Insomnia: feel tired but can’t sleep?

Feeling tired but can’t sleep? Our Chief Medical Office Dr Yasmine Nemazee shares the scoop on what exactly insomnia is, the effect it can have on your life and why feeling tired is not always directly related to not getting enough sleep.

It’s past 11pm and I’m tired. I haven’t been sleeping well for the past few nights because of jetlag and a sick child. But I have a deadline to meet so I’m staring at my screen while lying in bed, which, if you keep reading, you will see is exactly what not to do!

What is Insomnia?

Insomnia is a disorder of sleep regulation that can make it hard to fall asleep, stay asleep or get back to sleep if you wake in the middle of the night. In most cases this happens despite having plenty of opportunity for good quality ‘shut eye’.

The most obvious impact of insomnia is on your energy and mood, but there are some underlying health risks that insomnia can present and the effect on your work and overall quality of life can be immense.

Sadly most of us will have experienced sleepless nights at some point in our lives. All too often this is the product of high levels of stress or suffering a traumatic event. In turn, the lack of sleep often exacerbates the issue causing more stress. In fact, The American Psychological Association reports that over 40% of adults have reported lying awake at night due to stress and many report that the stress increases as the length and quality of their sleep decreases.

What causes insomnia?

Common causes of insomnia due to stress include all sorts of things from simple day to day concerns over work, finances, relationships, or children and then to more serious trauma such as death of a loved one, divorce or job loss. Taking time to work through these problems and talk to a professional can be an important part of taking care of your overall wellbeing.

Beyond stress, changes to your nighttime routine can be caused by medical problems. These can include thyroid disease, restless leg syndrome, sleep apnea, reflux and menopause are all good examples. The use of stimulants (such as nicotine or caffeine) and changes in your sleep cycle caused by shift work or jet lag also have an impact.

People often take sleep for granted, but it is as important to your health as diet and exercise. Untreated, chronic sleeplessness can lead to irritability, depression and anxiety; reduced focus and memory problems; an increased risk for errors and accidents and ongoing worrying about your sleep.

When your sleepless nights become chronic those issues can become more pervasive and translate into poor job or school performance, higher risk for mental health disorders. Insomnia increases risk for certain diseases like obesity, high blood pressure and heart disease.

Unfortunately insomnia does become more common as we get older. Those above 60 are at greater risk for sleep problems as are women.

If you feel you are tired despite getting enough sleep that can be a sign of an underlying condition. Depression, hormone dysfunction, and anemia are all examples of medical conditions that can lead to fatigue and low-energy.

How can you avoid insomnia?

Some simple interventions that promote good sleep habits (or sleep hygiene, as we call it in the medical world) can be useful in treating and preventing simple insomnia:
• Keep your bedtime routine consistent
• Be active – exercise promotes good sleep
• Avoid or limit naps
• Avoid or limit stimulants
• Try not to eat or drink in large amounts before sleeping
• Use your bedroom only for sleep and intimacy and keep work and other distractions outside of your room
• Ensure your bedroom environment is conducive to sleep – control the light, temperature and noise levels so that you are comfortable
• Avoid using your phone or other devices that give off light before bed and be sure to turn them off or to silent when you are going to sleep

If, despite these interventions, you remain sleepless or tired despite getting enough sleep, be sure to visit your doctor to be sure there is no underlying condition keeping you from getting those coveted 8 hours.

Now, if only I could follow a bit of my own advice…!

Dr Yasmine Nemazee, Health at Hand Chief Medical Officer

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