Why You Can’t Sleep



Published:

So you have a love-hate relationship with the Sandman? Are you one of the chronically tired that hits the snooze button multiple times in the morning? You’re hardly alone. About 70 million of us don’t get enough sleep, and nearly 10 percent experience chronic insomnia—trouble falling or staying asleep, according to the Centers for Disease Control and Prevention.

“In our busy society, we don’t view sleep as a priority,” says Dr. Oswaldo Nicastro, medical director of Delaware Family Medicine at St. Francis Hospital in Wilmington.

Indeed, getting a good night’s sleep has never been so tricky. So what’s keeping us up with the moon and the stars? Let’s count the reasons.

Worrying over sleep. Experts call it psychophysiologic insomnia, and it’s a nightmare for the working professional. Here’s what happens. You settle into bed and begin to stress over what you have to do the next day: that important early morning meeting, a project deadline or a job interview. You know you need to sleep to be at your best, but you toss, you turn and watch the clock tick away the hours. Actually, worrying about sleep is the best way not to sleep, experts say. When going to bed, it’s crucial to calm your mind and put the day on hold.

“I tell my patients to find 20 to 30 minutes after dinner when they can sit down and mentally go through what they’ve accomplished and what they need to get done tomorrow to help get it out of their heads before they go to sleep, or else it will prevent them from sleeping,” says Christiana Care neurologist Dr. Lisa Leschek-Gelman.

Conditioned or “Learned” Insomnia. Sitting in bed and watching TV, reading, texting or working on the computer might not seem like a big deal, but it can cause your mind to associate your bed with activities other than sleep. And the more mentally stimulating the activity, the more likely you’ll stay awake. “The bedroom should be used only for sleeping and sex,” says Bayhealth critical care physician and sleep specialist Dr. David Jawahar.

Caffeine. Wonderful as it is, caffeine’s kick can last way beyond that morning cup of joe. In fact, it can take six hours—more if you’re pregnant or you smoke—for your body to eliminate just half of what you’ve consumed, meaning there will plenty of it in your system when it’s time for shuteye. More than half of all American adults consume more than 300 milligrams of caffeine every day, making it America’s most popular drug, according to a study by Johns Hopkins University. And beverages aren’t the only culprits; chocolate and drugs containing the stimulant can rev you up as well.

Alcohol. Some people think a stiff drink will give them a good night’s sleep, but using booze to snooze doesn’t work, experts say. Indeed, research shows that while alcohol may make you feel drowsy, it greatly reduces the quality of sleep. “It can make somebody sleep in a very light state,” says Leschek-Gelman. “And the two stages of sleep people need the most are deep sleep and dreaming sleep.”

Exercise. Although research has shown that physical activity can reduce or even cure insomnia, too much of a good thing can be counterproductive. Exercise raises levels of stress hormones that can keep you awake at night, especially if you schedule intense workouts in late afternoon or evening, says Jawahar.

Age. Like everything else, sleep changes with age. Research shows that older individuals suffer from advanced phase disorder, meaning they fall asleep earlier, spend less time in deep restorative sleep and wake up earlier. “As you age, you tend to have less a requirement for sleep, however you tend to sleep more,” says Nicastro. “You find the aging population napping more, taking the famous siesta.”

Being a woman. Hormonal shifts during the menstrual cycle and pregnancy can cause sleep disturbances. During perimenopause, hot flashes and night sweats can disrupt sleep. In addition, women tend to suffer more from disorders that cause secondary insomnia, including depression, anxiety, fibromyalgia and some sleep disturbances, such as restless leg syndrome, says Nicastro.

Eating and drinking. Eating a big meal or something exotic too close to bedtime can result in indigestion or acid reflux, making it difficult to sleep. Filling up on fluids can cause frequent urination, further disrupting sleep. Jawahar recommends snacking on light fare a couple of hours before turning in to take the edge off evening hunger.

Environment. Everything from a sagging mattress to the temperature and color of your bedroom can affect your ability to get a good night’s sleep. Light can also be an issue, including the dim LED light coming from a digital alarm clock. “Light—any kind of light—is a sensory mechanism that impacts your brain, altering your sleep,” says Nicastro. He recommends turning the clock around so the light won’t get through your eyelids and using night lights with just enough illumination to allow you to safely navigate your surroundings.

