Insomnia: Causes + 10 Sleep Solutions

One of the most common things I hear from my readers is, “Dr. Axe, I can’t sleep.” If you’re one of those people who has trouble falling asleep or wakes up frequently during the night, you struggle with insomnia. Please know that this problem is very common.

It’s believed that up to 30 percent to 50 percent of the general population is affected by acute (short-term) insomnia at any given time, and up to 10 percent have chronic insomnia that lasts more than several months.

What is insomnia exactly? Having insomnia is another way of saying that you can’t fall or stay asleep.

Insomnia affects women more often than men and is more likely to affect older adults, those of lower socioeconomic (income) status, chronic alcoholics and people with mental health conditions, like depression.

Sleep is one of the most important things you can do to keep your body healthy. In fact, a lapse in adequate sleep time — at least seven hours a night — can lead to a decreased attention span, depressed feelings and difficulty processing ideas. Sleep problems can also be linked to increased weight gain and an increase in your chances of getting sick.

Below, learn tips — including some natural sleep aids and home remedies — to help you fall asleep faster and stay asleep throughout the night.

What Is Insomnia?

The definition of insomnia is habitual sleeplessness or the inability to sleep. Everybody struggles to get a good night’s sleep now and then, but insomnia is different because it’s an ongoing problem that causes sleep disruption despite someone having the chance to get good sleep. (For example, you can’t stay asleep even though you lay in bed for many hours at night.)

Not only does having insomnia cause sleep deprivation and typically day time fatigue, but, according to the Sleep Foundation, insomnia can also cause a number of other physical and mental problems. People dealing with insomnia commonly report feeling moody, dissatisfied with how much energy they have and frustrated that they can’t seem to concentrate or perform at work or in school.

Types

Did you know that there are different types of insomnia that are characterized by their symptoms and causes?

1. Acute insomnia

Acute insomnia is brief and normally happens in response to a stressful event or major life change. This type lasts less than three weeks and may cause restless sleep several times per week.

It is typically triggered by something that makes you feel worried, upset or nervous, such as a big presentation at work, exam, health problem or relationship change. Usually, acute insomnia resolves once the stressful event has passed or at least after you’ve accepted it more.

2. Chronic insomnia

This lasts at least three to four weeks and occurs at least three times per week. There are many different reasons why someone might struggle with ongoing, chronic insomnia.

To help reverse chronic insomnia, it usually requires making lifestyle changes, addressing underlying causes of stress and sometimes working with a medical professional (such as a therapist or doctor) to come up with a treatment plan.

3. Comorbid insomnia

Comorbid insomnia is when sleeping difficulty occurs with another health condition that’s associated with changes in sleep. Some medical conditions, like depression, can cause insomnia, and pain or muscle conditions, like back pain or restless leg syndrome, can make it hard to fall and stay asleep.

A similar insomnia category is what’s called psychophysiological insomnia, which is when insomnia symptoms are caused by cognitive, behavioral and psychological factors.

4. Sleep onset or initial insomnia

This is when a person has trouble falling sleep initially but doesn’t tend to wake up in middle of the night.

5. Maintenance or middle insomnia

This is when a person has trouble maintaining sleep and often wakes up in middle of the night.

6. Late or terminal insomnia

This is when a person wakes up too early in the morning and cannot go back to sleep.

Symptoms

• Difficulty falling asleep or waking up frequently during the night. Difficulty falling asleep is a sleep “onset” problem, while trouble staying asleep is a “maintenance” problem.
• Feeling stressed while trying to sleep, which usually means laying in bed with racing thoughts or experiencing physical symptoms.
• Feeling exhausted/fatigued during the daytime. This can cause poor concentration and focus, difficulty with memory, and impaired motor coordination.
• Low moods, irritability and difficulty with social interactions.
• Reduced quality of life and increased risk of developing depression, obesity and cardiovascular disease. In fact, some studies show that adults with insomnia are almost four times more likely to become depressed compared to those who don’t have insomnia.
• Decreased job performance and higher risk for motor vehicle crashes, work-related accidents and other occupational errors. All of these increase the odds of experiencing some type of disability.

Causes

Not being able to sleep is highly tied to stress and changes in hormone production and neurotransmitter levels in the brain known to be involved with sleep and wakefulness.

