Why You Can't Sleep

You can't win a stare-down with your alarm clock in the middle of the night. Instead, take this quiz to solve your sleep problems and finally get some rest! By Alyssa Shaffer, REDBOOK.

How long have you been trying to conk out?
If it's been more than 20 or 30 minutes and you still haven't dozed off, get up and leave the room. "At some point, your bedroom no longer becomes conducive to sleep--it turns into a torture chamber," says Erik St. Louis, M.D., an associate professor of neurology at Mayo Clinic College of Medicine and a consultant at the Mayo Center for Sleep Medicine. Find a quiet, dimly lit space in another part of the house and do something that lets your mind wander. Shives suggests listening to an audio book, as long as it's not too enthralling. "Choose a classic like Pride and Prejudice, where you know what happens," she says. If music is more your style, go for something soothing, like Chopin's nocturnes (not some rousing Beethoven). Above all, avoid doing chores or catching up on work, which can further activate your brain and make it harder to fall back asleep.

Do you have O.C.W.D. (obsessive clock-watching disorder)?

"Oh, no, it's 2:37 a.m. Now it's 2:57 a.m. Wait: 3:13 a.m.--really?" Every time you look at those glowing numbers on your alarm clock, that internal pressure builds, reinforcing all the sleep you're not getting. "Stealing a glance at the clock every few minutes tends to stimulate your brain and keeps you focused on the time rather than on falling back asleep," St. Louis notes. Try draping a towel over the clock so you can't see it, or just ditch it and use your cell phone's alarm function for your wake-up call.

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Were you hooked up to a caffeine IV all day?

Biology 101: We all have a natural sleep aid in our body. It's a chemical called adenosine, and the more of it that's flowing through our brain at night, the more drowsy we feel when it's time to go to bed. Caffeine fights off the effects of this substance by increasing brain activity, which is great when you need a jolt, and not so great when you're in all-out war with your pillow. If your afternoon or evening snack involves, say, a latte or a double-chocolate brownie, adenosine may have a hard time doing its job. Thomas Roth, Ph.D., director of research for the Henry Ford Sleep Disorders and Research Center in Detroit, advises: "Don't consume caffeine within three to four hours of bedtime, and if you have insomnia, cut yourself off at noon." And read labels, because there are some sneaky culprits that are loaded with caffeine. A regular can of Sunkist, for example, has more than 40 grams of the stimulant, equal to a shot of espresso; a Hershey's Special Dark chocolate bar has 31 grams of caffeine, almost as much as a can of Coke; and a serving of Ben & Jerry's Coffee Heath Bar Crunch has a whopping 84 grams--that's more than a can of Red Bull.

Do you worry yourself awake?
If you're anxious, or an endless to-do list is keeping you awake, ruminating over the details won't help. So what will? Experts recommend setting aside designated "worry time"--10 or 15 minutes during the day, at least two hours before bedtime, says Jodi A. Mindell, Ph.D., a professor of psychology at St. Joseph's University in Philadelphia who has studied sleep issues. "Use this planned worry time to write down what's bothering you, and brainstorm ways that you can solve these issues, so the same concerns don't creep up on you after midnight." Yes--therapy is one ballpoint pen away. "Several studies have shown that journaling can help decrease anxiety," she adds. Tried that and still can't sleep? Give that audio book a shot right now.

Did you sabotage yourself with a nap?

When you aren't getting enough zzz's at night, it's tempting to try to steal a few minutes of shut-eye during the day. And while a short nap (15 to 30 minutes) has restorative benefits, resting for longer can interfere with the quality of your nighttime sleep. "Your body is only really programmed to accept about eight hours of sleep a day, so if you take a two-hour nap, that's automatically going to reduce your nightly sleep to about six hours," Roth explains. And the closer to bedtime you nap, the harder it will be to fall asleep at night. Bottom line: Limit your mini snoozes to a late-morning or early-afternoon siesta.

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What did you do during the hour before bed?
Whether you're cracking up with Colbert or snuggling with an iPad, if you're like 95 percent of Americans, you use some form of electronics within the hour before bed. That's making night owls out of all of us. Scientists have found that light from our favorite gadgets, especially the blue light from computers or tablets, suppresses the release of the sleep-inducing hormone melatonin, which can make falling asleep more difficult. "The brain is activated by light," explains St. Louis. Even FaceTiming your BFF can jack you up. Switch to low-tech entertainment, like knitting or Sudoku or--novel thought--sex, at least an hour before you hit the sack.

