Why Can't I Sleep?

from Michael Dale Kimmel of Life Beyond Theraoy: Many of my clients (and friends) complain about poor sleep or lack of sleep. Why do so many of us not sleep long, well and deeply? The National Sleep Foundation (which receives financial support from pharmaceutical companies) estimates that 20 percent of Americans sleep fewer than six hours a night. The lucky few who sleep a full eight hours or more drops to 28 percent.

Not sleeping is Big Business: the global sleep aid technology market is projected to reach 136 billion dollars by 2030. Sleep marketeers cite rising awareness of sleep problems, aging populations, high-stress levels, and the adoption of wearable sleep trackers as reasons that we keep spending more and more money to try and sleep more and more hours.

While most medical authorities recommend at least 7 hours of sleep per night for adults, there are other factors can affect how many hours of sleep you need. For example:

Sleep quality. If your sleep is frequently interrupted, you're not getting quality sleep. The quality of your sleep is just as important as the quantity.
Previous sleep deprivation. If you're sleep deprived, the amount of sleep you need increases.
Pregnancy. Changes in hormone levels and physical discomfort can result in poor sleep quality.
Aging. Older adults need about the same amount of sleep as younger adults. As you get older, however, your sleeping patterns might change. Older adults tend to sleep more lightly, take longer to start sleeping and sleep for shorter time spans than do younger adults. Older adults also tend to wake up multiple times during the night.

For adults, getting less than seven hours of sleep a night on a regular basis has been linked with poor health, including weight gain, having a body mass index of 30 or higher, diabetes, high blood pressure, heart disease, stroke, and depression. After doing a little personal research on this topic (as I approach my 73rd birthday, my formerly-deep, all-night-long sleep has become more challenging), I wanted to share with you some of what I've discovered.

If your problem is insomnia (and not medically-related), here are some cost-effective ways to get the sleep you need, and a few things you should avoid altogether.

If you've been tossing and turning, don't drink caffeine after 2 pm. Yes, 2pm! (that's what the experts recommend).
Avoid downing more than a glass of wine (or the equivalent amount of other alcohol) in the evening.
Save stressful activities, like arguments with your partner or a review of your finances, for early in the day (doesn't that sound like fun?).
Get into bed a half-hour before you turn out the lights, and read a calming book. Avoid electronic diversions of any kind an hour or so before bed, because they tend to be stimulating, not relaxing.
Exercise regularly.
Over-the-counter medications that contain sleep-inducing antihistamines are fine for a night or two, but no more. They typically don't work over the long term and they bring unpleasant side effects like dry mouth and grogginess.
If you still cannot sleep and you've tried all of the above, find a doctor who is a Board-certified sleep specialist. Doctors with that certification have passed a rigorous exam and have a thorough knowledge of sleep medicine. Go to the American Board of Sleep Medicine's sleep center site (www.sleepcenters.org). All accredited sleep centers are required to have one certified sleep doctor on staff.
In addition to medications, consider a non-drug option. If you have insomnia that has been going on for months, consider cognitive behavioral therapy (aka "CBT"), which helps you change behaviors and thoughts that get in the way of a good night's sleep. The cognitive part of the process teaches you to change anxiety-producing thoughts that interfere with your ability to sleep. The behavioral part aims at actions that impair your ability to sleep, like spending too much time in bed or not exercising at all during the day.
"CBT should be the first-line therapy for people with chronic insomnia," says Dr. John Winkelman, a Professor of Psychiatry at Harvard Medical School and chief of the Sleep Disorders Clinical Research Program in the Department of Psychiatry at Massachusetts General Hospital. "In the short run, medication is helpful, but in the long run, people need to change their actual sleep habits - that's what CBT helps them do."

Whatever you chose to do about your sleep problems, take action. The cost of living with insomnia can be far more than the cost of treating it. The most wasteful thing is not doing anything.

About the Author

Michael Dale Kimmel

I am a California-licensed psychotherapist (LCSW 20738). With over twenty-five years of counseling experience, I bring warmth, practical insight and a healthy sense of humor to my practice.