10 Reasons You Can’t Sleep

We hear it all the time: Make sure you get enough sleep every night in order to improve your physical and mental health. Although we know what we need to do, it is admittedly very hard for many people to reach this goal each and every night. Even worse, on the nights when we decide to make sleep a priority, the precious hours of shut-eye can be more difficult to obtain than we would like, leading to even more frustration and sleepless nights.There are a number of sleep stealers—secret and not-so-secret—that are important to pay attention to in order to get great sleep each and every night. Here’s a list of the most common sleep stealers that I see with my patients on a daily basis. Making some simple changes to your lifestyle can help prepare your body for sleep and greatly enhance the chance that you’ll get a great night of quality zzz’s.1. Your room is too warm. Many people like to create a cocoon-like environment to sleep. Although it might feel nice to be warm and cozy at night, having a room that is too warm (or cold!) can cause multiple awakenings at night, leading to more disrupted and less refreshing sleep. The ideal bedroom sleeping temperature range is between 55 and 74 degrees Fahrenheit; however, most people find that in the upper 60s is best. If you have a radiator that’s hard to control, consider opening up your window before you go to sleep (yes—even in the winter), and leave it open a crack throughout the night.2. You had a bit too much to drink. This pertains to both alcoholic and non-alcoholic drinks. Let’s face it, drinks equal liquid, and liquid at night means having to use the bathroom when you’re trying to sleep. Plus, alcohol consumed close to bedtime can also make your sleep lighter and more broken throughout the night. Even though alcohol might make you sleepy, the quality of your sleep is poorer overall. Limit all liquids within three hours of bedtime.3. Look in your medicine cabinet. Certain medications can greatly impact your ability to fall and stay asleep at night. Some over-the-counter painkillers, such as Excedrin and Midol, contain caffeine, so make sure to check the ingredients listed on the box. Certain medications for blood pressure, decongestants, steroids and asthma medication can also impact your sleep. Most commonly, many antidepressants—SSRIs in particular, including Paxil, Prozac and Lexapro—release serotonin on a continuous basis and can be very alerting for patients. Talk with your doctor if you think your medications are impacting your ability to sleep well. Sometimes, a change in when you take them, such as switching to taking them in the morning, can make a big difference. If that doesn’t work, your doctor might be able to recommend another medication that doesn’t impact sleep as much.4. Your gym session ran a bit too late. Working out within three hours of bedtime can be too stimulating for many people. Exercise wakes up the brain and also warms up the body, which can interfere with sleep. The best time to exercise to help you fall asleep is between four to six hours before bedtime. If that’s too difficult to do, consider exercising in the morning. The bright light can also help wake you up and reinforces a good, regular sleep-wake cycle.5. You took a shower too close to bed. Good sleepers tend to have a slight drop in their body temperature just as sleep starts to happen at night. Poor sleepers don’t have as much of a drop in body temperature. While taking a hot shower or bath just before bedtime sounds like a good idea, it can actually warm up your body even more. The key is timing: It’s best to take a hot shower or bath one and a half to two hours before bedtime, which can help facilitate the cooling off process that the body is meant to do before sleep.6. Dinner was a bit too heavy and too late at night. Heavy or spicy foods and large meals within three hours of bedtime can be too stimulating for your body to sleep well at night. Limit big meals to before three hours of going to bed, and if you find yourself hungry closer to bedtime, have a small snack that consists of a combination of protein and a carbohydrate, such as a cracker with some cheese or a banana with some peanut butter.7. You had that afternoon cup of coffee. Caffeine can take upwards of 12 hours to leave your body and is found in coffee, many teas, including some herbal varieties, some sodas, chocolate and even some medications. Caffeine can cause you to have trouble falling asleep, but it also can cause more disrupted sleep throughout the night. Consider taking a short walk in the sunlight or eating your lunch near a bright window to perk up naturally. The exercise and sunlight can be just as alerting in the afternoon as a cup of coffee.8. You wind down with your TV or tablet at night. Yes, watching the news or a gripping show on TV can be psychologically stimulating, but it’s the blue light most screens give off that can make your brain think that it is still daytime. As a result, melatonin—a hormone in our brain that comes out in darkness and makes us sleepy—doesn’t come out as strong and we aren’t able to get sleepy. Turn off all screens within an hour of bedtime and wind down outside your bed with a book or relaxing hobby in dim light.9. You’re overwhelmed. Stress is the number one cause of short-term sleeping difficulties. Solutions don’t usually come to us in the middle of the night and we get caught up in unproductive worry. If you can’t sleep, get up and out of bed, sit in dim light in another room and do something quiet, calm and relaxing that helps take your mind off your worries. Writing out a to-do list earlier in the evening can also help to clear out the mind. If you wake up in the night remembering that you forgot to add something, just put it on the list. Prioritize the list as well so you know what is most important to get done. If you keep worrying about the things on your “to-do” list, recite to yourself that you’ve written it down and will handle it tomorrow.10. You’re wound up. Try some relaxation exercises within an hour of bedtime to calm your mind for sleep. Deep diaphragmatic breathing and body scan exercises, in which you become aware of and then relax each body part from head to toe, are excellent ways to relax your body and mind. Many great resources are available online to help you do these exercises. If you wake in the middle of the night, consider getting out of bed and trying some relaxation exercises to take your mind off your worries.If you’ve tried all of the above and still can’t sleep, let your primary care physician know. There are many excellent treatments—both medication and non-medication, such as cognitive behavior therapy for insomnia—that can help you get a great night’s sleep from here on out.

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