to help you achieve a good night's sleep.
Before considering medication for sleep, it's important to first explore behavioral interventions, particularly cognitive behavioral therapy. CBT is widely recognized as the first-line treatment for insomnia and is often more effective than sleeping pills. Unfortunately, many people miss out on this valuable option and instead turn to sleep medications, which often fail to address the underlying issues. The main objective of CBT is to reshape negative associations with sleep by providing constructive strategies to help individuals create a healthier relationship with sleep.
One of the best ways to improve your sleep is to establish a routine. A part of your brain called the suprachiasmatic nucleus regulates your sleep-wake cycle. This nucleus learns when you typically go to sleep and when you wake up, which helps to trigger hormone and other changes in your body to facilitate transitions between the sleep and awake state. As a result, it becomes easier for you to fall asleep and wake up at consistent times. By maintaining a regular bedtime and wake-up time, you help your body become more disciplined in regulating your sleep-wake cycle.
Establishing consistent bedtime rituals signals your body that it's time to wind down, which helps create an atmosphere conducive to sleep, making it easier for your body to transition into rest mode. Once your body adjusts to this routine, you may find that falling asleep and waking up becomes effortless.
Another behavioral approach is stimulus control therapy, which involves going to bed only when you feel sleepy, leaving the bedroom if you can't fall asleep, and engaging in simple activities if you are unable to sleep. Another behavioral method is sleep restriction therapy, which involves avoiding daytime naps. This increases the chances of feeling sleepy at bedtime. However, because there are benefits to daytime naps, eliminating them may not be suitable for everyone.
It's important to avoid using the bedroom for activities other than sleep and sexual activity. For example, try not to turn your bedroom into an office. If you live in a studio apartment or have a limited space where you only have one room, you should reserve the bed exclusively for sleeping.
The ideal room temperature for sleep is around 65 degrees Fahrenheit. Warmer temperatures may disrupt sleep for some individuals. If you live in a noisy environment, try to minimize it during your bedtime. Additionally, be mindful of light exposure in the evening, particularly from smartphones, laptops, and other devices. You should also avoid alcohol and caffeine consumption before bed.
The behavioral treatments won't solve your problem if you have sleep apnea. Sleep apnea affects at least 22 million Americans and around 85% of individuals with sleep apnea don't know they have it. One of the most obvious tip-offs that you might have sleep apnea is snoring, which affects at least 90 million Americans.
It's important to distinguish between snoring and sleep apnea, as they are not the same condition. Individuals who snore may or may not have sleep apnea, and those who have sleep apnea may or may not snore. In addition to snoring, other symptoms of sleep apnea can include bruxism (teeth clenching), neck pain, anxiety, and daytime drowsiness.
If you are experiencing any of these symptoms and have untreated sleep apnea, you may feel excessively sleepy during the day. Sleep apnea can worsen numerous medical conditions and increase the risk of serious health issues, such as stroke. Therefore, it is essential to get this condition diagnosed and treated.
By discussing your concerns with your medical provider, you may receive a referral to a sleep specialist, who may then recommend a sleep study. This study can be conducted either in a sleep lab or in your own home.
Once a clear diagnosis is made, you can begin treatment. Some individuals may benefit from a continuous positive airway pressure machine, while others may find relief with a mandibular advancement device, commonly known as a snore mouthguard.
Many medical conditions can negatively affect your sleep. For example, iron deficiency is known to cause restlessness in the legs which may keep you and your bed partner awake at night. Iron supplementation may be all you need, although it would also be advisable for your provider to find out why you had the low iron in the first place.
Conditions such as lung disease and heart failure can make it difficult to breathe, leading to disrupted sleep. By effectively managing these conditions, you can greatly enhance your sleep quality and potentially extend your lifespan.
Neuropathy can interfere with sleep, often causing pain or tingling in the feet that makes it difficult to fall asleep or wake you up periodically during the night. To address this issue, your healthcare provider will first need to conduct tests to determine the underlying cause of the neuropathy. Once the cause is identified, appropriate treatment can be provided.
These are just a few of the conditions that may negatively impact your sleep. Your medical provider may uncover other diagnoses that need to be addressed as part of the workup for your sleep problem.
Many factors can contribute to difficulties in getting a good night's sleep, including anxiety and various underlying medical conditions. If lifestyle changes do not improve your sleep, it is crucial to seek medical advice before considering sleeping pills. Self-medication may mask other problems that could be harmful in the long run. By prioritizing healthy sleep habits and making these intentional changes, you can take the first steps towards restful nights, which will allow you to embrace each new day with renewed energy and focus.