Nobody sleeps well every single night. But if you often find it hard to drift off, don’t stay asleep all night, or wake too early in the morning, you could have a sleep disorder called insomnia.
If so, you won’t just feel sleepy. A lack of quality sleep can also cause fatigue, low energy, a dip in your mood, and trouble with focus. You’ll find it harder to do a good job at work or school. It also raises the odds you’ll go on to have health problems like heart disease, cancer, obesity, dementia, depression, and anxiety.
Most of the time, insomnia is a symptom of another problem, rather than its own illness. To stop it, you’ll need to figure out what’s keeping your brain in its “wakefulness” cycle and preventing the sleep you need.
Causes of Insomnia
Sleep troubles can start for many reasons. These include:
Health issues. Plenty of medical conditions can disrupt your sleep, such as allergies, asthma, stomach issues like acid reflux, chronic pain, and sleep apnea. Mental health problems, like depression and anxiety, can keep you from getting enough rest, too.
Stress. Worrying about work, money, loved ones, or big life changes keep your mind going long after you turn the lights out.
Food and drink. Alcohol may make you fall asleep quickly, but it disrupts your deep sleep. So do caffeine and heavy meals.
Drugs. Some prescribed medicines will make it harder for you to sleep. Over-the-counter drugs, like ones you take for allergies or pain, can also cause insomnia.
Daily habits. Small choices you make every day can sabotage your sleep. For instance, the blue light from your tablet or phone screen tells your brain to “wake up” before bed. Long afternoon naps or working night or rotating shifts can also mess up your natural sleep cycle.
Find Out What Keeps You Awake
To figure out the cause of your insomnia, try keeping a sleep diary. For a week or two, jot down details like:
- When you go to sleep and wake up each morning
- How quickly you fall asleep
- Do you feel rested when you wake up?
- Does another person or a pet share a bed with you?
- Did you read or use a screen while in bed?
- What wakes you up (like worries, noise, or pain)
- If you drink alcohol or caffeine or smoke tobacco before bedtime
- Your exercise schedule
- When you nap
- Any new or different sleep medications you take
- Your mood each day
You can write this down in a notebook or find an online sleep diary to fill out. When you’re done, look back through it to see if you notice any patterns.
When to See a Doctor
It’s common for a stressful event or change in your schedule to upset your sleep. Short-term insomnia like this often goes away on its own. If your trouble with sleep makes it hard for you to get through your day or impairs your mood, talk to your doctor.
If you’ve had disturbed sleep for longer than 3 months, you may want to see a doctor who’s an expert on sleep. They’ll do a physical exam and ask questions about your health, daily habits, and any recent stressful events in your life. If the doctor thinks a medical problem, like sleep apnea, is the cause of your insomnia, you may need to do a sleep study to know for sure.
Treatments for Insomnia
There’s no one-size-fits-all treatment for insomnia. You’ll need to find what works best for you. That could mean:
Cognitive-behavioral therapy (CBT). This treatment helps you become more aware of negative thoughts and actions that keep you awake. It’s usually the first treatment your doctor will recommend for insomnia. There are different strategies. For instance, you may learn breathing exercises to help you relax or practice ways to ease your anxiety about sleep.
Alternative therapies. There’s some evidence that things like acupuncture, meditation, yoga, and tai chi can help along with traditional insomnia treatments.
Medicine. There are prescription drugs that can treat insomnia, like eszopiclone (Lunesta), ramelteon (Rozerem), suvorexant (Belsomra), zaleplon (Sonata), and zolpidem (Ambien, Edluar, Intermezzo, Zolpimist). But you shouldn’t take them for more than a few weeks -- they are not a good long-term sleep solution. It’s best to figure out what’s keeping you from sleeping and address that problem instead.
An over-the-counter option is melatonin, a hormone normally made by a gland in your brain. Though it's sold as a dietary supplement, it's not strictly regulated. It doesn't work for everyone, and doctors usually recommend it only for specific conditions. Talk to your doctor before you try it, and you shouldn't take it for more than 3 months at a time.
Although popular, there's little evidence that nonprescription sleeps aids with antihistamines work. In fact, they can cause side effects like daytime sleepiness, dry mouth, and blurred vision.
Lifestyle Changes That Help
Sometimes, a few changes to your daytime and nighttime habits can improve your sleep.
Stay active. When you exercise your body during the day, you boost your chances of a good night’s sleep. (Just don’t work out within 2 hours of bedtime.)
Say no to late afternoon naps. They’ll make it harder for you to drift off at night.
Use your bed only for sleeping and sex. Go somewhere else in your house to read, watch TV, or work.
Create a buffer zone. Say no to stressful tasks 2 hours before bed.
Watch what you eat and drink. Make 2 p.m. your cut-off for caffeine and nicotine. (Better yet, make sleep your reason to quit smoking.) Skip heavy meals, alcohol, chocolate, and sugary foods right before bedtime, too.
Keep your bedroom cool, dark, and quiet. You can use tools like ear plugs, white noise machines, a sleep mask, or black-out curtains.
Follow a relaxing, nightly routine. This might include a warm bath or shower, soothing music, or yoga poses that allow you to unwind.
Double-check your drugs. Ask your pharmacist or doctor if any drugs or supplements you take could keep you awake.