If You Can’t Fall Asleep In Under 20 Minutes, It Could Be A Sign Of These 9 Health Issues

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Some nights it’s easier to fall asleep than others. But for certain people, needing over 20 minutes to fall asleep every night is a given — and sometimes others have to wait hours more. The causes of insomnia can be due to all sorts of physical and medical health conditions, so it’s important to examine all of the factors that may be creating your difficulty falling asleep.

Falling asleep can say a lot more about what’s going on with your body than just how tired you are. “The amount of time it takes to fall asleep is known as ‘sleep latency,'” Conor Heneghan, lead research scientist at Fitbit, tells Bustle. “A normal amount of sleep latency is approximately 15-25 minutes, which is considered the ‘sweet spot’ for your body to drift into light sleep stages. However, sleep latency is impacted by [a variety of] factors.” These factors can be anything from what you’ve eaten that day, or whether you’ve altered your bedtime routine, to a more serious underlying medical condition that’s making it difficult for your body to rest at night.

And while having trouble falling asleep can be caused by a myriad of health issues, falling behind on sleep can cause sleep debt and add to these problems. So if you realize you’re taking more than 20 minutes to fall asleep every night, asking your doctor about this problem may get you some relief.

Here are nine health issues that not being able to fall asleep in 20 minutes could be a sign of, according to experts.

1GERD

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GERD, or gastroesophageal reflux disease, can cause symptoms that aren’t quite apparent until you lie down to try to fall asleep.

“When lying down, it’s easier for stomach acids to flow up your esophagus, causing heartburn,” Terry Cralle, RN, clinical sleep educator and sleep consultant for Saatva, tells Bustle. “Heartburn, in turn, can disrupt falling and staying asleep. That’s why many people with GERD experience an increase in symptoms at nighttime and may have trouble finding a comfortable position for sleeping.” Avoiding GERD trigger foods like spicy food, coffee, and alcohol, in the hours before bed, may provide some relief.

2Anxiety

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Anxiety doesn’t exist solely in the mind. If you’ve been dealing with feelings of stress and nervousness in your daily life, it may be building up and causing it to be difficult for you to fall asleep.

“Those who experience anxiety have a complex relationship with sleep,” Dr. Sujay KansagraMattress Firm’s sleep health expert, tells Bustle. “Anxiety can not only prevent someone from falling asleep but it can also be worsened once a person experiences the effects of sleep deprivation.” Dr. Kansagra recommends talking to your doctor if stress or anxiety may be affecting your ability to fall asleep.

3Asthma

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If falling asleep regularly takes more than 20 minutes for you, and you also experience respiratory symptoms, this could be caused by asthma.

“Asthma symptoms often worsen at night, [including symptoms of] nighttime coughing, chest tightness, wheezing and breathlessness: a condition referred to as ‘nocturnal asthma,'” Cralle says. Check in with your doctor if you realize that these sorts of symptoms tend to come along at night.

4“Social Jetlag”

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Keeping a completely different sleep schedule on weekdays and weekends can make falling asleep more difficult in general.

“Another major factor that may contribute to longer sleep latency is ‘social jetlag,’ brought on by the shift in sleep schedules that many experience on days off compared to workdays,” Heneghan says. This issue with your circadian rhythm can be addressed by keeping a more consistent bedtime and wake up time throughout the week.

5Arthritis

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If you have general aches and pains, and they worsen at night enough to make it difficult for you to fall asleep — you may have undiagnosed arthritis. And arthritis doesn’t only affect older people.

“It is estimated that as many as 80 percent of people with arthritis have difficulty sleeping,” Cralle says. “Pain makes it hard to get comfortable and to fall — and stay — asleep. Since sleep deprivation makes pain worse, it’s critical that arthritis sufferers get enough quality sleep.” So talking with your doctor both about your pain and your sleep problems can be a step in the right direction.

6Menopause

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Like arthritis, menopause is associated with aging but can show up in young peopleas well. Since you may not realize this is possible, you may not be connecting the dots between potential gynecological issues and lack of sleep.

