Counting Endless Sheep

Perhaps you are among the estimated 40% of adults who experience insomnia, the most common sleep disorder in the United States. It can involve difficulty in falling asleep, waking up and having a hard time getting back to sleep, or awakening too early. If it lasts only a few days, it’s called transient insomnia; if it lasts a few weeks, it’s called short-term insomnia. The problem is chronic if it happens most nights of the week and lasts a month or more.

The most common form of insomnia is learned insomnia, in which a few sleepless nights lead to anxiety about being unable to get to sleep, making it even harder to do so. However long it lasts, insomnia is not a disease in itself but a symptom of another problem, or several problems, whether physical, emotional, or behavioral. Common culprits include the following:

Stress. Many experts consider this to be the leading cause of short-term sleep disturbances. Common triggers include job-related pressures, marriage troubles, or a serious illness or death in the family. Usually the insomnia disappears when the stressful situation passes. If stress hormones are still pumping in your body by the time you’re ready for bed, they’ll inhibit the production of melatonin, a hormone that regulates circadian rhythms (your 24-hour body clock). High levels of stress hormones can also block the restorative effects of growth hormone, which aids in the manufacture of new cells.

Alcohol and caffeine. Too much caffeine or alcohol, especially when it’s consumed too close to bedtime, can ruin a good night’s sleep. Caffeine, a stimulant, can make it difficult to fall asleep.

Its effects can last for up to 10 hours after you consume it, especially in older people, whose metabolism is slower. And although alcohol is a sedative and may help you doze off more quickly, it can disrupt sleep later, when the effect wears off.

Pain and chronic medical conditions. Some people don’t sleep well because a medical condition is making them uncomfortable. The pain of arthritis, heartburn, a sore back, or a headache can wake you up and make it hard for you to get back to sleep. In a random sampling of adults in the United States, one-fourth reported having pain that disrupted their sleep 10 or more nights per month. Chronic conditions such as fibromyalgia, Parkinson’s disease and diabetes can also make it difficult to fall asleep or cause you to awaken during the night.

The ups and downs of female hormones. At the beginning and end of the menstrual cycle, low progesterone levels can make it difficult to sleep. If you think your hormones are contributing to your sleep problems, try keeping a sleep diary for a month. It can help you determine when in your cycle you should avoid caffeine, alcohol and other things that could make the problem worse. During menopause, hot flashes caused by fluctuating levels of estrogen can cause restless nights. Estrogen replacement therapy often helps.

Medications. Certain medications, such as corticosteroids and some drugs used to treat high blood pressure, asthma and depression can interfere with sleep. So can thyroid drugs if the dose is too high. Many common over-the-counter drugs, including decongestants and weight-loss products, contain stimulants such as pseudoephedrine, and some aspirin formulas contain caffeine. If you’re having trouble sleeping, review your medications with your doctor.

Depression. Sleep laboratory researchers have observed sleep abnormalities in people with depression, including reduced periods of slow-brain-wave sleep and an early onset of the first episode of REM sleep. Research has shown that as many as 90% of people with depression have sleep disturbances. These can range from early waking to excessive sleeping. Anti-depressants can help.

If you’re tired of feeling like you’re not at your best or like you’re not getting the sleep you need, then it’s time to take action! Sign-up for the National Sleep Foundation’s Sleep Challenge today!

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