A Guide on What to Do if You Can’t Sleep

Sleep is a vital part of a healthy lifestyle, contributing to physical health, cognitive function, and emotional well-being. Despite its significance, many individuals find themselves lying in bed, wide awake, in the middle of the night, wondering why sleep escapes them. As a sleep specialist, I see firsthand the impact that lack of sleep can have on daily life and am dedicated to helping individuals overcome their sleep challenges. This article aims to shed light on the importance of sleep, explore common reasons for sleeplessness, and provide practical solutions for those who often find themselves grappling with the challenge of falling and staying asleep.

Why is sleep good for you?

Before we deep dive into the complexities of sleeplessness, it’s important to understand why we sleep. We spend roughly 1/3 of our lives in this blissful slumber, so it needs to have a point, right? Otherwise, it’s one of nature’s biggest blunders! Sleep plays a vital role in nearly every function of our physical and mental health and is essential for our overall well-being. To break it down further, here are just a few of the key functions of sleep:

1. Cognitive Function: Sleep is fundamental to cognitive processes such as memory consolidation, learning, and problem-solving. It enhances creativity and decision-making abilities.
2. Emotional Regulation: Adequate sleep is linked to emotional stability. It helps regulate mood and reduces the risk of stress, anxiety, and depression.
3. Physical Restoration: During sleep, the body undergoes repair and rejuvenation. Tissues and muscles are repaired, toxins are cleared away, and the immune system is heightened.
4. Metabolic Health: Sleep influences various hormones, including those responsible for controlling hunger and satiety. Lack of sleep can lead to imbalances in these hormones, leading to weight gain, difficulties losing weight, and metabolic issues.
5. Cardiovascular Health: Chronic sleep deprivation is associated with an increased risk of cardiovascular diseases such as heart attacks and strokes. Quality sleep helps regulate normal blood pressure and maintain good heart health.

Sleep is important in so many ways. There does not appear to be an area of your health that is not detrimentally affected by poor sleep, or improved by gaining better sleep quality and quantity.

Why can’t I sleep at night?

There are so many different factors that can contribute to trouble falling and staying asleep at night, and rarely it is one sole thing causing all of your sleeping problems. It is often the case that it is a combination of different things confounding your sleeping difficulties.

Some common reasons include:

• Stress and Anxiety: An overactive and busy mind can be a significant barrier to sleep. Stressors from work, relationships, or daily life can create mental unrest, making it difficult to relax and switch your brain into sleeping mode.
• Light/Darkness Exposure: Exposure to bright light in the later parts of the evening (especially screens emitting blue light, such as phones and computers), can disrupt the body’s natural circadian rhythm, signaling the brain that it’s time to be awake rather than preparing it to fall asleep.
• Irregular Sleep Schedule: Inconsistent sleep patterns, such as irregular bedtimes and wake-up times, can confuse the body’s internal clock, making it challenging to establish a stable sleep routine and fall asleep within a reasonable timeframe. An irregular sleep schedule has also proven to affect the overall quality of the sleep you do get as well.
• Environmental Factors: Uncomfortable bedroom conditions, including excessive noise, light, and temperature as well as an uncomfortable mattress or pillow, can hinder the ability to fall asleep and stay asleep.
• Medical Conditions: Underlying medical issues, such as insomnia, sleep apnea, or restless leg syndrome, can contribute to chronic sleep difficulties. If you suspect you may have one of these issues, it is best to consult a medical professional trained in sleep medicine.

Understanding these factors can be the first step in addressing your sleeping troubles, as each may require a unique approach for resolution. Maintaining good sleep hygiene and taking up habits that can change your day-to-day schedule to optimise your sleep is important.

What to do if you can’t sleep

If you often find yourself lying in bed in the middle of the night, unable to fall or stay asleep, here are some practical strategies you can adopt to improve your sleep quality:

1. Establish a Consistent Sleep Schedule: Maintaining a regular sleep schedule helps regulate your body’s internal clock, making it easier to fall asleep and wake up at the desired times. Aim for seven to nine hours of sleep each night, and try to go to bed and wake up at the same time every day, even on weekends.
2. Create a Relaxing Bedtime Routine: Engage in calming activities about 1-2 hours before bedtime to help calm your mind before getting into bed. The activity itself should be something you find enjoyable, but it should not overly stimulate you. Ideally, introduce soft lighting where possible, and this will help signal to your brain that bedtime is approaching. This could include reading a book, doing a jigsaw puzzle, meditating, or other relaxation exercises. Avoid stimulating activities and exposure to blue light from screens in the hour leading up to bedtime.
3. Optimise Your Sleep Environment: Ensure that your bed and bedroom lend themselves to being a perfect sleep haven. Make it dark, quiet, and cool (approximately 18 degrees). Remove bright electronic clocks that display the time, and ideally keep your phone in another room of your house. Make sure your pillow and mattress support your head, neck, and back and are comfortable. Ensure you wash your sheets and pyjamas regularly.
4. Limit Stimulants and Caffeine: Avoid consuming stimulants such as caffeine and nicotine in the hours leading up to bedtime. These substances can interfere with your ability to fall asleep and reduce sleep quality. Also, avoid alcohol in the evening, as this greatly affects the depth and quality of your sleep and leads to a more disrupted sleeping pattern. Excessive amounts of sugar can also interfere with your blood glucose levels, which could in turn impact your sleep quality.
5. Manage Stress and Anxiety: Develop stress-reducing techniques, such as mindfulness meditation or deep breathing exercises, to help calm your mind before bedtime. These should not be used only when stress gets too much but as a regular part of your daily routine. Consider keeping a journal to jot down any lingering thoughts or worries during the early evening, allowing you to set them aside for the night and help quiet your busy mind.
6. Watch Your Diet: Certain foods can either promote or hinder sleep. Opt for a light snack if you’re hungry before bedtime, and avoid heavy meals, spicy foods, and excessive liquids, that are known to cause gastrointestinal discomfort and disruptions during the night.
7. Exercise Regularly: Regular physical activity can contribute to better sleep, but try to complete your workout at least a few hours before bedtime. Exercise raises body temperature, which may interfere with the natural sleep process if done too close to bedtime.
8. Limit Naps: While short naps can be beneficial, long or irregular napping during the day can disrupt your sleep cycle. If you need to nap, aim for a short duration (20–30 minutes) and avoid napping late in the afternoon. If you are having difficulties falling or maintaining sleep, then removing a daytime nap might be beneficial as well
9. Consider Sleep Aids with Caution: If lifestyle changes alone don’t improve your sleep, consult with a healthcare professional before considering sleep aids. Over-the-counter or prescription sleep medications may have side effects, become less effective with time, and not be effective at solving the cause of your sleeping problem. Sleeping medications should only be used under medical supervision.

What if these don’t work?

Despite implementing these strategies, some individuals may still find themselves lying in bed in the middle of the night, struggling to attain restful sleep. In such cases, it’s essential to explore additional options and consult with healthcare professionals.

1. Cognitive Behavioural Therapy for Insomnia (CBT-I): CBT-I is a structured program that helps individuals identify and replace thoughts and behaviours that cause or worsen sleep problems. It addresses the underlying causes of insomnia and provides practical techniques to promote better sleep. CBT-I is medication-free and is considered the most effective treatment for treating chronic insomnia, and its success is well-documented in the scientific community.

2. Professional Sleep Evaluation: If sleep troubles persist, consider consulting with a sleep specialist or healthcare provider who can conduct a thorough evaluation. This may involve sleep studies to diagnose conditions like sleep apnea or restless leg syndrome if they are also suspected.

3. Medication under Medical Supervision: In some cases, healthcare professionals may prescribe medications to help individuals with chronic insomnia. However, these should only be used under the supervision of a qualified healthcare provider, as they may have potential side effects and can interact with other medications.

4. Lifestyle Modifications: Review your lifestyle choices and habits with a healthcare professional trained in sleep medicine to identify any factors contributing to sleep difficulties. Adjusting aspects such as diet, exercise, and stress management may have a positive impact on sleep.

5. Addressing Underlying Medical Conditions: Certain medical conditions, such as menopause, chronic pain, depression, and anxiety, can contribute to sleep troubles. Treating these underlying issues may significantly improve sleep quality.

Who can help?

TM Insomnia Treatment is an online sleep consultant that can provide personalised sleep therapy to individuals anywhere in the world. TM Insomnia Treatment performs Cognitive Behavioural Therapy for Insomnia (CBT-I) for those identified with chronic insomnia and tailor-makes each session to meet the needs of the patient.

You do not need a referral to book an appointment, just book a free 15-minute video consultation with a qualified sleep coach who can offer some insights into your sleeping issues. Wait times are currently short, and appointment times can be flexible on request.

Take home message

While lying in bed in the middle of the night, unable to sleep, can be a frustrating and distressing experience, it’s essential to approach the issue with a proactive mindset. By understanding the importance of sleep, identifying potential reasons for sleeplessness, and implementing practical strategies, individuals can significantly improve their sleep quality.

Remember that achieving restful sleep is a multifaceted process that may require patience and consistency. If self-help strategies prove ineffective, seeking professional guidance is a crucial step toward uncovering the underlying causes of sleep troubles and implementing targeted interventions.

Ultimately, the journey to better sleep involves a holistic approach that considers lifestyle factors, sleep hygiene practices, and, when necessary, the expertise of healthcare professionals specifically trained in sleep medicine. With the right strategies and support, you can overcome the challenges of lying awake in bed in the middle of the night, and embrace the rejuvenating power of restful sleep.