Health & Wellness

Causes of Sleeplessness (+ 5 Home Remedies for Sleep)

I love a good night’s sleep. And my family will be the first to tell you that I am not a happy camper in the morning when my night consists of tossing and turning. I have struggled with periods of insomnia throughout my life and I know how frustrating it is. The good news is that with some patience and a consistent routine, you can identify the causes of sleeplessness and get those dreamy nights of sleep back, just like I did! And now, on occasions when I’m unable to sleep, I try a few home remedies for sleep that help me get restorative rest.

So, where do you start? Well, there are many causes of sleeplessness. Let’s discuss the different types of insomnia and other sleep disorders as well as some causes you may not have considered. I also share some easy, evidence-based ways to help you improve your sleep.

 

What Is Insomnia?

Insomnia simply means difficulty falling asleep or staying asleep. While we all have occasional nights when we don’t get restful sleep, insomnia is a sleep problem that is more ongoing. And I believe it’s only becoming more common as we continue to surround ourselves with increasing demands and technology. It is slowly becoming an epidemic in our society.

Let’s start to tackle this growing problem by reviewing the causes of sleeplessness—the different types of insomnia.

Types of insomnia: [1]

Short-term insomnia: As the name implies, this is a brief form of insomnia. It occurs in about 15 percent to 20 percent of people and lasts for up to about three months.

Chronic insomnia: About 10 percent of people have this longer-lasting form of insomnia. Sleeplessness usually about three times a week and the condition lasts for at least three months.

Benzodiazepines (such as Xanax or Valium) or certain non-benzodiazepine are commonly prescribed as sleep aids. Benzodiazepines are sedatives that were originally intended for short-term use only. Long-term use of these drugs can result in serious side effects and even cause rebound insomnia and withdrawal symptoms once you stop taking them.

Non-benzodiazepine drugs such as zolpidem (brand name Ambien) and other similar drugs have been known to cause serious side effects as well, including dangerous episodes of sleepwalking (for example, driving a car while “technically” asleep). These incidents have occurred because these drugs don’t induce normal sleep patterns.

In fact, my patients have shared some unbelievable stories about getting up in the middle of the night after taking Ambien and cleaning the house, driving to the store, or making meals on the stove—and they do not recall any of it in the morning. That means that they were not in a restorative sleep state after taking this medication. Instead, they were essentially “awake” and behaving as such. Scary, right?

Now, I understand that you are likely at a point of desperation after periods of minimal sleep, but try to take a step back and consider your holistic health picture before picking up these prescriptions. There are numerous studies on the higher mortality rate associated with these medications, so they should be approached with caution.

 

How Does Sleep Work?

Sleep is just as important and vital to survival as food and water. While its “biological purpose” isn’t yet fully understood, we do know that sleep is critical for virtually every system in your body. Your brain and nervous system, heart, lungs, and immune system all rely on getting enough quality sleep to function properly.

Without adequate sleep, the risk of disease increases, particularly for chronic conditions like high blood pressure, depression, diabetes, and obesity.

Sleep is actually part of your parasympathetic nervous system, which is essentially when your body is calm and performing daily functions such as digestion, toxin removal, and cellular repair. In this day and age of technology and cell phone attachment, we are continually stimulating our sympathetic nervous system, the “fight-or-flight” mode where the body ceases regular function and reacts to stimulation. As a result, we are adapting to this stimulation and spending less time in a calm state.

So, what does this do?  It results in poor digestion, anxiety, fear, anger, sense of urgency, and, of course, poor quality of sleep. By using the medications mentioned above to force sleep, you are not addressing the issue in your nervous system. I relate this to my “bear scenario.” In my opinion, taking prescription sleep aids is like being forced to sleep while your mind is still racing, worried about the bear. This means the sleep is non-restorative and you become dependent on the mediation to knock you out. The problem is that when you remove the medication, the underlying sympathetic nervous system will kick back in, resulting in more stimulation (or rebound insomnia).

 

The Stages of Sleep

Sleep occurs in stages. These stages fall under two types of sleep: rapid eye movement (REM) and non-REM. Non-REM occurs in three stages. The body repairs itself and strengthens the immune system during REM sleep.

As you age you spend less time in REM sleep. While people under 30 years old get about two hours of deep sleep per night, those over 65 only get about 30 minutes.

