"Why can't I sleep?" has become a typical American grievance. Six hours or less of sleep a night is estimated to be the norm for one-third of adults, which can have detrimental effects on health. Insufficient sleep, commonly characterized as fewer than seven hours per night for the majority of adults, raises the risk of heart disease, diabetes, and obesity. A lack of sleep is also linked to slow reaction times, memory problems, headaches, stomach problems, and sore joints.

Sleeping can be challenging for a variety of reasons, such as aging, health issues, lifestyle choices, and poor sleep hygiene. Insomnia and sleep apnea are two more sleep disorders that some people experience.

By taking care of underlying sleep-related problems, making dietary changes, increasing physical activity, and developing healthy sleep habits, people can enhance the quality of their sleep.

Why is sleep important?

Getting enough sleep is important for overall health and wellbeing. Inadequate sleep can have mild to potentially fatal effects, such as weight gain and heart attacks.

You experience partial sleep deprivation when you get some sleep but not all the necessary amount for your body. Most people function at or close to normal after just one brief sleepless night. Even though they might not feel well, they typically get through the day without anyone noticing.

After two or more nights of inadequate sleep, the effects of sleep deprivation on the mind and body become noticeable. Often, irritability and tiredness are the initial symptoms. People start to perform worse at work, especially on complex tasks, and they are more likely to report experiencing headaches, stomach issues, sore joints, memory loss, and slow reaction times. People also run a far greater risk of nodding off while operating machinery or while driving.

When someone has poor sleep for months or years, they are said to have long-term partial sleep deprivation. An increased risk of diabetes, heart disease, stroke, high blood pressure, viral infections, and mental illness can result from this, along with weight gain and cognitive decline.

How much sleep do I need?

How much sleep is necessary for humans? The response differs from person to person. Adults between the ages of 18 and 60 are advised by guidelines to get at least seven hours of sleep each night.

This percentage may vary as people get older. People sixty-one to sixty-four require seven to nine hours, and people sixty-five and beyond require seven to eight hours. However, remember that these are only estimates, and some people might need more or less.

On the other hand, kids require more sleep. Toddlers (one to two years old) should sleep 11 to 14 hours a day (including naps), according to guidelines. School-age children (ages 6 to 12) require nine to twelve hours, while preschoolers (ages three to five) should get ten to thirteen hours (including naps). Teens require eight to ten hours of sleep per night.

Why am I unable to sleep?

Everyone experiences the odd restless night, but persistent difficulty sleeping could be linked to a sleep ailment such as sleep apnea or insomnia.

Having insomnia can cause you to wake up too early, have difficulty falling asleep, or wake up several times during the night. While almost everyone experiences sleeplessness occasionally, not everyone experiences insomnia as a temporary issue. When insomnia occurs three nights a week or more for three months or longer, it is considered chronic.

People with sleep apnea experience brief cessations of breathing while they are asleep. People with apnea have trouble sleeping through the night, which impairs their alertness during the day.

What is insomnia?

The most prevalent type of sleep disorder, insomnia, is characterized by trouble falling or staying asleep through the night. Individuals suffering from insomnia may experience difficulty going to sleep, wakeful moments during the night, and restless nights. Typical signs of sleeplessness include:

Having trouble falling asleep
Occasionally awakening during the night
waking up early in the morning without feeling refreshed
Experiencing fatigue, agitation, and nervousness during the day
difficulty focusing

Short-term insomnia is frequently caused by habits during the day and at night. Some factors that can lead to transient insomnia are:

Anxiety or stress
A shift in sleeping arrangements (such as visiting a hotel or a relative's house)
An uncomfortable place to sleep (too bright, too loud, too cold, or too hot)
An uncomfortable sleeping surface
PJs that are excessively snug
A partner in bed who snores or has irregular sleeping habits
Often, spending extended amounts of time reading or watching television in bed can cause your brain to associate lying in bed with things other than sleeping.
Overindulging in food just before bed
consuming alcohol just before going to bed
excessive caffeine consumption during the day.
Smoking
Working out right before going to bed
Not getting enough exercise during the day
having a hot shower or bath before going to bed
Go to a high altitude or another time zone.

When insomnia occurs three nights a week or more for three months or longer, it is considered chronic and may be brought on by a physical or psychological issue. Among the frequent reasons for persistent insomnia are:

Mental health conditions, particularly anxiety, depression, or PTSD (post-traumatic stress disorder),

Chronic medical conditions, such as asthma, heart failure, or kidney disease

Prolonged discomfort, particularly from cancer, fibromyalgia, neuropathy, acid reflux, or arthritis

Hormone imbalance, particularly in cases of hyperthyroidism or menopause.