Some of the most common reasons that someone might develop insomnia include:

• Not having healthy “sleep habits,” such as staying up late to work or watch TV. Drinking alcohol and caffeine or eating sugary/processed foods close to bedtime can also disrupt sleep.
• Not sleeping in a very dark or cool enough room. Artificial lights in your bedroom and heat can both keep you up at night.
• Dealing with chronic stress or acute stress due to certain life changes or circumstances.
• Changes in your environment, such as from moving or traveling.
• Not having a regular sleep-wake routine. For example, shift work can disrupt sleep because it interferes with your body’s circadian rhythm. We get the best sleep when we wake up and go to sleep at roughly the same time each day.
• Having a mental health disorder, such as anxiety or depression. Chronic insomnia is considered “comorbid” (a common disorder that happens at the same time as another) and commonly linked to another medical or psychiatric issues.
• Being sick or dealing with a health problem that causes digestive issues during the night.
• Chronic pain that makes it hard to get comfortable, such as low back pain, arthritis or neck pain.
• Sleep apnea and other breathing problems.
• Limb movement disorders.
• Taking certain medications, such as psychotropic drugs and those that cause increased heart rate, nervousness, frequent urination at night, etc. This can include drugs used to treat colds, nasal allergies, high blood pressure, heart disease, thyroid disease, birth control, asthma and depression.

Conventional Treatment

How do you cure insomnia, according to conventional medicine? There isn’t a “cure” for insomnia but rather ways to help prevent and manage it.

Insomnia treatments can be both non-pharmacologic (non-medical) and pharmacologic (medical, such as using prescription drugs). Many experts feel that combining medical and non-medical treatments results in the most successful outcomes.

Some treatment approaches that doctors and therapists may use to manage insomnia symptoms include:

• Cognitive behavior therapy techniques to help address causes of stress.
• Lifestyle changes to promote better sleep patterns. Some of the best insomnia remedies include exercise, eating a healthy diet, and decreasing caffeine, alcohol and drug use.
• In some cases when deemed necessary, use of medications, including benzodiazepine sedatives and non-benzodiazepine sedatives. If your doctor or health care provider determines that you would benefit from medications for insomnia, he or she may prescribe one of the following types of drugs:
  • Benzodiazepines: These are a type of sleeping pill that are used to induce sleep for a long period of time. Possible side effects of these kinds of drugs include withdrawal symptoms, drowsiness during the day, unsteadiness, confusion and memory impairment. Examples of benzodiazepines include Ativan, Valium and Doral.
  • Non-benzodiazepine hypnotics: Non-benzodiazepines (also referred to as “Z drugs”) are sedatives that are used to treat insomnia because they act on the GABA receptor. These types of medications have become the most common prescribed hypnotic agents in the world. Possible side effects of Z drugs include memory loss, physical and psychomotor effects — such as falls or car accidents — fatigue, and withdrawal symptoms. Examples of non-benzodiazepines include Lunesta, Sonata, Ambien, Edluar and Intermezzo.
  • Melatonin receptor agonists: These types of drugs are used to treat insomnia, sleep disorders and depression. These medications bind to and activate the melatonin receptor, helping improve your circadian rhythm and sleeping patterns. A common type of melatonin receptor agonist is Rozerem, which may cause dizziness and drowsiness during the day.
• Use of melatonin, a hormone that is released by the pineal gland in response to darkness that helps regulate the circadian rhythm and sleep-wake cycle.
• Short-term use of antihistamines that have sedative properties, such as diphenhydramine (Benadryl), that induce drowsiness.

Diagnosis

If you’ve been struggling at night to fall or stay asleep, you may want to get tested for insomnia. There is no one definitive test for insomnia that doctors use, but there are signs and clues that can lead to a diagnosis.

If you find that you repeatedly can’t sleep, first discuss potential insomnia causes with your doctor and/or therapist. Let your health professional know about all insomnia symptoms you’re experiencing, including those that are emotional and physical. He or she will likely want to perform a medical exam, talk to you about any recent life changes and discuss your medical history.

Your health professional might also suggest that you take part in a sleep study test. Sleep studies/sleep tests are used to determine if insomnia is caused by conditions such as breathing problems, sleep apnea or limb movement disorders.

An insomnia test (which is called a polysomnography) is conducted at a sleep laboratory that has rooms for you to sleep in for one to two nights. During your sleep, you will be connected to an electroencephalogram and monitored at different stages of sleep in order to indicate how long you spend in deep, restful sleep.

