Do you lie in bed for hours and can’t sleep?

Cultivating healthy sleep is important; better sleep enables us to navigate stressful times better in the short term, lowers our chance of developing persistent sleep problems in the longer term, and gives our immune system a boost.

Yet all too often, when we finally climb into bed, we find ourselves wide awake. It’s frustrating.

Lets try to understand why by first explaining our circadian rhythm

The circadian rhythm is like an internal timekeeper for everything our bodies does in a 24-hour period. This system uses light, dark, and our biological clock to regulate body temperature, metabolism, hormones (including melatonin) and sleep. The body’s master clock is called the suprachiasmatic nucleus (SCN). Located in the brain, the SCN controls melatonin production. This hormone helps regulate sleep. During the day when it’s light outside, melatonin levels remain low. Later in the day, as it grows darker, our bodies produce more melatonin, with levels peaking between 2 and 4 a.m. before falling again. Our bodies are best primed to fall asleep about 2 hours after melatonin levels start to rise.?

So why can’t we sleep? Our circadian rhythm may be off. Sometimes it is not possible to follow your circadian rhythm, and our lifestyle needs and internal clock clash.?

Our circadian rhythm being off could be due to a number of factors. Here are some of them.

1. Overnight or off hours work shifts that go against the natural light and dark times of day; work shifts with erratic hours; travel that spans the course of one or more different time zones; a lifestyle that encourages late-night hours or early wake times
2. Napping. Naps aren’t inherently bad. However, the wrong nap strategy can keep us up when we should be getting deeper Zzz’s. Winter recommends keeping naps 20–30 minutes long, and napping at the same time every day so our body can anticipate it.
3. Anxiety. A racing mind isn’t conducive to peacefully nodding off, increased arousal and alertness, which can delay sleep even further. Sleep disturbance is a diagnostic symptom for some anxiety disorders, which are common risk factor for insomnia.
4. Depression. Depression can affect sleep quality and duration. People with depression may find it difficult to fall asleep and stay asleep during the night. They can also have excessive daytime sleepiness or sleep too much. At the same time, sleep problems can exacerbate depression, leading to a negative cycle between depression and sleep that can be challenging to break. Poor sleep may even provoke depression in some people.
5. Caffeine. Maybe it’s time to reconsider that afternoon latte or energy drink. It may be no surprise, then, that even 200 milligrams of caffeine — about 16 ounces of brewed coffee — 16 hours before bed, may impact your sleep. Winter recommends cutting off caffeine consumption 4–6 hours before you go to bed.
6. Screen time. The blue light emitted from phones, tablets, laptops, and TV screens suppresses evening melatonin production and decreases sleepiness. Winter recommends ceasing the use of any devices 2 hours before bed. We may also consider wearing blue-light blocking glasses at night.
7. COVID. Difficulty sleeping is a common symptom of COVID. This could be due to factors such as stress or an autoimmune response to the virus. Sleeping difficulties may be more prevalent in people with long COVID according to a 2022 data analysis. Researchers found that over 40% of 1,321 people with long-lasting COVID symptoms experienced moderate to severe sleeping difficulties. The COVID pandemic itself is associated with increasing sleep-related issues, according to a 2022 study. Social isolation, economic hardships, and parenting challenges are among the possible causes.
8. Other sleep disorders. Sleep apnea and restless legs syndrome can do the same. In sleep apnea, breathing repeatedly stops or is very shallow, then starts again. With restless legs syndrome, your legs feel uncomfortable, triggering you to want to move them. Both conditions can disrupt nighttime sleep, which then causes daytime sleepiness.
9. Diet. A 2016 review found that high-fat diets were associated with less REM sleep, more deep sleep, and increased arousal from sleep. In the short term, a high-carb diet may be associated with more REM sleep, less deep sleep, and falling asleep faster. However, in the long run, eating evening meals high in protein may correlate with less daytime sleepiness. According to this review, what we eat before going to bed may affect the quality of your sleep. For example, almonds, kiwifruit, and fatty fish contain melatonin that signals our body to sleep.

Once we identify what might be going on, we can take action to support better sleep.?

Daytime tips to help with sleep

• Keep a consistent routine. Get up at the same time every day of the week. A regular wake time helps to set our body’s natural clock (circadian rhythm, one of the main ways our bodies regulate sleep). In addition to sleep, stick to a regular schedule for meals, exercise, and other activities. This may be a different schedule than we are used to, and that is okay. Pay attention to our body’s cues and find a rhythm that works for us and that we can maintain. Make this a priority for all members of our household.
• Get morning light. Get up, get out of bed, and get some light. Light is the main controller of the natural body clock, and regular exposure to light in the morning helps to set the body’s clock each day. Natural sunlight is best, as even cloudy days provide over double the light intensity of indoor lighting. If we are living in an area with shelter-in-place, try to expose ourselves to natural light by stepping outside, at a distance from others, for at least 20 minutes.
• Exercise during the day helps improve your sleep quality at night, reduces stress, and improves mood.?
• Don’t use our bed as an escape. While the gravity of our stresses in life makes us all tired, try not to spend too much time in bed during the day, especially if we are having trouble sleeping at night. If we must take a nap, try to keep it short — less than 30 minutes.
• Avoid caffeine latte in the day.

Nighttime tips to help with sleep

• Prepare for bedtime by an electronic device blackout. Remind ourselves by setting a timer or putting your television on the sleep setting. Make a pact with your family members to respect these parameters. If we need something to watch to help us unwind, watching something that we find relaxing on TV from far away and outside the bedroom is likely okay for a limited time. We can also curl up with a book or listen to music.
• Minimise alcohol intake. While alcohol can help people fall asleep, it leads to more sleep problems at night.
• Set a regular bedtime. There are certain times at night that our body will be able to sleep better than others. If we feel sleepy but our brain is busy thinking, it can’t shut off and go to sleep. It may be helpful to sit down with a pen and paper in the evening and write down the things that worry us; we can review this list in the morning and attend to any important concerns. If we have a bed partner, enlist their support to helping us stick to your schedule.
• Reduce stress. The evening and bedtime hours are also a good time to perform some relaxation techniques, such as slow breathing or yoga. There are many free resources available for bedtime meditation.
• Create a comfortable sleep environment, a place that is cool, dark, and quiet.
• Don’t spend too much time in bed during the night (or the daytime). Minimise spending time in bed in which you are not sleeping. If we are having trouble going to sleep or staying asleep, don’t stay in bed for more than 20 minutes. Get out of bed and do a quiet activity — read a book, journal, or fold some laundry.

What if I am doing all these things and I still can’t sleep?

This may be a sign that you have a clinical sleep problem, such as insomnia disorder or sleep apnea. If we are doing all the right things, and still have trouble falling or staying asleep then it is best to consult our GP, seek a clinical psychologist and/or a sleep specialist to support with better sleep.

Remember, don’t stress out about sleep

Disrupted sleep is a normal response to stress, and it is okay to have a few nights of poor sleep as we adjust to new routines and big changes to our work and personal life. But with some simple measures we can preserve our sleep and improve our well-being.