“Women are twice as likely to suffer from insomnia than men, according to the National Sleep Foundation, and their sleepless nights have been linked with hormonal changes —especially during menopause, when hormone levels are erratic,” Dr. Kent Smith, founding director of Sleep Dallas, tells Bustle. Making sure you regularly see an OB/GYN, and always tell your doctors about changes to your health, can help you stay on top of these potential issues.

7Restless Leg Syndrome

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Tossing and turning doesn’t have to be something that you ignore. Health issues like restless leg syndrome could be seriously impacting your ability to fall and stay asleep.

“Approximately one in 10 adult Americans suffer from Restless Leg Syndrome, according to the National Sleep Foundation,” Dr. Smith says. “This sleep-related movement disorder causes overwhelming and often unpleasant urges to move the legs while at rest, often making it difficult for sufferers to drift off to sleep.” If you find it particularly hard to lie still at night, it may be best to get in touch with a doctor.

8Sleep Apnea

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While sleep apnea is known to cause disruptions during sleep, it can cause difficulties during the process of falling asleep as well. And since sleep apnea can be difficult to diagnose, you might not connect the dots on this sleep disorder immediately.

“Sleep apnea, a condition in which a person ceases to breathe multiple times per hour when they sleep, can inhibit a person’s ability to fall asleep,” Dr. Smith says. “The brain detects that it is receiving less oxygen during sleep, so, in a life-preserving attempt, it actively prevents the sufferer from falling asleep.” If you have difficulty falling asleep, plus other signs of sleep apnea, then it’s important to see a sleep specialist and seek treatment.

9Vitamin Deficiency

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Sometimes, the root cause of your difficulty falling asleep can be hard to pinpoint but relatively straightforward to treat. One of the examples of this is vitamin deficiency.

“Several common vitamin deficiencies can lead to sleep disturbance,” Arielle Levitan, M.D., co-founder of Vous Vitamin LLC, tells Bustle. “[…] Determining which vitamins to take and in which safe and proper doses is important.” Particular deficiencies like magnesium and iron can cause difficulty falling asleep, Levitan says. To find out if this is a problem, the first step is to speak with your doctor and potentially have them perform blood tests to check for deficiencies.

In order to protect your physical and mental health, it’s important not to normalize your difficulty falling asleep. Taking note of why you may be struggling to fall asleep within 20 minutes or so, and how you feel the next day, may provide you some of the data you need to discuss this issue with your doctor — and find a treatment that works for you.

Night Owls May Experience ‘Jet Lag’ On A Daily Basis

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Some people declare themselves to be morning larks, or early risers, and they effortlessly wake up at the crack of dawn and fall asleep earlier in the evening.

Others, however, are night owls, or evening people, who stay up until the early hours of the morning and wake up later in the day, if left to their own devices.

Previous research has shown that the night owls face some health risks due to their daily rhythms. These include a tendency towards poorer dietary habits, which, in turn, can increase the risk of metabolic conditions, such as diabetes.

Now, a study led by investigators from the University of Birmingham in the United Kingdom has found out how activity patterns in the brains of night owls are different from those of morning people. The study also highlights how these differences can impact their lives and levels of productivity in a world that typically favors early risers.

“A huge number of people struggle to deliver their best performance during work or school hours they are not naturally suited to,” notes lead researcher Dr. Elise Facer-Childs, previously of Birmingham University and now based at the Monash Institute for Cognitive and Clinical Neurosciences in Melbourne, Australia.

“There is a critical need to increase our understanding of these issues in order to minimize health risks in society, as well as maximize productivity,” she emphasizes.

The researchers have now published their findings in a study paper featured in the journal SLEEP.

Brain activity in night owls

For this study, the research team recruited 38 healthy participants. They divided the volunteers into two groups, putting 16 early risers into one group and 22 late sleepers into the second.

The researchers split the participants into these two groups based on their melatonin and cortisol circadian rhythms — the natural circulation of these two hormones affect sleep and waking cycles.