You can also help determine if you may have insomnia by taking an online assessment at home, such as the ones offered by the London Sleep Center or Sleep Education website.

If you are not ready to be monitored for insomnia but you want to keep track of your sleeping patterns, you can keep a sleep log. A sleep log tracks your bedtime and wakeup time. You can also note how many times you woke up and how you feel throughout the day.

This may help your health care provider determine the cause of your insomnia and the extent of your sleep disturbance.

There are also devices that you can wear that will monitor your sleep from home. Although the results won’t be as accurate as what you would receive after an insomnia test in a lab, this can serve as a useful tool if you are unsure about how many hours of sleep you are getting every night.

Natural Remedies

1. Meal Timing

Meal timing can impact your sleep. Try not to go to bed feeling hungry, which may wake you up due to low blood sugar.

On the other hand, you also don’t want to eat right before you sleep. Most people should aim to eat about two to four hours before going to sleep.

2. Eat More of These Foods

You may need to change your diet. It’s surprising to a lot of people to hear that their diets are keeping them from falling asleep, but your diet plays a huge role in normal hormone and neurotransmitter production, which is key in allowing you to feel relaxed and sleepy.

Many people aren’t aware that they suffer from low potassium or have signs of a magnesium deficiency, and both are crucial nutrients you need to help your body feel relaxed so you can sleep.

These are some top foods to help you sleep:

• Foods high in tryptophan — This amino acid stimulates the production of serotonin, which helps promote relaxation. Tryptophan foods include those high in protein, such as turkey, chicken or tuna. It’s best not to over-consume protein to increase tryptophan uptake — the best way to increase levels in your brain is to eat balanced meals that include some complex carbs, protein and fat. Having these with dinner may help you feel sleepier afterwards.
• Complex carbohydrates — Carbohydrates can also help with the production of serotonin, but you don’t want to have simple carbs and sugar that can spike your energy level at night. Try to include starchy veggies like butternut squash or sweet potatoes in your dinner to help release serotonin.
• Foods high in magnesium — Magnesium is known as the “relaxation” mineral — plus it fights muscle cramps and tension headaches that might keep you up. Magnesium foods include green leafy vegetables, sesame and sunflower seeds, raw cocoa, fermented/raw dairy, and oats.
• B vitamins — Organic meat, brewer’s yeast, liver and green leafy vegetables are all foods high in B vitamins, including vitamin B12. B vitamins support the nervous system and some people report that their insomnia symptoms diminish noticeably once they begin taking B-complex vitamins.

3. Eat Less of These Foods

Before you go to bed, drop your carbohydrate and sugar consumption. If you’re consuming too many sugars and carbs at night, your body is burning through those and getting warm, which prevents you from comfortably going to to sleep.

These are the foods and beverages to limit or avoid for better sleep:

• Caffeine — Don’t consume caffeine after noon or at all if you are having difficulty sleeping. In fact, a review of two randomized control trials showed that eliminating caffeine for a whole day was able to improve sleep quality and lengthen sleep duration.
• Alcohol — Stop drinking alcohol at least two hours before bed, and drink in moderation. Try drinking no more than one alcoholic drink per hour and ideally not more than one to two drinks per day.
• Any potential food allergens — Food allergies can cause restlessness, gastrointestinal issues and other symptoms that contribute to insomnia. Avoid food groups like dairy, gluten, shellfish or nuts if they contribute to any discomfort.
• Sugar — Variations in blood sugar levels can cause symptoms of anxiety/nervousness and trouble sleeping. Avoid high-sugar foods, and switch to using organic stevia extract to sweeten foods instead.
• Processed fats — Too much fat at night can slow down digestion and may lead to indigestion. This is especially true if you deal with heartburn/acid reflux at night. Limit fried foods, processed meats like bacon or salami, low-quality cheeses, and other fatty meals before bedtime. Have healthy fats instead like coconut oil, olive oil, ghee or grass-fed butter, avocado, nuts and seeds. Spread your fat intake out throughout the day for help controlling your appetite and energy levels.

4. Reduce Stress

One of the greatest insomnia remedies is reducing stress and promoting relaxation. For most people, along with diet, this is a major culprit for keeping you up at night — your mind starts racing with ceaseless thinking, and you’re seemingly unable to shut your brain off.

There are several ways in which stress may be keeping you up. You might not