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Suddenly Can’t Sleep? Here’s What May Be Causing Your Insomnia

Surprising factors that can sabotage your shut-eye


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Sleep. It’s as elusive as leprechaun gold, and twice as valuable. The number of health conditions linked to poor or inadequate sleep is almost endless, with obesity, diabetes and heart disease topping the list. But sleep ought to be something we can control — just get to bed early and sleep the night away, right?

So, how come you’re still so tired? The answer may surprise you. If you are lying in bed for hours unable to fall asleep, are waking up during the night, or are just plain not feeling refreshed in the morning, see if one of these factors is souring your sweet dreams.

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What is insomnia?

Insomnia is a common sleep disorder that can be caused by a variety of factors such as stress, anxiety, depression, medical conditions and medication side effects. Poor sleep habits, which sleep expert Nathaniel Watson, M.D., says “develop over a lifetime,” can also contribute. These habits may include not keeping to a regular sleep schedule, napping during the day or drinking too much alcohol right before bedtime.

What’s more, hormonal fluctuations in women related to the menstrual cycle, pregnancy and menopause can lead to insomnia, says Shelby Harris, clinical associate professor at the Albert Einstein College of Medicine in New York and director of sleep health at Sleepopolis.

Temporary vs. chronic insomnia

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Insomnia is considered chronic when it occurs three nights a week for three months. Fewer nights of disrupted sleep would be indicative of short-term, or temporary, insomnia.

“When people have these unhappy moments in their life, there’s probably a little bit of difficulty sleeping and we shouldn’t get too hung up on that,” says Watson, who is codirector of the University of Washington Medicine Sleep Center. “If somebody’s having a short-term insomnia issue related to something happening in their life, I would caution people from catastrophizing around that and think of that as the normal experience of human emotion.”

What causes insomnia?

1. Age-related insomnia

Age, alone, can be to blame for your sleep troubles. For one, older adults are more susceptible to health issues that can disrupt sleep. Plus, as you age, your circadian rhythm changes, which is why you might notice wanting to go to bed earlier and, likewise, waking up earlier.

“It’s not chiseled in stone that as we get older that we’re going to have problematic sleep,” says Watson. “When we look at epidemiology, we do see that sleep difficulties do become more prevalent as we age, but it’s not necessarily predetermined.”

If you’re battling age-related insomnia, it’s important to keep a consistent sleep schedule so you don’t skimp on the recommended seven hours a night. Try to go to bed at the same time every night to avoid those late-night, early-morning days.

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2. Blue-light insomnia

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You’ve heard time and again to turn off electronics an hour or so before bed because these devices emit a blue light that suppresses melatonin, a sleep-inducing hormone. However, glaring blue light even three or four hours earlier — like watching TV during or shortly after dinner — is enough to delay melatonin production, says Karl Doghramji, M.D., director of the Jefferson Sleep Disorders Center in Philadelphia. You don’t have to turn off the tube, though.

He recommends wearing a eyeglasses that block blue light (available from a variety of online retailers) until you tuck in (and when you wake up at night too). That way, you’ll have no problems winding down with the TV on.

3. Menopausal insomnia

Declining estrogen can prompt disturbances — including hot flashes — in the middle of the night. Research indicates that about a quarter of menopausal women have sleep problems severe enough to impact their ability to function during the day.

Head off hot, sweaty wakeups by using sheets and pajamas that wick moisture, and sleeping on a buckwheat pillow, which is more cooling than traditional latex or down, advises Harris, who wrote The Women’s Guide to Overcoming Insomnia. If your partner likes it warmer, consider having a separate comforter for each side of the bed.

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4. Stealth caffeine insomnia

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While it may be intuitive that drinking coffee for an afternoon pick-me-up could interfere with your sleep later, “people often have no idea that they’re consuming caffeine in other forms, like iced tea or chocolate,” says Beth Ann Malow, M.D., director of the sleep disorders division of the Vanderbilt University Medical Center in Nashville, Tennessee. Everyone metabolizes it at a different rate, so you may be surprised at what time of day you should be cutting off caffeine. “If you’re having trouble falling asleep, eliminate it after lunch,” she says.

5. Lack of a routine

“One positive among older adults is that they often feel as if they’re under less stress,” says Malow.

However, that can mean schedules go out the window — and make the time you go to bed or wake up feel less important. But these times affect how your body releases melatonin later in the day. Maintain as close to a regular schedule as possible, even on weekends.

