Insomnia is something most people have experienced. In fact, insomnia is third most frequent health complaint after pain and headache. One out of four people in the US suffer from chronic insomnia, and just about everyone has dealt with it on occasion.
The good news, the bad news
The good news is that insomnia is rarely serious. It neither causes nor indicates a major health problem. The bad news is that, since sleep is when we restore, heal, and digest, insomnia can worsen other health issues, which in turn can cause or worsen insomnia in a vicious cycle. Not getting enough sleep can worsen overweight, depression, brain fog, and stress-related illness such as heart disease.
Not all insomnia is the same
Distinguishing between patterns of insomnia can help point to a cause. For example, one person might have trouble getting to sleep but sleep well once asleep; another person might go to sleep with little or no problem but waken, perhaps to urinate, and be unable to go back to sleep. Yet another person might get to sleep fairly quickly, but the sleep is of poor quality with many small and brief awakenings.
What causes insomnia?
As with any chronic condition or illness, there are a number of causes of insomnia, and these causes can vary by person.
Chemical toxicity can contribute to insomnia. If you are exposed to toxins, you might stay in sympathetic stress mode rather than the desired parasympathetic rest-and-digest mode. Some of these toxins – or allergens, since the body interprets an allergen as a toxin – can be particular to your bed, such as bedding or the detergent, fabric softener, or bleach used on your sheets, or dust or dust mites. Since the kidneys and liver filter out toxins, kidney and liver problems can cause insomnia due to the buildup of toxins in the body.
Pain or discomfort from any source will negatively impact sleep, as can difficulty breathing from lungs or nasal congestion, or emotional upset or stress. The key in these cases is to address the underlying cause of the discomfort.
Bright lights at night can keep you from falling asleep. The bluish light that comes from TV, computer, and phone screens will especially interfere with getting to sleep. For this reason, even if the light level is the same, reading yourself to sleep will usually work better than watching TV or playing computer solitaire until you fall asleep.
Shift work, especially the night shift or frequent shift changes, can seriously disturb sleep schedules, as can jet lag.
Sleep medications
Sleep medications, including alcohol for those who use it for this purpose, can bring on sleep in the short term but risk worsening the problem in the long term. The sleep produced is usually short-lived and of poor restorative quality. In fact, if you read the list of possible side effects of most sleep medications, one of the ironic side effects is insomnia. Sleep medications have potential for addiction, and going off of them after regular use can lead to insomnia that is worse than it was originally.
Diet and nutrition
Eating too close to bedtime can keep you awake, as your body is busily digesting rather than gearing down for sleep. Some foods can cause heartburn or bloating, and the resulting discomfort can interfere with sleep.
Food allergies can cause a number of symptoms, including insomnia. One food reaction is a faster pulse rate, which can make it hard for your body to relax.
Proper mineral balance is important, especially the mineral potassium. Low potassium can cause rapid or pounding heartbeat and pulse, mind racing, obsessive thinking, anxiety, irritability, and tossing and turning. In many cases where the level of potassium in the body is borderline, you get to sleep just fine, wake up to urinate, and can’t get back to sleep – you have just urinated out some of your potassium and brought yourself below the threshold level. A potassium supplement can help you sleep within 20-30 minutes of taking it if your insomnia is due to this cause.
The amino acids tryptophan and tyrosine, found in protein and supplements, are tied to sleep. Tryptophan is good for getting to sleep (PM sleep), while tyrosine is good for staying asleep (AM sleep). However, tryptophan and tyrosine are antagonists and should not be taken together. Tyrosine should only be taken in the morning before breakfast, or it can actually interfere with sleep. The amino acid theanine increases the neurotransmitter GABA, which can improve sleep.
Melatonin
Melatonin is a hormonal supplement that can aid sleep, but only if your insomnia is related to low melatonin in the first place. Melatonin, which comes from the stimulation of the pineal gland in the brain by sunlight, is released at night to help regulate sleep cycles. Getting some early morning sunlight might be sufficient to raise melatonin levels and help you to sleep better. If taken as a supplement, melatonin needs to be taken properly. A common mistake is to toss and turn for hours and then finally take melatonin at 2AM. This signals your body that the desired bedtime is 2AM, which is not your intention. It’s better to take it just before your desired bedtime.
Sleep hygiene
Those things in the external environment or activities that can help promote sleep are sometimes called sleep hygiene.
Your bedroom should be used only for sleep (and romance, if applicable), not TV watching, office work, or your exercise treadmill. It should be psychologically and physically associated with sleep and relaxation and nothing else.
As mentioned, avoid electronic screens: TV, computer, and phone. Your bedroom should be as dark as possible when you’re trying to sleep – even a night light can be perceived through closed eyelids and keep you from sleep. A clock visible from the bed is a bad idea for a couple of reasons. Its visibility is a constant trigger of I-should-be-sleeping thoughts, and most bedtime clocks emit additional light. Also, do what you can to minimize and eliminate noise.
As any parent of small children knows, bedtime rituals – the pajamas, evening bath, bedtime story, toothbrushing – help a reluctant child ease into sleep. Bedtime rituals are useful for adults as well, signaling that the busy daytime is over and it’s time to shift gears into relaxation mode.
A cooler temperature in the bedroom, and fresh air if possible, helps many people to get to sleep.
Another external factor in poor sleep is your sleep partner, if any – and this includes the family dog. If a sleep partner tosses and turns, snores, sweats, grinds his or her teeth, or gets up at night, this can adversely impact your sleep. Another issue with a sleep partner is that such partnering often means compromises on your own ideal sleep conditions, such as room temperature or mattress hardness.
Other sleep disorders
There are other sleep disorders, many of which can contribute to insomnia. These include sleep apnea, snoring, restless legs, narcolepsy, excessive sleepiness, parasomnias, night sweats, and nightmares. These are discussed in the next article.
