Other Common Causes of Poor Sleep

Stress is one of the major causes of disturbed sleep, but there are many other causes.  Colds or allergies which make it hard to breathe or cause post-nasal drip can interfere with our ability to fall asleep, stay asleep, or spend sufficient time in REM.  Light from the sun or from electronic devices; street noise or noise from within the home (televisions, pets, family members, alarm clocks); carrying too much weight; body aches and pains; exercising too close to bedtime; watching too much television or using the computer too close to bedtime; eating too close to bedtime; having a mattress or pillow which is not comfortable to your body, drinking alcohol or caffeinated beverages within a few hours of bedtime–all of these things can cause sleep disturbance.  If you have any of the following five issues more than twice per month you are suffering from clinically significant sleep disturbance: 


1) Difficulty falling asleep.

2) Difficulty staying asleep all the way through the night.

3) Busy, frightening, frustrating, or otherwise stressful dreams.  

4) Waking up tired and unrefreshed in the morning.  

5) Excessive snoring, gasping for air, or grinding of teeth.

The Stress Connection

In the next post I will discuss the issue of stress in more detail.  For now suffice it to say that the pressures, worries, and frustrations of our daily lives directly impact sleep.  Many people even today are under the impression that sleeping is the act of inactivity.  People who undergo sleep studies in which they are evaluated by video, breathing monitors, and surface electrodes all night are asked in the morning questions like, “How many dreams did you have?” and “How many times did you change your body position during the night?”  The most common answer given to both questions is “none.”  But the most common findings documented by video and surface electrode recordings are: 7 dreams and 30-40 changes in body position!  

That’s right, far from being the activity of inactivity, sleep is actually a time when we work through the things which press down upon us but which get left unresolved while we are conscious.  Forgot to take care of an errand today?  Had a testy exchange with a coworker?  Caught your teen-ager in a little lie?  Got an angry email from a client?  Heard whispers that you might be up for promotion?  Chances are, whether you give these things much thought or not they are going to show up in the form of dreams which represent, usually symbolically, the the worries, pressures, hopes, and fears that we feel in connection to them.  


Stress can prevent us from spending enough time in the deeper states of sleep or from even reaching them at all.  Sometimes stress can result in bad dreams which activate the release of stress hormones, like cortisol, which cause inflammation and interfere with essential restorative processes. Have you ever dreamed that your teeth are falling out?  How about being in a public place without your clothes?  Or how about trying to run from something terrifying but your legs will not respond properly?  These common dreams are symbolic representations of various kinds of stress: fear that something is wrong beneath the surface; anxious about being unprepared for something important; feeling trapped and/or powerless.  People have, on average, seven dreams each night, but typically remember less than one each month.  When our consciousness shifts to wakefulness, the content of our dreams is instantly washed away.  We live in two worlds which are, for the most part, mutually exclusive of one another.  This is how we can wake up in the morning with a terrible stiff neck but have no memory of the dreams during which we clenched and twisted our back, neck and jaw muscles hard enough to cause a strain injury.  Stress dreams are the reason we wake up sore all over, feeling unrested, as though we had been through a battle.  


Tip: Keeping a pad and pen or a smartphone with dictaphone function next to the bed can help you to record your dreams; the trick is to write down or dictate them immediately upon waking up, before the conscious state sweeps them away.  Dreams can be a window into our unconscious state.  Many of my patients who believe that they have little or no stress are surprised by how often they have fear or frustration-based dreams.