Why Can’t I Sleep? 5 Common Sleep Questions Answered

This blog post was orginially published on the blog of Beyond the Body Health Psycholgy Services, LLC (Owned by Dr. Jennifer Steiner) on 3/10/22  https://www.beyondthebodypsych.com/blog/why-cant-i-sleep-5-common-sleep-questions-answered

1.  How much sleep do I really need?

Most people learn that adults need 8 hours of sleep per night for optimal functioning, but that’s not entirely true.  The CDC says that adults need 7 or more hours of sleep per night for overall health and wellbeing, and the CDC defines “short sleep duration” as “less than 7 hours of sleep n a 24 hour period” (CDC, 2017).

2.  Is it normal to feel like I’m not sleeping well? Everyone always seems tired…

According to the CDC data, between 26.3-39.0% of adults from 2007-2013 reported getting less than 7 hours of sleep, with adults aged 45-54 being the most common age group to experience less than 7 hours a night (CDC, 2017). 

Although 7+ hours of sleep tends to be the average amount of sleep that most adults need, everyone is a little different.  Some people function well with 6.5 hours of sleep, others really need a full 8 or more.  If you are getting between 6-8 hours a night, the most important question is really: how is your sleep (or lack of sleep) is impacting your functioning during the day.  Are you having a hard time focusing at school or at work?  Do you feel exhausted all the time?  Are you irritable?  These are the types of questions to ask yourself.

3.  Why am I not getting good sleep?

Lots of factors can contribute to disrupted sleep.  Some of these factors may be biological, some may situational, and some may be related to habits that we’ve picked up.  Any of the factors below might be contributing to your sleep challenges:

• Biological pre-disposition to insomnia or other sleep disorders (click here to read more about insomnia)

• Stress

• Worry

• Busy mind (trouble turning your mind off at night)

• Chronic pain or other chronic medical issues

• Certain medications may have side effects that impact sleep

• Too much light or noise in the room

• Substances like caffeine, nicotine

• Foods that are high in caffeine or sugar

• Exercising or working too close to bedtime

• Screens (TV, tablet, laptop, smartphone)

• Mental Health conditions (such as depression and anxiety)
  

4.  Do I have insomnia?

Insomnia is just one of many different sleep disorders, so if you are having difficulty sleeping or experiencing excessive daytime sleepiness or fatigue, that doesn’t necessarily mean you have insomnia. 

Insomnia is defined as the inability to initiate or maintain sleep (i.e. difficulty falling asleep or staying asleep).  However, many other factors can cause difficulty sleeping, and so usually doctors will want to rule out other possible explanations such as medical conditions, other sleep disorders (such as sleep apnea or other breathing related sleep disorders), medication side effects, and any signs of mental health conditions.    

 Additionally, there are actually two different types of insomnia:

• Primary insomnia: difficulty initiating or maintaining sleep (difficulty falling asleep or staying asleep) at least 3x a week, lasting at least three months.  It is considered primary insomnia when it cannot be better explained by another mental health condition, substance, or medical condition (DSM-5; APA, 2013)

• Secondary or psychophysiological insomnia: this definition takes into account the potential role of mental health concerns, stress, and learned behaviors that may contribute to the development of disrupted sleep and aid in continued disruption of sleep (Perlis et al, 2005, pg2)

5. How do I get some help with my sleep?

As mentioned above, the first step is likely to talk to your doctor and make sure that you rule out any underlying medical conditions.  Once medical issues such as sleep apnea or restless leg syndrome (RLS) have been ruled out, or if you continue to experience disrupted sleep then it might be time to consider working with a trained therapist.  Health psychologists or sleep psychologists are trained in techniques to help you re-train your brain to sleep better.  They will help you figure out what factors are getting in the way of your sleep, and help you make a plan that best fits your unique sleep situation.  For example, you may realize that you’ve picked up some bad habits that are making it hard for you to fall asleep; in this case the therapist may help you identify those habits and work to change those habits.  

Alternatively, you may realize that you’re dealing with a lot of stress or worry and that it is challenging to turn off your mind when you try to go to sleep; the therapist can help you learn strategies to help quiet your mind and help initiate sleep.  Maybe it’s pain getting in the way of sleep; a good health psychologist can help with that too.  Cognitive-Behavioral Therapy for Insomnia (CBT-I) is an evidence-based approach that can be incredibly effective and help you transform your sleep, and is considered the gold standard in treatment of insomnia (Perlis et al, 2005), and many therapists are trained in this approach.

The most important thing to remember is that you don’t have to suffer from poor sleep forever.  Click here to learn more about therapy for disrupted sleep through Beyond the Body Health Psychology Services, LLC, or check out the resources below.

References:

American Psychiatric Association. (2013). Sleep-Wake Disorders. In Diagnostic and statistical manual of mental disorders (5th ed.).

Centers for Disease Control and Prevention. (2017, May 2). CDC – data and statistics – sleep and sleep disorders. Centers for Disease Control and Prevention. Retrieved February 22, 2022, from https://www.cdc.gov/sleep/data_statistics.html

Perlis, M.L., Jungquist, C., Smith, M.T., & Posner, D.  (2005).  Cognitive Behavioral Treatment of Insomnia: A session-by-session guide.  Springer Science + Business Media, LLC. 

Additional Resources:

Basic Information about Insomnia and Other Sleep disorder:

https://www.cdc.gov/sleep/about_sleep/key_disorders.html

https://www.behavioralsleep.org/index.php/sbsm/about-adult-sleep-disorders/adult-insomnia

Learn more about Behavioral Sleep Medicine and CBT-I:

https://www.behavioralsleep.org/index.php/sbsm/what-is-behavioral-sleep-medicine

https://www.behavioralsleep.org/index.php/sbsm/community-education