9 Causes of Sleeplessness (And What to Do About Them)

Americans are so sleep-starved that in a recent survey, 67% said they’d trade a vacation day for better night's sleep. And there's good reason: Recent research has linked sleep deprivation to everything from obesity to diabetes to heart disease to cancer. Find out what you can do, before it starts hurting your health.

By Denise Foley

By Mark Lund

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1. SLEEP KILLER: TOO MUCH COFFEE: Caffeine blocks the sleep-inducing action of the brain chemical adenosine. It can also reduce the amount you make of the sleep hormone melatonin. Not only will it lead to trouble dropping off, but also you’ll sleep restlessly. In an Israeli study, subjects given caffeinated coffee had about half as much melatonin in their systems as those who were given decaf. They also took twice as long to fall asleep and slumbered an average of 79 minutes less.

Solution: Drink early, but not often. Limit caffeine consumption to 250 milligrams a day (about 16 ounces of coffee), the amount most of us can handle without its causing bedtime troubles. It takes about six to eight hours for your body to clear enough caffeine to avoid its interfering with your sleep, so put your cup down by 2 P.M.

2. SLEEP KILLER:TOO MUCH LIGHT: While playing a few rounds of Words With Friends on your iPad or spending two hours in front of the tube may help you wind down, your body’s response to the short-wave blue light emitted by these devices’ backlit screens is, "Hey, more daylight! Let’s stay up and play." (This is true for compact-fluorescent, LED, and incandescent lights, too.) Sleep hormones kick in at about 9 or 10 P.M., but if the bedroom never gets dark, your body holds off on melatonin production, making it harder for you to fall asleep.

Solution: Say “Ta-Ta” to your tech toys. It may be hard to sacrifice your post-dinner Facebook activity but try to pull yourself away an hour before bed and dim the lights in your house.

3. SLEEP KILLER: YOUR BIOLOGY: Though we’ve been trained to believe that we need an uninterrupted seven to eight hours of sleep, research by historian A. Roger Ekirch of Virginia Tech found that in the past, people in many cultures traditionally had two distinct sleep periods per night, separated by an hour or so of wakefulness. In other words, it was normal to sleep in split shifts. Today, we toss and turn because we’re worried we’re never going to get back to sleep, which can make doing so impossible.

Solution: Take it instride “Don’t lie awake fretting and telling yourself you need to go to sleep,” advises Fiona Baker, Ph.D., a sleep researcher at SRI International in Menlo Park, CA. “Shift your thoughts. Immediately turn to a relaxation technique like deep breathing.” Or, you could look at your midnight wake-up as a gift of time—get something done, then go back to bed when you’re sleepy.

4. SLEEP KILLER: TOO MUCH ALCOHOL: While drinking wine, beer, or spirits can help you conk out, alcohol disrupts sleep patterns: You’ll wake more often during the night, and you’ll get more deep sleep at the start of the night and not so much in the second half, thus ending up with less of the kind that’s important for feeling rested. This effect is more pronounced in women, researchers found in a 2011 multi-university study, probably because we metabolize alcohol differently.

Solution: Make it an “evening-cap” Or, have it with dinner. While studies show that the effect on sleep lingers even after alcohol is out of your system, a cocktail or a glass of wine with supper is not as disruptive as a nightcap. And since the reaction is dosedependent—the more you drink, the worse your sleep—limit your sips to a glass or two.

5. SLEEP KILLER: WORRY Your emotional life is like a set of invisible arms that shake you out of a sound sleep so you can fret a little while longer. “About 75% of the people I see with sleep problems have anxiety or depression,” says Breus.

Solution: Count your blessings In a study conducted by Robert A. Emmons, Ph.D., of the University of California, Davis, people who listed five things they were grateful for each day in a gratitude journal fell asleep faster, slept for longer periods of time, and also woke up feeling more refreshed than those who didn’t use such a journal.

