Health

Why You’re Not Sleeping—And How To Fix It

Is there a miracle cure for sleepless nights? Dr. Eva Libman, sleep specialist at Montreal’s Jewish General Hospital, looks at some popular sleep issues.

I lay in bed staring up at the suspicious spot on the ceiling. Spider? Cobweb? A crack in the plaster? Each option came with its own implication, and I spent hours traveling down every path. I turned and glanced at the clock–3:11 a.m. I listened, and heard nothing. Everyone was asleep. My husband beside me, the two dogs at our feet, and most importantly, our nine-month-old son. He’d been sleeping through the night consistently since he was 12 weeks old. So why was I wide awake?

I don’t function well without rest. I have never met a nap I didn’t like. Yet for nine months, I lay night after night, examining the ceiling. When I inevitably broke down in tears in my doctor’s office, she sent me to a Montreal psychologist at the Jewish General Hospital who specializes in sleep, Dr. Eva Libman. I had developed insomnia.

In my case, there were a few issues at play. One of them, funnily enough, was that I hated my husband for being able to sleep so easily. I could hold a screaming baby to his ear and he’d snore away, while I worked myself into such a rage that there was no way I’d be able to relax enough to fall asleep myself. I can say “funnily” because we laugh about it now, but then? Well, I was in therapy.

My bigger issue was anxiety. My whole life I’d been a worrier, but I could spread out the worry during daylight hours. Once my son came along, I was too busy during the day for anything but him. Once everyone was asleep, the hamsters went wild on their wheel. Dr. Libman taught me how to stop my brain from processing so that I could get some rest at night. It was life changing. I went from months of insomnia to sleeping through the night after just a few short sessions. That was over a decade ago, and to this day her techniques work when I’m having trouble.

Here’s Dr. Libman on the reasons why so many aren’t getting a good night’s rest—and what can be done about it.

Issues Affecting Our Sleep

Yes, some people are solid sleepers while others are more sensitive, but anyone can get tipped into having problems. We’re a society that values work, family, success, and the dream of having it all. That doesn’t leave much time for sleep. Common issues include:

Anxiety and Depression

“Anxiety and depression are frequent contributors to poor sleep, but they’re often also the consequences of poor sleep quality,” Libman says. It’s a vicious cycle and it’s often helpful to treat the sleep issue before the underlying cause. I’m on anxiety medication now, and it’s helped my sleep a lot.

Stress

Stress usually has a more specific cause than generalized anxiety and depression, in that there’s a clear external factor at play. But stress is also a physical/psychological predisposition that may result in sleep disturbance. Coping means attacking the underlying cause at the same time as the sleep issues.

Trauma

Trauma can also affect sleep in different ways, from difficulty falling asleep, to darkness-related anxiety, to nightmares once asleep. Again, it’s best to manage the two issues in parallel, dealing with the traumatic incident as well as the associated disrupted sleep.

Hormones

“If women come in around the right age and tell me they’ve never had trouble sleeping before and now suddenly they can’t sleep… it’s often menopause,” says Dr. Libman Hormonally induced sleep problems can often be treated with a short dose of low-level HRT. Pregnancy is another frequent cause for sleep disturbances. “Early in the pregnancy it’s daytime sleepiness/fatigue,” Libman says. “Later it can be anything from physical discomfort to psychological concerns.” The good news is something can almost always be done, tailored to each person’s situation.

How To Fix It

First, the bad news. “There’s no one-size-fits-all solution,” says Dr. Libman. Everywhere you turn there’s talk of proper “sleep hygiene”—exactly how to behave before bedtime—and the magic number of hours one needs in order to function as a normal human being. But according to the good doctor, “sleep is involuntary. You have no control over it.” However, there are things you can do to make getting there easier. Cognitive Behaviour Therapy (a therapeutic approach focused on altering unhelpful thoughts and behaviours)  is the most-used tool in the sleep specialist’s kit. The goal is to get the muscles of the body relaxed and the mind feeling calm and peaceful.

Routine

“Don’t just get into bed and expect to fall asleep,” says Dr. Libman. “We have bedtime routines for little kids, why not for big people?” If you do the same thing at the same time every day, your body will figure out what’s coming, and what it’s meant to do.

Watch your intake—maybe

Cutting down on alcohol and caffeine might help, but don’t get anxious about giving up rituals that you enjoy. “People come in and say, ‘I’ve cut out coffee completely’ or ‘I don’t have a glass of wine with dinner anymore’ because these things are on The List [of good sleep hygiene],” Libman says. “I wouldn’t recommend a double espresso before bedtime, but for some people, it just doesn’t make a difference.” Adjusting what you’re drinking is worth trying, but it’s not guaranteed to help.

No screens

“The bright light undermines our melatonin, so there’s a direct physiological effect,” says Libman. “Texting, gaming, Facebook are highly alerting activities not conducive to the relaxed state we’re aiming for to promote good sleep.” Try reading by soft lighting and disconnecting from the outside world. Practice some yoga breathing or muscle relaxation. If you must watch TV, dim the screen or wear sunglasses.

Find comfort in what you can control

A huge part of my battle was learning that it wasn’t the end of the world if I missed a night’s sleep. I literally turned my clock around so I couldn’t see it at night. If I wasn’t tired, I’d get out of bed and do something else, since Dr. Libman explained that it was important to associate bed with sleep, not staring at the ceiling. Doing these things helped me take back a sense of control. But try not to turn on the TV—she suggested listening to something that was interesting enough to prevent my own thoughts, but not so interesting that I’d want to stay awake to hear the end. Talk radio turned out to be enough to quiet my mind, but not enough to keep me from nodding off.

Don’t count the hours

“Sleep patterns follow a normal distribution curve,” Libman explains. “Sure, at the top of the curve you have the people with seven to eight hours a night, but at either end you have those with three to five hours, or 10 to 12. And for those people, that’s their normal. So, I’m loath to assign a number. It just makes people nervous.”

For me, Dr. Libman’s help was life changing. With the proper amount of quality sleep, I became a different person, someone I like much better. What worked for me might not work for everyone, but keep trying—I’m almost positive that something else will.

“It’s different for everyone,” Libman says. “But be comforted in knowing that the sleep will take care of itself. You just need to learn how to relax.”

FILED UNDER: