Ask Dr. Lo: Why Can’t I Sleep? ‘

by Dr. Thomas K. Lo

Insomnia is a common sleep disorder. If you have insomnia, you may have trouble falling asleep, staying asleep, or both. As a result, you may get too little sleep or have poor-quality sleep. You also may not feel refreshed when you wake up.

Is My Insomnia Acute or Chronic?

Insomnia can be acute (short-term) or chronic (ongoing). Acute insomnia is common and often brought on by situations such as stress at work, family pressures, or a traumatic event. Acute insomnia lasts for days or weeks.

Chronic insomnia lasts for a month or longer. Most cases of chronic insomnia are secondary, which means it is the symptom or side effect of some other problem. Certain medical conditions, medicines, and substances can cause secondary insomnia.

In contrast, primary insomnia is not due to medical problems, medicines, or other substances. It is its own distinct disorder, and its cause is not that well understood. Many life changes can trigger primary insomnia, including long-lasting stress and emotional upset.

Digging Deeper into Secondary Insomnia

Secondary insomnia is the symptom or side effect of another problem. It is often a symptom of an emotional, neurological, or other medical disorder. Some examples of emotional disorders are depression, anxiety, and posttraumatic stress disorder. Examples of neurological disorders are Alzheimer’s disease and Parkinson’s disease.

Many other disorders or factors can cause insomnia like conditions that cause chronic pain, conditions that make it hard to breathe, an overactive thyroid, as well as gastrointestinal disorders, stroke, restless legs syndrome, and sleep-related breathing problems.  Menopause and hot flashes can also cause insomnia.

It can also be a side effect of some medicines like certain asthma medicines, allergy and cold medicines, and beta-blockers.

Commonly used substances like caffeine, stimulants, tobacco, alcohol, and sedatives can also cause insomnia.

Treating the underlying cause of secondary insomnia may resolve or improve the sleep problem, especially if you can correct the problem soon after it starts.

Primary Insomnia

Primary insomnia is not a symptom or side effect of another medical condition. It is its own distinct disorder, and its cause is not well understood. Primary insomnia usually lasts for at least one month.

Many life changes can trigger primary insomnia. It may be due to major or long-lasting stress or an emotional upset. Travel and work schedules that disrupt your sleep routine also may trigger primary insomnia.

Even if these issues are resolved, the insomnia may not go away. Trouble sleeping can persist because of habits formed to deal with the lack of sleep.

Who is Affected by Insomnia?

Insomnia is a common disorder. It affects women more often than men. The disorder can occur at any age. However, older adults are more likely to have insomnia than younger people.

People who might be at an increased risk for insomnia include those who have lower incomes, work at night or have frequent major shifts in their work schedules, and those who travel often across time zones and have an inactive lifestyle.

Young and middle-aged African Americans also might be at increased risk for insomnia. Research shows that, compared with Caucasian Americans, it takes African Americans longer to fall asleep. They also have lighter sleep, do not sleep as well, and take more naps. Sleep-related breathing problems also are more common among African Americans.

Sleep History

To get a better sense of your sleep problem, your doctor will ask you for details about your sleep habits. Before your visit, think about how to describe your problems. Some things to think about is how often you have trouble sleeping and how long you’ve had the problem, what time you go to bed and get up on workdays and days off, how long it takes you to fall asleep, how often you are wake up at night, and how long it takes to fall back asleep. Also, think about whether you snore loudly and often or wake up gasping or feeling out of breath, how refreshed you feel when you wake up, and how tired you feel during the day and how often you doze off or have trouble staying awake during routine tasks, especially driving. 

To find out what’s causing or worsening your insomnia, your doctor may ask you more questions. Are you worried about falling asleep, staying asleep, or getting enough sleep; what do you eat or drink and do you take medicines before going to bed; what routine you follow before going to bed, what the noise level, lighting, and temperature are like where you sleep; and what distractions, such as a TV or computer, are in your bedroom.

To help your doctor, consider keeping a sleep diary for one or two weeks. Write down when you go to sleep, wake up, and take naps. (For example, you might note that you went to bed at 10:00 p.m.; woke up at 3:00 a.m. and could not fall back asleep; napped after work for two hours.) Also, write down how much you sleep each night, as well as how sleepy you feel throughout the day.

Lifestyle Changes

If you have insomnia, you may want to avoid substances that make it worse, such as caffeine, tobacco, and other stimulants. The effects of these substances can last as long as eight hours.

Be aware of certain over-the-counter and prescription medicines that can disrupt sleep. Know that an alcoholic drink before bedtime might make it easier for you to fall asleep. However, alcohol triggers sleep that tends to be lighter than normal. This makes it more likely that you will wake up during the night.

Try to adopt bedtime habits that make it easier to fall asleep and stay asleep. Follow a routine that helps you wind down and relax before bed. For example, read a book, listen to soothing music, or take a hot bath. Try to schedule your daily exercise at least 5 to 6 hours before going to bed. Try not to eat heavy meals or drink a lot before bedtime.

Make your bedroom sleep-friendly. Avoid bright lighting while winding down. Try to limit possible distractions, such as a TV, computer, or pet. Make sure the temperature of your bedroom is cool and comfortable. Your bedroom also should be dark and quiet.

Go to sleep around the same time each night and wake up around the same time each morning, even on weekends. If you can, avoid night shifts, alternating schedules, or other things that may disrupt your sleep schedule.

If you are struggling with health issues, call the Advanced Chiropractic & Nutritional Healing Center at 240-651-1650 for a free consultation. Dr. Lo uses Nutritional Response Testing ® to analyze the body to determine the underlying causes of ill or non-optimum health. The office is located at 7310 Grove Road #107, Frederick, MD. Check out the website at

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