Why Can’t I Sleep?

If you struggle with getting a good night’s sleep, you are not alone. According to the National Institute of Health, about 50 to 70 million Americans have sleep disorders, and 1 in 3 adults do not regularly get the recommended amount of uninterrupted sleep they need to protect their health.

What causes poor sleep?

Poor sleep or lack of sleep can be caused by a number of factors, many of which are all or partially within our control, including:

• Alcohol consumption
• Anxiety and stress
• Caffeine or nicotine consumption late in the day
• Heavy eating before bed
• Irregular/inconsistent sleep schedules
• Screen time (television, mobile devices, etc.) before bed
• Uncomfortable or bright bedroom

While the above items are within our control to a significant degree, understanding the causes of and managing anxiety and depression may require seeking help from a behavioral health specialist.

Medical reasons for lack of sleep

Poor sleep may also be related to a medical condition such as:

• Acid reflux
• Chronic pain
• Conditions causing frequent urination
• Heart disease
• Insomnia
• Obstructive sleep apnea (OSA) or other respiratory issues
• Restless leg syndrome
• Thyroid issue

Some medications can also cause poor sleep, including:

• Antidepressants
• Cold medicines
• Stimulants for attention-deficit/hyperactivity disorder (ADHD)

Risks related to poor sleep

Consistent poor sleep impacts your mental, emotional and physical health and wellbeing. Short-term risks include:

Relationship impacts:
Lack of sleep can lead to irritability and mood swings, which can have negative impacts on your relationships with family, friends and co-workers.

Job performance:
Decreased ability to maintain attention or remember details can cause poor productivity and lack of quality work.

Public safety risk:
Just like drunk, drugged and distracted driving, drowsy driving is a public health issue. According to the National Highway Traffic Safety Administration, an estimated 100,000 crashes each year are caused primarily by drowsy driving, resulting in more than 71,000 injuries.

Persistent sleep deprivation has been linked to some health problems, some of which are life-threatening, such as:

• Cardiovascular disease, including high blood pressure (hypertension), heart attack and stroke
• Cancers: Breast, colon, ovaries and prostate
• Cognitive decline and neurological issues
  Sleep deprivation has been associated with higher risk of dementia and Alzheimer’s disease.
• Gastrointestinal disorders (irritable bowel syndrome and GERD)
• Mental health issues
• Obesity and weight gain
• Type 2 diabetes
• Weakened immune system

What should I do if I have a persistent sleep issue?

By understanding the causes of poor sleep within your control, you can take the first steps to improve your quality of sleep by:

• Maintaining a consistent sleep schedule and ensuring you get the recommended 7-9 hours of sleep each night
• Not consuming alcohol or nicotine products at least 4-6 hours prior to going to bed
• Refraining from eating or drinking (any beverages) for 2-3 hours prior to bed
• Turning off screens (television, mobile devices) at least 30-60 minutes prior to bedtime
• Identifying sources of stress and anxiety and tools to manage them. If needed, seek the help of a behavioral health specialist

If you still have sleep challenges, schedule an appointment with your primary care provider (PCP). Be prepared to provide details to your PCP about you habits before bedtime, medications you take (over the counter and prescription) and the time of day you take them, sources of stress or anxiety and other physical symptoms you are having. Your PCP will likely have bloodwork done and other tests to determine if a referral to a specialist is needed. For example, if OSA or other lung/respiratory issues are suspected, your PCP will refer you to a pulmonologist for a sleep study evaluation and other lung function tests. If heart conditions are detected, you will be referred to a cardiologist.

Like any condition impacting your quality of life, being aware and seeking medical evaluation at the first sign of symptoms is key to minimizing long-term health risks. Listen to your body, so you can live the lifestyle you enjoy with minimal medical complications.