REM occurs in the last stage. The percentage of this type of sleep is highest during infancy and childhood and declines as we age. [2]

Here are brief descriptions of the sleep stages: [3]

  1. Stage 1. This is a light non-REM stage of sleep that only lasts a few minutes. It occurs as you begin to fall asleep. As your brain waves begin to slow down as they transition from wakefulness to sleep, your heart rate and breathing also slow and your muscles relax.
  2. Stage 2. During the second non-REM stage, your heartbeat and breathing slow and your muscles continue to relax as your body temperature drops. Your eye movements stop during this stage and your brain activity slows down yet has short periods of electrical activity. You spend more time in this stage than the others.
  3. Stage 3. The third non-REM sleep stage is critical because this is the period of deep sleep that allows you to feel rested when you wake up. At this stage, you are fully relaxed and your heartbeat and breathing are at their lowest levels.
  4. REM sleep. This occurs after about 90 minutes of sleep and it is the stage when you dream the most. Your arms and legs are temporarily paralyzed to stop you from acting out your dreams. This stage is called REM because your eyes move quickly under your closed eyelids. Your breathing gets faster and may become irregular. Your blood pressure and your heart rate increase, similar to levels when you are awake.

 

Key Neurotransmitters for a Good Night’s Sleep

Several neurotransmitters or hormones are important to ensure that your body gets the rest it needs. Here are four of the key hormones you need to get a good night’s sleep:

GABA (gamma-aminobutyric acid)

GABA calms the body and it’s crucial for sleep. Lower levels of GABA have been linked to major depressive and anxiety disorders. Some medications that are often prescribed for sleep, such as benzodiazepines like Xanax and non-benzodiazepines such as sedatives like zolpidem (brand name Ambien), affect GABA. Chronic use of these medications lower our ability to make more GABA on our own, which will absolutely worsen not only insomnia but other health conditions as well.

Serotonin

The amino acid tryptophan is converted into serotonin, along with the help of some key vitamins and minerals. Although often associated with depression, serotonin also helps to regulate sleep as it goes on to make melatonin. Low levels of serotonin can cause difficulty in sleeping.

Cortisol

Cortisol is a hormone that is released to divert the body into a sympathetic “fight-or-flight” state. It’s also critical in our sleep/wake cycles. If you are surrounding yourself with constant stimuli, the cortisol rhythm will change course, resulting in higher-than-normal levels in the evening hours. This will commonly impact your ability to fall asleep. It can also jolt you awake in the middle of the night (often between 1 and 3 a.m.), and make you unable to fall back asleep easily.

Melatonin

Your body needs to produce enough serotonin to in turn make melatonin. If your body has enough serotonin to make melatonin, levels of cortisol are reduced and you will sleep. Without enough serotonin and melatonin, your cortisol level will be impacted and it will be difficult to sleep. Conversely, having higher cortisol levels will impact melatonin production. Many people take melatonin to help them sleep, and often it will work for a while. However, if you do not address the underlying cause of why the melatonin was low, it will eventually lose its effectiveness.

Certain vitamins and minerals are necessary to produce the neurotransmitters you need to sleep. These include vitamins C, B6, B5, and the minerals zinc and magnesium. Deficiencies in these vitamins and minerals can impact your sleep. In my experience, I have found numerous cases of poor sleep linked to low levels of iron. We also need proper gut bacterial flora to balance and maintain these neurotransmitters. Proper nutrition, good elimination, and gut microflora are a critical component to sleep.

Causes of sleeplessness and more - Dr. Pingel

7 Causes of Sleeplessness

There can be many causes of sleeplessness, from dealing with chronic stress to medical conditions and lifestyle factors, among others. Here are seven of the most common causes. [4]

1. Stress. This is a big one and often misunderstood. Dealing with daily stressors (such as a constantly ringing cell phone) to more difficult times of stress such as a divorce or death of a loved one can make it hard to fall or stay asleep.

2. Medical conditions, particularly those that cause pain or immobility. Discomfort caused during pregnancy or menopause can also be causes of sleeplessness.

3. Psychological disorders. Various psychological disorders can affect sleep patterns, including depression, anxiety, and bipolar disorder.

4. Medications and substance use or abuse. Some prescription and over-the-counter medications, including cold and allergy medicines, antidepressants, and high blood pressure medication. Alcohol and caffeine can also impact sleep. If you take sleeping medication and stop taking it, you may experience rebound insomnia.

5. Keeping an irregular sleep schedule due to shift work can be one of the causes of sleeplessness because the body’s natural circadian rhythm (sleep-wake cycle) is disrupted. This is because your body uses sunlight to help it determine patterns of sleep and wakefulness. Trouble sleeping due to shift work is often especially apparent for those who work the night shift or rotating shifts. [5]

6. A variety of environmental factors can impact sleep. These may include noise, extreme temperature changes, lights, or a partner who snores.