Changes in work schedule. Travel or working a late-night or early-morning shift can disrupt your body’s circadian rhythm, the internal clock that regulates such things as the sleep-wake cycle, metabolism and body temperature. “Shift-work insomnias are very common,” says Nicastro. “But by fixing the drapes to darken the room, people can train their bodies to feel like it’s nighttime, restoring their circadian rhythm.”

Medical conditions. Individuals with chronic pain, breathing difficulties, neurological disorders, hyperthyroidism, cardiovascular disease or the need to urinate frequently can develop insomnia. Depression, anxiety and other mental illnesses can also disrupt sleep. In addition, many chemicals affect both the quantity and quality of sleep, including antihistamines, decongestants, beta blockers, alpha blockers and antidepressants.

Sleep-related disorders. There are more than 80 conditions that can affect the quality of sleep but the most common is obstructive sleep apnea. Obstructive sleep apnea occurs when the walls of soft tissue at the back of the throat collapse, blocking the passage of air until the airway opens—often with a loud choking or gasping sound—and you breathe again.

Treatment usually involves fitting the patient with a device supplying continuous positive air pressure to keep the airway open during sleep.

Untreated sleep apnea is associated with a number of health concerns, including daytime drowsiness, obesity, hypertension, heart disease, stroke, dementia and depression. Recent research has linked it to an increased risk for developing cancer. Unfortunately, most people don’t seem to take sleep apnea seriously. Eighty percent to 90 percent of cases go undiagnosed, according to the American Academy of Sleep Medicine.

That’s where Dr. Ray Lynch comes in. Lynch is director of Sleep Disorders Management in Wilmington, the state’s only out-of-center sleep testing service. The facility recently received accreditation from the American Academy of Sleep Medicine for its home testing service.

“It’s always better to test (patients) in their home where they’re comfortable and can get their best night’s rest,” says Lynch, who was diagnosed with obstructive sleep apnea 14 years ago.

Men are generally thought to experience sleep apnea more than women, but a recent study by Swedish researchers suggests that a high percentage of women experience the condition as well. Women like LeeAnn Simmons.

Simmons, who has a family history of sleep apnea, thought she might be affected when she awoke one night 10 years ago with her heart racing for no apparent reason. She got tested, but the results were negative. “They told me it was ‘positional snoring,’” says the 54-year-old from Woodstown, N.J.

But within the past five years, she noticed her snoring was getting worse and she struggled to get up in the morning. “I did caffeine all day long just to stay awake,” she says.

Simmons decided to re-test when Lynch visited her workplace with his mobile physician unit. This time the results were positive. “They told me that at one point I stopped breathing for 40 seconds,” she says.

Simmons was given a CPAP device to wear during sleep. She calls the results “remarkable.” She awakens feeling refreshed and hopes she can eventually reduce or even eliminate the medications she takes to treat her hypertension and depression.

“It’s a shock the first time you put it on, but once you see how good you feel, you’re glad to put it on,” she says.

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May 2018

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Telephone: 302-654-8638
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Telephone: 302-654-8638
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Cost: free

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Telephone: 302-577-8283
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Cost: free

Where:
The Station Gallery
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View map »


Telephone: 302-654-8638
Website »

More information

Mary Pritchard is an award winning pastel artist from Chestertown, Maryland. Following a career in education administration at the University of Delaware, Mary returned to painting full-time....

Cost: free

Where:
The Station Gallery
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View map »


Telephone: 302-654-8638
Website »

More information

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Cost: free

Where:
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View map »


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Cost: Included with general admission ($5-20)

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More information

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Cost: Free

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820 N. French St.
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View map »


Sponsor: Delaware Division of the Arts
Telephone: 302-577-8283
Contact Name: Roxanne Stanulis
Website »

More information

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Cost: free

Where:
The Station Gallery
3922 Kennett Pike
Greenville, DE  19807
View map »


Telephone: 302-654-8638
Website »

More information

Mary Pritchard is an award winning pastel artist from Chestertown, Maryland. Following a career in education administration at the University of Delaware, Mary returned to painting full-time....

Cost: free

Where:
The Station Gallery
3922 Kennett Pike
Greenville, DE  19807
View map »


Telephone: 302-654-8638
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Mary Pritchard is an award winning pastel artist from Chestertown, Maryland. Following a career in education administration at the University of Delaware, Mary returned to painting full-time....