6. Nap insomnia

“Many adults don’t nap voluntarily or intentionally, but often fall asleep when not busy or watching TV,” says Doghramji. Either way, your brain sees it as sleep. The most common time of the day when people get sleepy is between 2 and 3 in the afternoon, when we experience a natural dip in energy, he says. This may prevent you from feeling tired at bedtime; then spending too much time lying awake can contribute to insomnia. If your afternoon energy tends to be low, try scheduling something active for that time instead of napping. It will help you feel refreshed, and research shows that exercisers have better sleep quality too — so it’s a double bang for your buck.

7. Spending too much time in bed

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Reading may be a relaxing activity but you should take your book to an armchair — not your bed, Harris advises. “I prefer that the bed is only used for sleep and sex,” she says. Even calm activities like puzzles or an adult coloring book can cause your brain to associate the bed with activities that you pursue while awake, which can affect your ability to drift off at night.

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8. Alcohol-induced insomnia

Yep, a glass of vino can simmer you down and make it easier to fall asleep. However, research shows that while it may help you conk out, there’s also a rebound effect that causes lighter and more fragmented sleep in the second half of the night; that’s why you’re up at 3 a.m. It also decreases sleep quality — so you rise less refreshed.

Limit alcohol to three hours before bedtime and imbibe moderately (one drink for women and two for men, as recommended by the Centers for Disease Control and Prevention).

9. Prescription insomnia

Sleep can also be interrupted by poor timing of your medications. Some, like diuretics for blood pressure, can make you have to urinate more often. More than one or two bathroom breaks at night is abnormal, Doghramji says.

Others, like antidepressant SSRIs, can either be energizing or sedating, depending what type you’re on. Ask your doctor about the best time to take your meds to ensure they won’t interfere with your bedtime.

10. Anxiety insomnia

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You may be able to fall asleep just fine — that’s thanks to “sleep pressure” that builds during the day to get you down at night, Doghramji says. But in the wee hours you may find yourself awake and staring at the ceiling, your mind spinning with worry. Your goal shouldn’t be to stop worrying (via writing down thoughts and the like) in the middle of the night, but to address the root cause.

Cognitive behavioral therapy for insomnia (CBT-I) can help you retrain your thoughts to diminish the speeding of your brain, he says. A specially trained CBT-I therapist can help, but there are also apps that teach you these important skills. “Don’t just use them at 3 a.m.; practice with these apps during the day,” Doghramji says. If you do need to use them at night, make sure to set your smartphone to night setting so the light doesn’t make you even more awake.

11. Forced-sleep insomnia

Lying in bed trying to force sleep to happen out of boredom backfires, Harris says. It can convince your brain that being awake in bed is normal. Instead, get up and go into a different room and do something relaxing and calm in dim light, she advises. (No screens allowed.) Having an accepting mindset about it can also help. “Sleep will come when it comes. If not tonight, don’t sleep in to compensate — and you’ll likely sleep better the next night,” she says.

12. Secondary insomnia

“Insomnia is both a symptom and a disease,” says Watson. If you’ve improved your sleep habits (stick to a regular sleep schedule, avoid afternoon caffeine and so on) to no avail, your insomnia may be a symptom of another disease (such as depression, restless leg syndrome or obstructive sleep apnea). If you’ve tried the advice above for a month and still aren’t getting adequate sleep, see your doctor for an evaluation.

Treatment options for insomnia

Treatment options encompass a range of choices, from therapy to medication. Cognitive behavioral therapy for insomnia (CBT-I) is typically recommended as the first-line treatment because it identifies and addresses habits, behaviors, thoughts and other factors that keep you awake during the night. Think of it as getting a toolbox for overcoming insomnia.

Those who opt for medication should know that there can be side effects and it’s not a great long-term fix. But, if you’re dealing with temporary insomnia, your doctor might give you a short-term prescription.

Generally, you should steer clear of over-the-counter options like melatonin and Benadryl. They may not provide the most effective solution and could mask an underlying medical condition responsible for insomnia, which might require a doctor’s evaluation to identify, says Watson.

“If you’re just addressing the insomnia yourself over the counter, you might miss an opportunity to address the root cause,” he adds.

For those who reach for alcohol to aid sleep, it’s important to be aware that while it may help you fall asleep, as the alcohol wears off your sleep becomes more disrupted toward the last half of the night.

Meanwhile, the role of cannabis in promoting sleep remains uncertain, and its potential effects are still a topic of research.

When to see a doctor

You should reach out to a doctor when insomnia begins to impact your daytime function or if you routinely have trouble with your sleep quality or quantity, multiple nights a week.

Working with a sleep specialist or other another health care professional is important for managing insomnia because you can identify its root causes and establish a personalized treatment plan that addresses your specific needs.

“Healthy sleep is crucial to presenting the best version of yourself to the world,” Watson says.

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