Who else shares your bed?
In good times and in bad, in sickness and in health--nowhere in your vows did you promise to put up with uncontrolled leg action or a deafening snore in bed. If your sweetheart is a snorer, encourage him to seek treatment, for his sake and your own, advises Mindell. "Snoring is disruptive, and it can even indicate a potentially serious condition like sleep apnea. But luckily, in most cases it's treatable." If your guy's flailing limbs are the problem, try taking a walk together after dinner to encourage him to move more. Regular exercise can help reduce the severity of restless legs syndrome at night. It's also possible your issue is non-human: More than one in five people with sleep problems have pets in bed with them. Kick them out!

Is your bedroom set up for sleep?
Think of a bear hibernating in a cave, where it's cool, dark, and quiet. Experts say our rooms should be kept between 65 and 70 degrees--warm enough for your body's natural falling temperature (which reaches its lowest level at about 5 a.m.), yet cool enough to help you drift off comfortably. Since exposure to both artificial and natural light can send an immediate wake-up call to your brain, try using blackout shades, as well as a soft bedside lamp--not the harsh overhead light--when you're winding down for sleep. And if you're constantly awoken by street noise or your upstairs neighbor thumping around, you may be shifting too abruptly between the different stages of sleep, which will ultimately make you feel more tired when you wake up. Drown it out with steady, white noise in the background--like from a fan or a white-noise machine. Try HoMedics SS-2000 Sound Spa Relaxation Sound Machine ($24.99, amazon.com) or an app like Sleep Machine or Relax Melodies.

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When was the last time you washed your sheets?
You know that feel-good sensation you get when you slip into a freshly made bed? It's not just cozy; it's medicinal. According to a poll by the National Sleep Foundation, about 75 percent of people report they actually get a better night's sleep when the sheets smell fresh. And do your laundry with a detergent or softener that has a lavender scent, like Mrs. Meyer's Clean Day Lavender Laundry Detergent or Tide Plus a Touch of Downy Lavender; research shows that people who smelled a lavender scent before bed slept more deeply and felt more energized in the morning.

What did you have for dinner?
If you ate a chili dog with the works and your belly is in revolt, sleep will definitely be a challenge. Studies show that poor sleepers eat more fatty foods than their well-rested peers, and heartburn has been linked to sleep disorders. For the 20 percent of Americans who experience reflux issues at least once a week, cutting back on fatty, spicy, or acidic foods and drinks (yes, even wine) can help relieve digestive distress like bloating and heartburn, which will ultimately help you sleep at night.

What medications are you taking?

Even if you haven't picked up NoDoz since you pulled all-nighters in college, your medicine cabinet may be lined with stimulants. "Several types of prescription drugs, ranging from cardiac drugs that regulate blood pressure to decongestants for the common cold, can aggravate or worsen insomnia," St. Louis says. Certain asthma medications and antidepressants also fall into the category of meds that can make it hard to fall asleep. Of course, that doesn't mean you should ditch your Rx; just be sure to talk to your doctor if sleep issues develop. The solution may be as simple as taking the meds earlier in the day or switching to a different prescription. And if you take a multivitamin, consider downing that in the a.m. hours too. "Vitamins like B6 and B12 are involved in nerve and blood cell function as well as energy metabolism," notes Mindell, "so they can easily disrupt sleep."

Are you flopping around like a fish?

If you can't seem to get comfortable in bed, "your sleep position and pillows could be interfering with your sleep quality, especially for those with back pain during the day," St. Louis says. A few simple tweaks can make a big difference. If you're a side sleeper, try putting a pillow between your knees and thighs to keep your spine straight. If you're a back sleeper, try placing a flat pillow under your knees or a small, rolled towel under the small of your back. Snoozing facedown on your tummy? While this is typically the position that puts the most strain on your neck and back, you can alleviate some of the pressure by placing a pillow under your pelvis and lower abdomen and using just a thin cushion under your face--or ditch your head pillow altogether.

You answered all of these questions--so why are you still up?

If you've run through this list and the reason you can't sleep still remains a mystery, consider calling your doctor tomorrow morning. "Almost anyone can have an occasional night or even a week or two of bad sleep, but if it goes on and on for a few months, you need to address the problem," St. Louis says. Insomnia is defined as difficulty falling asleep at least three times a week, with daytime consequences like feeling impaired or distressed (translation: incompetent and cranky). The good news, he says, is that "the majority of cases can be helped by treatment, either through short-term medication or behavioral modification therapy." The fix could be as simple as sticking to a regular schedule of waking and getting to bed. If you need a sleep-medicine expert to help you pin down the causes of your issues, find referrals from the American Academy of Sleep Medicine at sleepcenters.org. Goodnight, and good luck!


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