Cost: free

Where:
The Station Gallery
3922 Kennett Pike
Greenville, DE  19807
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Telephone: 302-654-8638
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A needle's eye in a pond, a Greek temple in the garden, an Ottoman tent sitting on a hill—these are just a few of the inspirations for our upcoming, first-ever outdoor exhibition Follies:...

Cost: Included with general admission ($5-20)

Where:
Winterthur Museum, Garden & Library
5105 Kennett Pike
Wilmington, DE  19807
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Sponsor: Winterthur Museum, Garden & Library
Telephone: 800.448.3883
Contact Name: Information and Tours
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THE FIGURE: THE INDICATIVE AND THE ALLUSIVE Group Exhibition  April 1 - August 26, 2018 Opening Reception: Friday, April 6, 2018 | 5 - 9 PM during Art Loop with Panel Discussion: 6 - 7 PM...

Cost: FREE

Where:
The Delaware Contemporary
200 South Madison Street
Wilmington, DE  19801
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Telephone: 302-656-6466
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GUARDIANS OF THE IMAGE MAKER Group Exhibition & Programs Commemorating The 1968 Riots April 6 - June 29, 2018 Opening reception: Friday, April 6, 2018                      5 - 9 PM...

Cost: FREE

Where:
The Delaware Contemporary
200 South Madison Street
Wilmington, DE  19801
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Telephone: 302-656-6466
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Glory of Stories introduces young visitors to art and the Museum through a story reading followed by an interactive tour of relevant works of art and a studio art project. This program encourages...

Cost: Free to Members, $5 per child and one adult free for Non-Members

Where:
Delaware Art Museum
2301 Kentmere Parkway
Wilmington, DE  19806
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Meeting every Friday, Bayhealth Kent General Hospital, 640 s. State Street, Dover, 7:30 pm., Private Dining Room #3 in the basement. For those who have, or think they may have a gambling problem....

Cost: 0.00

Where:
Bayhealth Kent General Hospital
640 S. State Street
Private Dining Room #3
Dover, DE  19901
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Telephone: 800-855-2CALLGA
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The 11th annual Artisans Fair, featuring unique handcrafted art objects, will be from 9 a.m. to 3 p.m. Saturday, May 26, at Lord Baltimore Elementary School on Route 26 in Ocean View, DE. ...

Cost: Free

Where:
Lord Baltimore Elementary School
Route 26
Ocean View, DE  19970
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Sponsor: South Coastal DE AARP Chapter
Telephone: 302-732-6336
Contact Name: Ida Crist
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GUARDIANS OF THE IMAGE MAKER Group Exhibition & Programs Commemorating The 1968 Riots April 6 - June 29, 2018 Opening reception: Friday, April 6, 2018                      5 - 9 PM...

Cost: FREE

Where:
The Delaware Contemporary
200 South Madison Street
Wilmington, DE  19801
View map »


Telephone: 302-656-6466
Website »

More information

THE FIGURE: THE INDICATIVE AND THE ALLUSIVE Group Exhibition  April 1 - August 26, 2018 Opening Reception: Friday, April 6, 2018 | 5 - 9 PM during Art Loop with Panel Discussion: 6 - 7 PM...

Cost: FREE

Where:
The Delaware Contemporary
200 South Madison Street
Wilmington, DE  19801
View map »


Telephone: 302-656-6466
Website »

More information

A needle's eye in a pond, a Greek temple in the garden, an Ottoman tent sitting on a hill—these are just a few of the inspirations for our upcoming, first-ever outdoor exhibition Follies:...

Cost: Included with general admission ($5-20)

Where:
Winterthur Museum, Garden & Library
5105 Kennett Pike
Wilmington, DE  19807
View map »


Sponsor: Winterthur Museum, Garden & Library
Telephone: 800.448.3883
Contact Name: Information and Tours
Website »

More information

Science Saturday – River Rangers River Rangers learn how to gauge the health of our local waterways by observing the variety of critters living in it. Visitors of all ages are invited to...

Cost: Activities are included in regular admission and free for members.

Where:
Hagley Museum
201 Hagley Creek Road
Wilmington, DE
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Sponsor: Hagley Museum & Library
Telephone: (302) 65802400 x 238
Contact Name: Jessica Eisenbrey
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