Prescription medication with a side effect of insomnia

The disorder known as restless legs syndrome produces uncomfortable sensations in the legs that cause Jerking or twitching movements.

Obstructive sleep apnea

Additionally, pregnant women are more susceptible to sleeplessness. Hormonal changes, heartburn, leg cramps, restless legs syndrome, or an increased need to urinate can all contribute to insomnia during pregnancy. Furthermore, the growing size of the unborn child frequently makes it more difficult for the mother to find a comfortable sleeping position.

Which insomnia treatments can improve my quality of sleep?

The best ways to treat and manage insomnia usually involve making changes to your daily routine and environment that promote sleep. These cover everything from eating habits to sleeping patterns to physical activity. As examples, consider:

Maintain a consistent sleep schedule. Establish a regular bedtime and wake-up time every morning.

On a cozy mattress, wear loose, comfortable clothing while you sleep.

Remove any bright lights or noise sources that interfere with your ability to fall asleep. If you are unable to block out outside noise in your bedroom, you can use pink noise, such as a fan or a recording of rain or waves in the ocean.

Keep the temperature in your bedroom comfortable.
Reduce the number of coffee-containing drinks you have each day.
Don't overeat right before bed.
Get rid of the alcohol. Many become awake after the effects of alcohol wear off. Moreover, alcohol inhibits REM sleep, which is the phase of sleep during which dreams arise.
Every day, try to get in at least four hours of exercise before going to bed.

A psychological or emotional issue, such as recent stressful events, depression, or anxiety disorder, is the cause of nearly half of cases of insomnia. Sleeplessness and depression or anxiety may be correlated, meaning that insomnia exacerbates the mood disorder and the mood disorder fuels the insomnia. The insomnia usually goes away with appropriate treatment of the underlying cause, though it might be more beneficial to treat the mood disorder in addition to the insomnia.

Medication and behavioral therapy are the two main methods used to treat insomnia brought on by these problems.

The first line of treatment for insomnia is cognitive behavioral therapy (CBT), which consists of several behavioral therapies such as:

Relaxation therapy. Specialized techniques to calm the mind and ease tense muscles are called relaxation therapy.

Sleep restriction: a program that gradually increases the amount of time spent in bed after first limiting it to strengthen the drive to sleep.

Reconditioning: A regimen that teaches a person to avoid daytime naps and only go to bed when they are extremely sleepy in order to associate the bed with sleeping (and sexual activity).

You can work with a sleep physician or psychologist to use CBT for insomnia. It can also be completed online with web-based applications created by sleep experts.

Medications for insomnia

Some people find that prescription medications help them sleep, but it's best to use them for as little time and at the lowest effective dose as possible. These include sedative-hypnotics, which help you fall asleep by slowing down brain activity. Related drugs that might aid in falling asleep are benzodiazepines, which are also used to treat anxiety. Both kinds of drugs, nevertheless, have the potential to become addictive or develop habits. Dual orexin receptor antagonists, a more recent class of medication that blocks the action of the neurotransmitter orexin, which keeps people awake, and certain antidepressants, which are usually prescribed in doses lower than those used to treat depression, are other classes of medications that may help treat insomnia.

You can occasionally use over-the-counter sleep aids with an antihistamine as the main active ingredient. When taken as prescribed for short periods, antihistamines are generally safe and sedative, especially when used for allergies. However, they may have unfavorable side effects like nausea and, less frequently, a fast or erratic heartbeat. Adults over 65 are typically not advised to take them due to the possibility of anticholinergic side effects like confusion, dry mouth, or blurred vision. Additionally, they have a quick tolerance-building effect, so the more often you take them, the less likely it is that they will induce sleep.

It is not actually advised to use the sleep hormone melatonin to treat insomnia. It is used to treat sleep timing disorders. However, your doctor may prescribe Rozerem, a melatonin receptor agonist, as a medication that might be helpful.

If your insomnia is a sign of a medical condition, addressing the underlying issue might be all that's necessary. For instance, using a CPAP machine to treat sleep apnea or a specific medication to treat restless legs syndrome can significantly improve the quality of sleep.

What is sleep apnea?

Sleep apnea is a sleep disorder that causes individuals to stop breathing for brief periods of time while sleeping. We refer to these times as apneas. Apneas typically last from ten to thirty seconds. Apneas can occur hundreds of times a night in severe cases.

