Experts tell why your daytime activities may be causing insomnia at night
Reviewed By Louis Chang, MD
Tick tock, tick tock, tick tock. You stare in the dark at the numbers glaring back at you on your alarm clock. It is 3 a.m., and the makings of another night of interrupted sleep and frustration are apparent. As you contemplate what is wrong with you, think about this: It may be what you do during the day that's giving you insomnia at night.
Sleep is one of the most important needs in life. All creatures need it to function. Without it, we break down mentally and physically. Lack of sleep can cause moodiness, lack of concentration, and sluggishness. But why is it so essential? Researchers still don't know.
Regardless, Americans with their jam-packed schedules often try to delay sleep as much as possible and may unknowingly do other things that could hinder sleep when they actually do want it. In fact, diet and other lifestyle habits could be secretly sabotaging efforts to get a few much-needed ZZZs.
"We know that certain foods that we consume can interfere with sleep, says Carl E. Hunt, MD, director of the National Center on Sleep Disorders Research at the National Institutes of Health in Bethesda, Md. "The most obvious one in terms of stimulating wakefulness would be caffeine, and then there's nicotine."
Nearly half of Americans report having insomnia at least on occasion, according to the National Sleep Foundation. Adults need an average of eight hours of sleep to function well. Older people tend to need a little less -- about 7.5 hours. It's estimated that nearly half of people over age 65 have sleeping difficulties. This can stem from changes in lifestyle, such as napping more during the day, discomfort from physical conditions, such as arthritis, and emotional difficulties and depression.
But lifestyle habits can play a leading role in quality of sleep, too, or lack thereof. So the first thing you should do is analyze your patterns and environment. The Cleveland Clinic recommends these tips for good sleep "hygiene":
- Not going to bed until you are tired
- Setting a regular schedule to get up in the morning, even on weekends
- Not napping during the day
- Avoiding caffeine, alcohol, and nicotine at night
- Not watching TV, eating, or reading in bed
- Following the same bedtime rituals each night
- Avoiding rigorous exercise three hours before bedtime
- Getting out of bed when you can't fall asleep
The list includes some major sleep bandits: caffeine and nicotine.
Caffeine late in the day is a no-no -- that includes items such as chocolate, teas, and sodas. But it's not always obvious where caffeine lurks, says Hunt, so make sure to check food labels.
"Everyone is aware that coffee can keep them awake; what they're not necessarily appreciating is there's caffeine or related items in many other things that they consume," he tells WebMD.
The National Sleep Foundation reports the effects of caffeine can cause problems falling asleep as much as 10-12 hours later in some people.
Nicotine often falls below the radar screen when it comes to sleep interruption, but it, like caffeine, is actually a stimulant. Research shows that nicotine is linked to problems with insomnia. Hunt says smoking within a few hours of bedtime should be avoided; better yet, don't smoke at all.
Spicy and acidic foods can also kill sleep efforts because they cause heartburn. Heartburn is especially problematic for people with gastroesophageal reflux disease (GERD), also known as acid reflux. Why is eating these foods close to bedtime such a concern? Lying down makes heartburn worse, and the discomfort from heartburn hinders sleep.
But what about the old standbys -- such as drinking warm milk or having a nightcap -- to lull us to sleep? Do they truly work?
Milk contains a substance called tryptophan. The body uses this substance to make serotonin, a neurotransmitter in the brain. Serotonin helps control sleep patterns, appetite, pain, and other functions but unfortunately doesn't contain enough tryptophan to change our sleep patterns. However, Hunt says some people say it works and doesn't knock trying it.
Alcohol is a tricky substance: It's an undercover sleep marauder. It's also the most common self-medicated sedative, Hunt tells WebMD. Contrary to popular belief, that seemingly harmless nightcap before bed may be relaxing at first but has a rebound effect and can cause you to wake up in the wee hours of the night. So if you want some quality shut-eye, it's best to just say no.
If worse comes to worst, a sleeping pill could help. Sleeping pills are safe and effective in moderation. But doctors caution they are not a long-term solution for insomnia but merely a Band-Aid for the symptoms. A doctor may prescribe sleeping pills on a short-term basis for patients who are having a stressful period in their life, such as coping with the death of a loved one. Hunt also says natural remedies such as melatonin or valerian (sold in health-food stores) may provide some relief. But check with your doctor first -- some supplements can interfere with your regular prescription medication.
Don't Forget Exercise -- in the Daytime
While exercising close to bedtime can undermine your best efforts to sleep, doctors say regular exercise during the day can do wonders. Exercise can keep weight, blood pressure, and cholesterol in check, staving off other health conditions that can hinder sleep. It also boosts energy levels during the day and can help give you more restful sleep. Exercise can also relieve stress, another major cause of insomnia.
Hunt says you shouldn't exercise less than three hours before bedtime because exercise has an alerting effect. It also raises your body temperature. This rise leads to a drop in temperature five to six hours later, which makes it easier to sleep at that time. This may be why exercising in the late afternoon may be ideal -- and evening not.
This is more reason to go out and make the most of your day so a good night's sleep will be more than just a dream.
SOURCES: Carl E. Hunt, MD, director, National Center on Sleep Disorders Research, National Heart, Lung, and Blood Institute, Bethesda, Md. The Cleveland Clinic. The National Sleep Foundation.
Published Nov. 1, 2004.
Medically updated March 9, 2006.
© 2004 WebMD, Inc. All rights reserved.