The researchers monitored the participants’ sleeping and waking patterns, and the volunteers filled in questionnaires about their rhythms. On average, late sleepers went to bed at 2:30 a.m. and woke up at 10:15 a.m.

To assess brain activity patterns, the investigators asked the volunteers to undergo MRI scans. The researchers also tested the participants’ performance on various tasks they undertook at different times throughout the day to see how sleep-wake cycles affected daily functioning.

The team noticed a difference in brain activity patterns between the two groups, namely that night owls had lower resting brain connectivity in brain areas that scientists primarily associate with maintaining a state of consciousness. They correlated this with shorter attention spans, as well as slower reactions and lower energy levels.

Early risers performed better and had faster reaction times during morning tasks. They also declared themselves as being much less sleepy at that time.

On the contrary, as expected, late sleepers performed best and experienced the fastest reaction times around 8:00 p.m. However, even at the time when they were at their peak performance, night owls did not do much better than their early rising peers.

This suggests that throughout the day — or from around 8:00 a.m. to 8:00 p.m. — resting-state brain connectivity is affected in late sleepers, adversely impacting their productivity.

Social expectations ‘could be more flexible’

Dr. Facer-Childs likens the night owls’ state throughout the day to a form of constant jet lag, emphasizing that this may have a significant effect on their well-being in the long run.

This mismatch between a person’s biological time and social time — which most of us have experienced in the form of jet lag — is a common issue for night owls trying to follow a normal working day.”

Dr. Elise Facer-Childs

“Our study is the first to show a potential intrinsic, neuronal mechanism behind why night owls may face cognitive disadvantages when being forced to fit into these constraints,” she adds.

For this reason, the researcher argues that societies need to take a long, hard look at their organizational structures, chiefly in terms of working hours and how to become more accommodating to people’s individuals needs. This flexibilty should mean that night owls can put their best foot forward while avoiding adverse health outcomes.

“To manage this [situation], we need to get better at taking an individual’s body clock into account — particularly in the world of work,” Dr. Facer-Childs argues.

“A typical day might last from 9:00 a.m.–5:00 p.m., but for a night owl, this could result in diminished performance during the morning, lower brain connectivity in regions linked to consciousness, and increased daytime sleepiness,” she warns.

She further advises that “If, as a society, we could be more flexible about how we manage time, we could go a long way toward maximizing productivity and minimizing health risks.”