The most common cause of sleep apnea is a relaxed tongue and tissues in the throat that become trapped in an airway-obstructing position. In response to sleep apnea, your body releases "alarm" hormones that are similar to adrenaline, causing you to wake up and start breathing again. Though frequently people are unaware that they are even waking up, occasionally people wake up and find it impossible to go back to sleep. Although not everyone who has sleep apnea is overweight, obesity is frequently the cause of the condition. Many sufferers of sleep apnea are unaware that they have the condition.

The symptoms of sleep apnea include dry mouth, morning headaches, excessive daytime sleepiness, and loud snoring. A few sleep apnea sufferers also wake up several times during the night to use the restroom. Individuals who do not receive treatment for sleep apnea face a seven-fold increased risk of being involved in auto accidents and experiencing high blood pressure.

Sleep apnea is classified into two types:

Obstructive sleep apnea This form of sleep apnea is significantly more prevalent. It happens when there is a partial or total blockage of the upper airway. Large tongues, tonsils, or airway tissue can obstruct it.

Central sleep apnea. The brain's signal to the diaphragm, the muscle that helps you breathe, is disrupted in central sleep apnea. Atrial fibrillation and heart failure patients are far more likely to have central sleep apnea. It can also happen following a stroke, at high altitudes, or as a result of some drugs, particularly opioids.

The cause of sleep apnea and the efficacy of treatment determine how long the condition lasts. In general, sleep apnea is a long-term condition. This implies that you will have to live with it forever. The course of treatment for underlying neurological or cardiovascular disorders or the ability to discontinue the medication causing the condition will determine how long central sleep apnea patients experience symptoms.

Testing at home or in a sleep lab can be used to diagnose sleep apnea.

How is sleep apnea treated?

A continuous positive airway pressure (CPAP) machine is a common tool used in the treatment of obstructive sleep apnea. Your mouth and nose are covered by a mask, and the machine uses light air pressure to push open your airways so you can breathe easier.

A partial airway closure occurs in some cases of obstructive sleep apnea patients when their jaw shifts backwards while they are asleep. For these individuals, wearing a fitted mouthpiece that keeps the jaw forward at night may be beneficial.

Obese individuals with sleep apnea are not uncommon. Reducing body mass could have a significant impact and, in certain situations, treat sleep apnea.

Some sufferers of obstructive sleep apnea only experience symptoms when they are in a prone position. To prevent rolling onto your back in that situation, try sleeping on a wedge pillow or encircling your waist with a stuffed fanny pack.

Some patients may think about surgery if other treatments don't work. The most popular procedure involves cutting short the soft tissue that hangs down (the uvula) and removing extra tissue from the back of the throat.

A hypoglossal nerve stimulator, which resembles an implanted pacemaker, is an additional treatment option for moderate-to-severe sleep apnea. This procedure involves surgically implanting a pacemaker-like device in the upper chest. Inspire, an FDA-approved device, keeps an eye on your breathing and, if necessary, fires a nerve to keep your tongue from falling backward.

Treating any underlying neurological or cardiovascular conditions may help to solve the issue of central sleep apnea. One possible solution is to stop taking medications that cause central sleep apnea. While some people may benefit from PAP therapy, others may require oxygen or medication.

What are the other common sleep disorders?

Other sleep disorders or conditions such as narcolepsy, parasomnias, periodic limb movement disorder, and restless legs syndrome can also contribute to sleep problems.

Restless legs syndrome (RLS) : Abnormal sensations in the legs (and sometimes the arms) and an overwhelming urge to move them are the symptoms of the excruciating condition known as restless legs syndrome (RLS). For those who have RLS, sleep deprivation poses a serious issue because the condition's symptoms are most noticeable at night or, in many situations, only manifest at that time. Those with RLS symptoms may find it difficult to fall or stay asleep, which makes getting in and out of bed frequently necessary.

Periodic limb movement disorder (PLMD): A neurological disorder known as periodic limb movement disorder (PLMD) makes people kick and jerk their arms and legs all night long. Their arm and leg muscles contract involuntarily every 20 to 40 seconds, which can result in brief arousals and hundreds of repetitions throughout the night. There may be brief episodes or long-lasting ones, interspersed with peaceful slumber. Usually, they cluster during the first part of the night rather than happening all at once.

Parasomnias are unusual behaviors that some people exhibit while sleeping, such as sleepwalking and sleep eating. Individuals who suffer from parasomnias may awaken sufficiently to perform intricate tasks but not sufficiently to comprehend what they are doing.

Narcolepsy is a condition that alters the sleep-wake cycle. Extreme daytime sleepiness episodes and unexpected sleepiness at inappropriate times are common in narcoleptics.