What Disrupts Sleep?

     Many factors can prevent a good night’s sleep. These factors range from well-known stimulants, such as coffee, to certain pain relievers, decongestants, and other culprits. Many people depend on the caffeine in coffee, cola, or tea to wake them up in the morning or to keep them awake. Caffeine is thought to block the cell receptors that adenosine (a substance in the brain) uses to trigger its sleep-inducing signals. In this way, caffeine fools the body into thinking it isn’t tired. It can take as long as 6–8 hours for the effects of caffeine to wear off completely. Thus, drinking a cup of coffee in the late afternoon may prevent your falling asleep at night.
     Nicotine is another stimulant that can keep you awake. Nicotine also leads to lighter than normal sleep, and heavy smokers tend to wake up too early because of nicotine withdrawal. Although alcohol is a sedative that makes it easier to fall asleep, it prevents deep sleep and REM sleep, allowing only the lighter stages of sleep. People who drink alcohol also tend to wake up in the middle of the night when the effects of an alcoholic “nightcap” wear off.
     Certain commonly used prescrip­tion and over-the-counter medi­cines contain ingredients that can keep you awake. These ingredients include decongestants and steroids. Many medicines taken to relieve headaches contain caffeine. Heart and blood pressure medications known as beta blockers can make it difficult to fall asleep and cause more awakenings during the night. People who have chronic asthma or bronchitis also have more problems falling asleep and staying asleep than healthy people, either because of their breathing difficul­ties or because of the medicines they take. Other chronic painful or uncomfortable conditions—such as arthritis, congestive heart failure, and sickle cell anemia—can disrupt sleep, too.
     A number of psychological disorders—including schizophrenia, bipolar disorder, and anxiety disorders—are well known for disrupt­ing sleep. Depression often leads to insomnia, and insomnia can cause depression. Some of these psychological disorders are more likely to disrupt REM sleep. Psychological stress also takes its toll on sleep, making it more difficult to fall asleep or stay asleep. People who feel stressed also tend to spend less time in deep sleep and REM sleep. Many people report having difficulties sleeping if, for example, they have recently lost a loved one, are going through a divorce, or are under stress at work.
     Menstrual cycle hormones can affect how well women sleep. Pro­gesterone is known to induce sleep and circulates in greater concen­trations in the second half of the menstrual cycle. For this reason, women may sleep better during this phase of their menstrual cycle. On the other hand, many women report trouble sleeping the night before their menstrual flow starts. This sleep disruption may be related to the abrupt drop in progesterone levels that occurs just before menstruation. Women in their late forties and early fifties, however, report more difficulties sleeping  (insomnia) than younger women. These difficulties may be linked to menopause, when they have lower concentrations of progesterone. Hot flashes in women of this age also may cause sleep disruption and difficulties.
     Certain lifestyle factors also may deprive a person of needed sleep. Large meals or vigorous exercise just before bedtime can make it harder to fall asleep. While vigorous exercise in the evening may delay sleep onset for various reasons, exercise in the daytime is associated with improved nighttime sleep.
      If you aren’t getting enough sleep or aren’t falling asleep early enough, you may be over scheduling activi­ties that can pre­vent you from getting the quiet relaxation time you need to prepare for sleep. Most people report that it’s easier to fall asleep if they have time to wind down into a less active state before sleeping. Relaxing in a hot bath or having a hot, caffeine-free beverage before bedtime may help. In addition, your body temperature drops after a hot bath in a way that mimics, in part, what happens as you fall asleep. Probably for both these reasons, many people report that they fall asleep more easily after a hot bath.
     Your sleeping environment also can affect your sleep. Clear your bedroom of any potential sleep distractions, such as noises, bright lights, a TV, a cell phone, or computer. Having a comfortable mattress and pillow can help promote a good night’s sleep. You also sleep better if the temperature in your bedroom is kept on the cool side. For more ideas on improving your sleep, check out the tips for getting a good night’s sleep below.