6. SLEEP KILLER: THE CALENDAR As people get older, they’re more likely to have long periods of wakefulness, often early in the morning. That’s because in your 20s and 30s, you start getting less and less of the deepest stages of sleep—“the kind that allows a sleeping child to be lifted out of the car, carried upstairs, and undressed and tucked into bed without waking up,” explains Harvard sleep researcher Jeanne Duffy, Ph.D. “That’s one reason that even healthy older people have sleep disruptions—if you’re not as deeply asleep, anything is likely to wake you,” like a truck outside or even birds chirping. Aging, it turns out, may have a smaller impact on sleep than many have thought. A 2010 British study found that older folks slept only about 20 minutes less a night than middle-aged men and women, who in turn slept only 23 minutes less than young adults. What’s more, says Duffy, in her research she has found that healthy older people can miss sleep—even stay up all night—and not be as exhausted the following day as someone younger might be.

Get an early start to the day It’s what many tightly scheduled (and successful) business leaders do. They may use the early morning hours to work out, catch up on e-mail, and read the news before heading out to the office. Remember the old saying “Early to bed and early to rise makes a man healthy, wealthy, and wise”? It goes for women, too.

7. SLEEP KILLER: PAIN OR DISCOMFORT Two major sleep disrupters are back pain and gastroesophageal reflux disease (GERD), a condition in which the ring of muscle fibers (or sphincter) in the esophagus can’t prevent a backup of stomach contents into the throat. It occurs during the day, but there’s also a nighttime version.

Solution: If you have back pain When sleeping on your back, use a small pillow for your head; place another under your knees to take pressure off your lower back. When on your side, put a pillow between your knees and thighs.

If you have GERD Raise the head of your bed—or your own torso—with pillows, so you’re not lying flat. It may also help to lose weight if you are overweight. In one study, a loss of just 10 to 15 pounds reduced heartburn in women by 40%. (As for back pain, there’s surprisingly little research on the topic, but in studies of people who’d had weight-loss surgery, losing weight helped.)

8. SLEEP KILLER: OBSTRUCTIVE SLEEP APNEA (OSA) When you have this serious, widespread condition—it’s as common as type 2 diabetes—your breathing stops periodically (sometimes for a minute of times to restart it. OSA is caused by a blockage of the airway, usually when the soft tissue in the back of the throat collapses. Why this cause of your daytime sleepiness can be such a surprise: You’ve been waking up all night, but with no awareness of its even happening. OSA’s major symptom is loud snoring—ask your partner (if he hasn’t complained already), or run a tape recorder one night.

Solution: Start that diet you’ve been talking about About 65% of people who have OSA are overweight or obese. The condition can contribute to—or be a consequence of—extra pounds. Slimming down often improves symptoms and may even cure your obstructed breathing. If you have mild apnea that occurs only when you lie on your back—the case for many people—try sleeping on your side. One way to keep from rolling back again: Place a tennis ball in a sock, then pin the sock to the back of your PJs.

Check in with a pro Even if your bedmate hasn’t said you’ve been snoring, see your doctor about unexplained and profound daytime sleepiness. If you have OSA, you may need a continuous positive airway pressure (CPAP) machine. It works by not allowing the soft tissue in your throat to collapse and stop your breathing.

9. SLEEP KILLER: RESTLESS LEGS SYNDROME (RLS) If you wake up because you have the irresistible urge to move your legs to stop them from tingling, you may have this nerve disorder, which occurs in about 5% of the population. It can also lead to difficulty falling asleep and frequent waking. RLS often runs in families, and like so many other things, it tends to be worsened by stress. Some people with RLS have an additional condition called periodic limb movements in sleep, in which their legs jerk every 20 to 40 seconds in clusters throughout the night.

Solution: Get an RX for RLS While massages, relaxation exercises, regular workouts, and elimination of caffeine and alcohol can help, your doctor may suggest one of several FDA-approved drugs to treat RLS. Or she might prescribe medications that have been approved to treat other conditions (such as Parkinson’s disease), but which also ease RLS symptoms. You might ask your doctor to check your iron levels; anemia can cause RLS. 

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