I’m Exhausted & Why Can’t I Sleep??

In talking with women about the various aspects of their day-to-day lives, it is not uncommon to hear complaints about a lack of sleep. With this conversation comes talk about exhaustion, irritability, diminished concentration and memory. Sleep is essential in order to maintain physical and emotional well-being, but is frequently overlooked as one of the key elements in our quest for better health.

Women, in particular, are prone to sleep disorders for several reasons. Times of hormonal fluctuation (as in adolescence, pregnancy, menopause, or even the monthly cyclical changes) lead to a biological increase in the requirement for sleep. Ironically, hormonal changes are also often associated with an increase in sleep disturbances, making it all the more difficult to get the restorative sleep needed. Women experience frequent sleep interruptions with babies or children waking during the night, or in waiting for their teenager to get home at night. Women (or men) may have disturbances in sleep which relate to anxiety or depression, drug or alcohol use, sadness or grief, or an overly active mind – perhaps reflecting the over-extended lives we lead! Still, other causes of sleeplessness may include excessive caffeine intake, lack of exercise, smoking, an inconsistent sleep schedule (night shift workers), or even medical conditions such as sleep apnea or restless leg syndrome. Whatever the cause–while many of us will occasionally experience the irksome sleepless night, for some, sleeplessness will become a more chronic and troubling issue.

For those who unhappily experience chronic insomnia, a complete evaluation with a health care provider (and perhaps at a sleep disorders research lab) will be an important first step toward improving sleep. Sleep disorders that stem from a medical condition, depression or anxiety, or drug/alcohol use will necessitate help and treatment around that particular issue which is identified. For many, however, some or all of the following basic strategies may be useful in greatly improving one’s quantity and/or quality of sleep. This is frequently called “sleep hygiene”, and is considered the first line, and most successful form of treatment for most sleep disorders.

  1. Get regular exercise. Exercise releases endorphins, a natural sleep aid. It is most beneficial to exercise late in the day, but not within 3 hours of sleep.
  2. Avoid caffeine entirely, or limit use. Stop consumption within 6 hours of bedtime.
  3. Avoid alcohol, or limit use. Alcohol affects quality of sleep by preventing the deep “delta” sleep which is so restorative and necessary to a “good night’s sleep”.
  4. Avoid smoking. Nicotine is a stimulant.
  5. Keep a regular sleep schedule, as much as is possible. Going to sleep and waking at consistent times leads to a consistent circadian rhythm, which helps the body to remember when to become drowsy and fall asleep, and when to wake up.
  6. Eliminate or decrease fluid intake in the evening, in order to avoid waking during the night with a full bladder.
  7. Complete the day’s activities prior to bedtime, allowing for pure relaxation time in the 2 hours prior to sleep. This should include making a list of the following day’s activities. Then, try reading, listening to music, or watching a non-stressful television program prior to bed.
  8. Try a light, carbohydrate snack in the 2 hours prior to bedtime. Carbohydrate intake leads to the production of serotonin, a natural chemical which increases restorative sleep.

Allow for some time and consistent practice with these techniques before determining whether or not these strategies are useful for you. If after a few weeks of committed effort you do not start to notice improvement in the quality of your sleep, seek the advice of your health care provider.
Occasionally a person may require sleep medication in order to break a cycle of poor sleep. This type of treatment should only be initiated under the care of an experienced health care provider, and should ideally be implemented only for short-term use. Medications used to help induce sleep can be habit-forming, can lose their effectiveness over time, can cause a grogginess or “hangover” effect following use, and can cause”rebound” insomnia with discontinuation. Therefore, the decision to use sleep medication bears careful consideration. Please talk with your provider if you feel that this form of treatment is a necessary part of a plan to help you get the rest you need.

Remember – sleep begets sleep! Start by taking simple steps as illustrated to improve your sleep habits. You may soon notice vast improvements in both your quality of sleep and your overall sense of well-being and health.