Prepare Yourself For The Best Night’s Sleep

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Getting a good night’s sleep requires more than plopping down on your bed. In fact, sleep is an active process. While we snooze, we pass through several stages of sleep, each with its own distinct physiological changes. We also alternate between non-REM (rapid eye movement) — which serves to restore the body — and REM sleep, during which we dream and restore the brain. The time you spend in these stages varies by age, but a good night’s rest means the sleep should be continuous and uninterrupted.
Dim the lights throughout the house this evening. Gradually reducing the amount of light in your home will mimic the way sunlight goes down and help trigger sleepiness.
The urge to sleep is dictated by two natural forces. Our homeostatic sleep drive helps us balance our wakefulness with sleep. “It tells us we’re only good for so many hours of alertness before we become functionally intoxicated,” says Helene Emsellem, MD, director of the Center for Sleep and Wake Disorders in Chevy Chase, Maryland, and author of Snooze or Lose. Our circadian rhythm, on the other hand, regulates the timing of our sleepiness and wakefulness. You can thank your circadian rhythm for that daily afternoon slump, for instance.
Both forces are highly affected by our habits, our routines and even our exposure to sunlight. So, for truly sound slumber, it’s important to respect these internal drives and do things that gear your body for sleep — some folks call this practicing good sleep hygiene. Here’s how you can ensure that you’re properly prepped for a good night’s sleep.
Move That Body
A good workout that gets your heart pumping and muscles flexing works wonders on promoting sleep. Regular physical activity makes it easier for you to get to sleep and improves the quality of your sleep. For maximum benefit, avoid rigorous activity three to four hours before bed. Body temperature rises when you exercise, which can make it hard for you to get to sleep.
Get Some Sun
Exposure to sunlight influences circadian rhythm, which is controlled by brain cells in the hypothalamus. These cells respond to light and dark signals from our environment, and set off reactions in our bodies to either wake us up or make us sleepy. In the mornings, it triggers the release of cortisol, a stimulating hormone, which raises body temperature. “Sunlight is a strong stimulus for wakefulness in humans,” says Nancy Foldvary, DO, director of the Sleep Disorders Center at the Cleveland Clinic and author of The Cleveland Clinic Guide to Sleep Disorders. “So, getting sun exposure promotes wakefulness during the day and can help people sleep at night.” Darkness, on the other hand, triggers our brains to produce melatonin, a hormone that regulates circadian rhythm and promotes sleepiness.
Create A Sanctuary
Think of your bedroom as your private retreat where you go every night to be renewed. Here’s how to turn it into the ideal environment for sleep:
Look For A Mattress And A Pillow That Are Comfortable
Preferences for bedding vary widely, so be sure to test out a mattress for a good 15 minutes before you buy.
Set The Thermostat On The Cool Side
Body temperature naturally falls at night. By keeping the room cool, your body will mimic its surroundings.
Darken The Room With Shades And Curtains To Keep Out Light
You might even try using an eye mask. Darkness helps stimulate the production of melatonin, a hormone that promotes sleepiness.
Ditch the Electronics
Clear your bedroom of TVs, computers, and any other electronics. These gadgets emit blue light, which like any light, can cause wakefulness at night and disrupt the body’s natural inclination to sleep. Use your bedroom only for sleep (and sex), so you won’t associate it with any other activity.
Don’t Smoke
Poor sleep is just one more reason you shouldn’t light up. Smokers are four times more likely to report feeling unrested after a night’s sleep than nonsmokers. The smokers also spent less time in deep sleep and more time in light sleep. Smoking before bed pumps your body with nicotine, a stimulant that can keep you up at night. It also raises overall body temperature and elevates your heart rate and metabolism — all of which will keep you awake. To make matters worse, smokers go through withdrawal when they’re asleep, which disrupts their sleep, too.
Stick With A Routine
It doesn’t matter whether you soak in the tub, read a good book, or listen to your favorite music, the key is doing the same thing every night, so your body gets the signal that you’re prepping for sleep.
And, okay, we know you want to sleep in on the weekends and make up for the slumber lost during the week. But, don’t. Get in the habit of waking up and going to bed at the same time every night, even on weekends. Sleeping in on Saturdays and Sundays will only make it hard for you to get to sleep on Sunday night, and you’ll feel less refreshed on Monday.

The Best Foods to Eat for Better Sleep

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Nonfat Popcorn
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Nonfat Popcorn

The carbohydrates in nonfat popcorn help bring the amino acid tryptophan into your brain, where it’s used to make a sleep-inducing neurotransmitter called serotonin. Since eating a heavy meal within two hours of bedtime can keep you awake, popcorn (just 93 calories in three cups popped) is a great late-night snack. Choose plain, fat-free popcorn and jazz it up with some curry powder or any of these other tricked out popcorn toppings.

Halibut
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Halibut

Halibut is packed with two building blocks for better sleep: tryptophan and vitamin B6, and when it comes to seafood, halibut has a mild flavor and meaty texture that appeals to finicky fish eaters. Other foods high in tryptophan include poultry, beef, soybeans, milk, cheese, yogurt, nuts, and eggs.

Mango Lassi
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Mango Lassi

Packed with antioxidants, protein, and vitamins, this treat satisfies your creamy, sweet craving as well as ice cream—without the sugar bomb.

BTW, a lassi is basically a smoothie, but it’s always made with yogurt. To make a mango lassi: cut up one fresh, peeled mango and put it in a blender. Add a handful of ice, a small scoop of plain Greek yogurt (go with full-fat dairy for all its health benefits) and a splash of water or milk. Add a dash of stevia for extra sweetness if desired.

Don’t like mangoes? Substitute frozen berries or watermelon.

Garbanzo Beans (Chickpeas)
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Garbanzo Beans (Chickpeas)

High-fiber garbanzo beans (or chickpeas) are rich in vitamin B6, which your body uses to produce serenity-boosting serotonin. Try adding garbanzo beans to salads, soups, and stews when you need sleep.

Chamomile Tea
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Chamomile Tea

This herbal drink lacks the caffeine found in traditional teas, and it has a calming effect on the body. Also, a warm liquid before bed can make you feel cozy and ready to hit the sheets.

Related: How to Practice Mindfulness with Tea

Honey
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Honey

A rise in blood sugar can reduce the production of orexin in the brain. Orexin is a recently discovered neurotransmitter that’s been linked to wakefulness. Try drizzling a small amount of honey in your chamomile tea for a touch of sweet without a full-down sugar rush.

Dried Tart Cherries
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Dried Tart Cherries

A handful of dried cherries not only provides the requisite serotonin-boosting carbs, but it’s also one of the few food sources of melatonin, which has been found to promote better sleep and lessen the effects of jet lag. Plus, tart cherries are packed with antioxidants.

Turkey
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Turkey

The reason behind your epic post-Thanksgiving feast nap is also the secret to helping you sleep better. Tryptophan, an amino acid found in turkey, is known to help calm you down and naturally get you to sleep.

Not feeling a deli turkey sandwich? Try roasted pumpkin seeds, which also contain tryptophan.

Banana  Soft Serve
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Banana “Soft Serve”

Frozen bananas make the perfect base for healthy, vegan “nice cream”. and the potassium in them will not only help you fall asleep faster but can prevent those awful cramps (AKA Charlie horses) that wake you up. All you need is the proper blending technique. The trick is to keep blending for several minutes. At first, they’ll just look slimy, but then air works its magic and before you know it frozen bananas morph into a creamy, light treat. Add a handful of chopped nuts for a sweet and salty treat.

Kale Chips
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Kale Chips

Don’t knock these roasted green “chips” until you’ve tried them. The hefty dose of vitamin K helps repair and build muscles while you sleep. Simply chop up a bunch of kale, toss with olive oil and sea salt, and spread out and bake at 350 degrees until crispy.

Here’s How Relationships Can Affect Your Sleep In The Long-Term, According To Experts

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By Julia Guerra

Not to freak you out or anything, but the choices you make today really do have an impact on your future, even in ways you wouldn’t expect. Life is funny that way; sometimes two completely different aspects of life can collide like colors in a messy drawing, and you’re stuck trying to figure out the bigger picture. Take your love life, for example. Did you know your romantic relationships can affect your sleep? I’m not necessarily referring to that can’t-eat, can’t-sleep phase where everything’s coming up roses and you and your partner can’t get enough of each other, either. According to new research, negative relationship experiences in early adulthood might have some unexpected effects on your sleep quality well into your 30s.

According to the American Sleep Apnea Association, 50 million Americans suffer from chronic sleep disorders, while an additional 20 to 30 million report the occasional night of tossing and turning. If you’re among that 20 to 30 million, but haven’t been able to identify the issue just yet, the results of a new study, published in Personal Relationships, a journal of the International Association For Relationship Research, suggest that negative romantic relationship experiences can impact your sleep quality over the long-term. I know, like the negative relationship itself wasn’t bad enough, right?

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The study documented the possible correlation between participants’ romantic relationships, stress, and how both of these elements affect sleep quality over the course of adulthood. Researchers recruited 112 participants from the Minnesota Longitudinal Study of Risk and Adaptation and studied them from the age of 23 years old to 32 years old. In the end, per a ScienceDaily press release, the researchers found that people who reported having positive relationship experiences in their early 20s were less stressed and enjoying quality sleep in their early 30s. “Although a large body of evidence shows that relationships are important for health, we are just beginning to understand how the characteristics of people’s close relationships affect health behaviors, such as sleep,” Chloe Huelsnitz, a PhD candidate at the University of Minnesota and lead author of the study, said in a statement, per the ScienceDaily press release.

Generally speaking, says Dr. Tammy Nelson, a sex and relationship expert and licensed psychotherapist, one of the most common emotions that can affect your sleep patterns is anxiety, and as I’m sure you know from experience, no matter how good or bad your relationship is, it can sometimes give you a little bit of stress.

“Being anxious can keep us up at night, prevent sleep, and wake us up once we are asleep,” because it raises blood pressure, increases heart rate, quickens your pulse, and tenses up your muscles, Nelson tells Elite Daily over email. “These are all reactions that are in direct opposition to the relaxation that needs to happen when we are asleep.”

But even after you and a partner eventually decide to part ways, if you’re still dealing with pent-up feelings of stress from the relationship, Natalie Dautovich, an environmental scholar for the National Sleep Foundation, says you can still be affected. “We are physically most vulnerable when we are sleeping, so sleep is most possible when we feel safe and secure,” Dautovich tells Elite Daily.

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If you’re reading all of this and thinking “well, that’s pretty unfair,” you aren’t wrong. But the thing is, you still have control over your sleep health, and there are ways to ensure that, no matter what happens in terms of your love life, you’re still doing everything you can to get your rest.

Of course, if you are currently in a relationship, that doesn’t just automatically mean your sleep health, in the short- or long-term, is doomed. In fact, a physical connection with a loved one, such as a hug, kiss, or even sex, can calm your nervous system, therefore decreasing stress and anxiety, making it easier to fall and stay asleep, Nelson explains. However, at the same time, it’s important to remember that having your own bedtime routine of some kind, made up of rituals (taking a warm bath, meditating, journaling, diffusing essential oils, etc.) that soothe you without the help of a partner, she adds, is just as key.

Having an SO around can also benefit your sleep health in some slightly more unexpected ways. For instance, they can be there to help hold you accountable when you’re trying to cut back on using your phone in bed, or stick to an earlier bedtime. “A benefit of having a sleeping partner is that they often are the first to notice sleep difficulties (e.g., snoring related to sleep apnea),” Dautovich says, so the two of you can both provide support and promote healthy sleep behaviors for one another. It’s certainly worth the try, right? Clearly the sleep of your future self depends on it.

Cognitive Behavioral Therapy for Insomnia | Patient Advice | US News

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By Michael O. Schroeder

Many, many people have difficulty falling asleep or staying asleep. Research generally suggests that around a third of Americans have insomnia at any given time, and about 1 in 10 have chronic insomnia, lasting three months or longer.

Not getting adequate rest can affect mood (while depression can also contribute to insomnia), undermine motivation, increase irritability and make it difficult to just get through the day. “For those who take care of small children or have a lot of family and work responsibilities to balance,” the National Sleep Foundation notes, “insomnia can make these tasks feel even more overwhelming when you are tired.”

Often people try over-the-counter sleep aids or nothing at all – just thinking they have to live with it – rather than seeking help from a professional.

It’s common for patients who see Dr. Rafael Pelayo to have been struggling with insomnia for years. It’s “not unusual for me to see someone with decades of poor sleep,” says the sleep specialist and clinical professor of psychiatry and behavioral sciences at the Stanford Center for Sleep Sciences and Medicine. But even those who’ve had chronic insomnia for years can still get better when the insomnia is addressed correctly, he says.

And although the treatment isn’t new, there’s growing recognition of a tailored therapeutic approach used to change a person’s thinking and behavior that has lasting benefits for the majority who undergo it: cognitive behavioral therapy for insomnia. Most who undergo four to eight sessions of CBT-I experience a significant reduction in their symptoms – namely the time required to fall asleep, the amount of time spent awake or both – notes Michael Perlis, director of the behavioral sleep medicine program in the department of psychiatry at the University of Pennsylvania.

While experts note that sleep medication, prescribed in combination with CBT-I or alone, is another option, CBT-I’s “durable results” – generally continuing after a person stops the therapy – make it an optimal approach. “It is recommended as the first line treatment,” Perlis says.

It’s not just mental health professionals advocating for the treatment either, but the medical establishment. The American College of Physicians led the way in guidelines published in 2016ACP recommends that all adult patients receive cognitive behavioral therapy for insomnia (CBT-I) as the initial treatment for chronic insomnia disorder,” the medical society asserted.

Perlis explains that CBT-I has four components: sleep restriction, stimulus control, sleep hygiene and cognitive therapy. Often it’s counterintuitive, too, like with sleep restriction. One might think that if you can’t sleep you should stay in bed for longer. But actually experts say it’s important to match your sleep opportunity, or how long you’re in bed, with how long you’re able to sleep, and then gradually work on increasing sleep time. “It doesn’t aim to restrict actual sleep time but rather to initially restrict the time spent in bed,” Stanford Health Care’s website explains, regarding the sleep restriction component of CBT-I. “Subsequent steps consist of gradually increasing the time spent in bed.”

While some people may feel they’re familiar with certain concepts and components of CBT-I, like sleep hygiene (being mindful of how factors like substance use, such as caffeine and alcohol consumption, can affect sleep), implementing it correctly tends to be more complex and involved. Experts say that’s why it’s key to see a professional experienced in CBT-I for effective treatment. “Those that try to do CBT-I to themselves are likely to not be successful,” Perlis says. “But worse is that they will believe that they’ve been there, done that, and so the likelihood of seeking out professionally administered CBT-I goes way down.”

One significant limitation with CBT-I, however, is access. “Finding a therapist is not easy,” Perlis says. “CBT-I is not yet available in every state or every city.” However, there are some directories – he recommends a couple through Perelman School of Medicine at Pennsylvania University and the Society of Behavioral Sleep Medicine, respectively – that can be used to find therapists who do CBT-I.

Pelayo points out that for those who aren’t able to see a professional who does CBT-I in their area, there are online CBT-I programs that allow a person to engage in the therapy from home virtually. “I’m OK with somebody doing it online if they want to – if they live far away,” Pelayo says. “And if they got better, I’m happy for them, of course. But if they don’t get better, if they’ve done the online thing, then we actually want them to have a face-to-face.”

He says patients typically pay cash for online CBT-I.

Insurance coverage of in-person cognitive behavioral therapy for insomnia varies. So it’s important to check in advance to determine that. As the therapy is more widely used, and given the support for its effectiveness, clinicians are hopeful insurance coverage of CBT-I will improve, but it’s not universal today.

Pelayo says some individuals, like those with profound autism or schizophrenia, aren’t able to participate in CBT-I. Others, he says, either prefer not to undergo therapy, or aren’t able or don’t want to make the time commitment.

Certainly, CBT-I has advantages – notably the lasting benefits, after a person has stopped therapy; that differs from medication that provides benefit while on it. But experts say, first and foremost, it’s key that those with chronic insomnia generally seek help to get a better idea of what’s behind it and explore treatment options.

In some cases, it may be a medical or mental health issue that’s causing sleep problems or making things worse, and cognitive therapy may still be useful (like with depression). But having a fuller picture, is critical. For example, often thyroid disease can contribute to sleep woes and is overlooked, Pelayo says. Or a person may have another disorder like sleep apnea, along with insomnia, that needs to be addressed as well, he says.

None of that will be rectified through an online search in your pajamas (though you might find a sleep specialist that way).

“I tell all my patients that if they don’t wake up feeling refreshed, something is wrong,” Pelayo says. When sleep problems persist, experts say, instead of trying to put them out of your waking mind – seek help to get them addressed.

Why People With A History Of Bad Relationships Don’t Sleep Well

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By Kelly Gonsalvez

Anyone who has ever slept next to a partner knows being part of a unit can affect how well you sleep—from dealing with the other person’s weird tossing and turning all night to battling for your fair share of the blanket to trying to get some shut-eye when you’re still halfway through a fight with the person lying next to you and you can’t stop thinking about it.

Past research has shown your relationship can affect your sleep, but a new study published in the Personal Relationships journal has now found an even deeper connection between your love life and sleep: Apparently having a history of stressful relationships may make you more likely to have poorer sleep quality.

Researchers analyzed existing data that had been collected on over 260 people born in the mid-1970s regularly from the time they were born until mid-adulthood. These participants were asked questions about their lives periodically, including being surveyed and interviewed about their recent romantic relationships, experiences with stress, and sleep quality. Analyzing these people’s responses between ages 23 and 37, the researchers discovered a trend: People who’d had better relationships during their early adult years dealt with fewer and less disruptive stressful life experiences at age 32, and that led to having better sleep quality at age 37. That was true regardless of depression status, gender, ethnicity, income, education, and even how much stress people currently had at age 37.

In other words, having a history of good relationships as a young adult—that is, stable long-term relationships where there’s mutual care, trust, emotional closeness, and sensitivity to each other’s needs and where conflicts are resolved in a healthy and satisfying way—tended to lead to less stressful experiences throughout adulthood, which in turn led to better sleep over time.

It’s understandable why stressful life experiences (like job changes, health issues, legal battles, and interpersonal conflicts) would take their toll on a person’s sleep quality; a lot of past research has shown that having a lot of stress can seriously disrupt your sleep. But why might having a better love life lead to having fewer of these types of seemingly unrelated tough life events, or at least having them be less stressful?

“One explanation is that people who possess the interpersonal competencies necessary to maintain relationships marked by mutual caring, trust, conflict resolution, and other positive characteristics are also more likely to have other traits that may mitigate their exposure to and reduce the severity of those stressors when they occur,” the researchers write in the paper. “For instance, people who score high in romantic relationship effectiveness may be more likely to demonstrate caring and responsiveness in other types of relationships (e.g., with family or co-workers), which might reduce exposure to conflict. Moreover, when stressful events due to uncontrollable sources are encountered (e.g., unemployment, death of a family member), people high in relationship effectiveness may also be more likely to possess intrapersonal and interpersonal resources, allowing them to cope better with the stressful life event and reduce its severity.”

So people who are good at romantic love are probably good at dealing with people in other parts of their life, and those skills and emotional experiences set them up to either avoid stressful occasions or deal with them well when they occur.

“Cues of social belongingness and emotional security can facilitate a sense of protection that down-regulates stress reactivity and promotes better sleep,” the researchers explain. “Given that romantic relationships are an especially potent source of social belongingness and emotional security in adulthood, one’s experiences, tendencies, and engagement in his or her romantic relationships should have a particularly strong impact on sleep patterns.”

This is all pretty hard news to hear for anyone who feels like they’ve had a pretty unlucky love life thus far. But don’t worry: The point here isn’t that if romance isn’t the easiest for you, you’re doomed to a life of stress and bad sleep. Rather, this study simply reinforces one of the most important benefits of being in a relationship: being able to learn about how to communicate better, navigate conflicts, take care of another person, and take care of yourself. Relationships are far less about validating your worth as much as they are about learning how to become a better human being.

The good news? You can totally do that without a partner, too. Romantic relationships happen to be a great place to learn those lessons, but so are so many other parts of our social lives—our family relationships, our friendships, our professional connections, and more.

If your sleep and mental health are important to you, then your social relationships should be too. Interfacing with other people is pivotal not only to learning how to deal with stress and conflict but also to having a support system in place during all those bad times. That stability seems to be the real key to being able to have a secure, peaceful night’s sleep over time.

Insomnia Series: How Did You Sleep? NPR Wants Your Slumber Stories

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Meagan Keane

Getting a good night’s rest is easier said than done. NPR’s Science Desk is reporting on the science of sleep, and we want to hear from you.

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