7. Other sleep disorders. There are several other sleep disorders that can be causes of sleeplessness, including:

  • Sleep apnea. Not only can sleep apnea cause you to wake up feeling unrefreshed, but it is also a very serious condition because it causes you to stop breathing periodically during sleep. It can cause you to wake up many times—even hundreds of times—but you most likely won’t realize how many times you were awakened. This constant waking takes its toll and the lack of oxygen can lead to a number of health problems, including high blood pressure, heart disease, and depression. [6]
  • Restless legs syndrome(RLS). This sleep movement disorder causes an uncomfortable sensation of burning or itching in the legs, making it difficult to sleep. [7]

 

5 Home Remedies for Sleep

Many patients ask me about natural cures for insomnia or tricks to fall asleep fast. First and foremost, I encourage you to seek a doctor who will investigate the functional cause of your insomnia. In my experience, once the imbalance is discovered, you can easily hone in on your causes of sleeplessness and what natural sleep remedies will work the best for you as an individual.

Below I have listed six common home remedies for sleep that may help you fall asleep faster or at least wake up feeling more refreshed.

1. Make some dietary changes.

Dietary deficiencies in protein and vitamins and minerals have been shown to negatively impact sleep. Eating a healthy, balanced, plant-based diet (not necessarily vegetarian, but primarily vegetables) is a foundational way to improve your sleep. In fact, there are even certain foods for insomnia that can help you get a better night’s sleep.

Research supports the sleep-promoting effects of certain foods such as kiwi fruit and tart cherries. Foods high in omega-3 fatty acids and vitamin D, such as fatty fish like wild-caught pacific salmon, can also have sleep-promoting effects. [8, 9]

2. Get enough vitamins and minerals.

Along with eating a healthy diet, your body requires certain vitamins and minerals to produce the neurotransmitters you need for sleep. Be sure you are getting enough vitamins C, B6, B5, and the minerals zinc, magnesium, and iron. L-Theanine is an amino acid found in tea. When used in conjunction with other therapies, it has a significant impact on sleep, mood, and anxiety. It is a precursor to the production of serotonin and GABA, making it a great way to supplement without the side effects of medications.

Try taking daily multivitamin or mineral supplements to ensure that you are getting enough of these important micronutrients. [10]

3. Herbal remedies.

Herbal remedies and aromatherapy—using aromatic essential oils to help promote health and wellness— can be a help manage relaxation and sleep.

Three great essential oils for insomnia and relaxation to try are lavender, lemon balm, and bergamot. [11, 12, 13, 14, 15, 16, 17]

Try putting a few drops of one or more of these oils in an essential oil diffuser or bath.

A cup of tea made from dried chamomile flowers is an easy and effective way to enjoy the relaxing benefits of chamomile. [18, 19]

You can also try taking an herbal tincture at bedtime. Valerian and passionflower (often termed passiflora) tinctures are both sleep-promoting tinctures you may want to try. [20, 21] I find that the tincture version has a stronger impact than dried leaves in capsule and personally take these herbs when I have had a long day and am concerned that I may not be able to calm down enough to sleep.

As always, check with your healthcare provider first before trying a new herbal remedy, especially if you are taking other supplements or medications.

Herbal sleep remedies - Dr. Pingel

4. Buy a weighted blanket.

While conclusive evidence that confirms this remedy is still lacking, many people use weighted blankets for anxiety and insomnia. These blankets typically weigh anywhere from 3 to 20 pounds. They have been used for a long time to help calm children with autism or behavioral disorders and they are a common sensory tool used on psychiatric wards.

The thinking is that using a weighted blanket is similar to swaddling a baby and simulates a calming hug, which in turns helps to settle the nervous system.

However, note that weighted blankets aren’t recommended for everyone.

If you have sleep apnea, respiratory or other medical conditions, or other sleep disorders, check with your healthcare provider first. Also, note that these blankets tend to be rather expensive, ranging from about $100 to more than $200. [22]

5. Practice good sleep hygiene.

Follow these sleep hygiene tips on a consistent basis to build healthy sleep habits that can help you relax in the evening and prepare your body and mind for a restful night’s sleep. [23]

  • Maintain a regular bedtime and relaxing bedtime routine.
  • Eat a healthy diet.
  • Get enough exercise each day.
  • Lights out: Turn off your electronic devices about 30 minutes or more before you plan to go to bed. And as a standard practice—especially if you are prone to checking it immediately upon waking (a common sign of overstimulation)—try leaving it out of your bedroom at night altogether.
  • Avoid big meals and limit beverages before bedtime.
  • Cut back on caffeine and alcohol in the afternoon and evening. Avoid drinking alcohol before you go to sleep.
  • Sleep in a cool dark room.

Key Takeaways

  • There are many possible causes of sleeplessness, from stress to medical conditions, environmental factors, and more.
  • When struggling with insomnia, take the time to seek your root causes of sleeplessness rather than reach for addictive sleep aides that can cause dependence and worsen your symptoms.
  • A few key ways to improve your sleep quality include practicing good sleep hygiene, getting enough vitamins and minerals, and finding healthy ways to relax.
  • If home remedies don’t help you fall asleep, see your healthcare provider. I recommend investigating a full functional lab work-up and discussing other potential causes of insomnia.

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