Posted on by Dr Dani Gordon MD

Can’t Sleep? Here’s Why and What To Do About it!

If you can’t sleep, you are not alone.  Being ‘tired yet can’t sleep’ is a common complaint in the family doctor’s office and often patients are unsatisfied with the options they are given.

The Problem with Sleeping Pills

Most often, they are prescribed sleeping pills, which are now proven to  alter normal sleep architecture (ie. deprive you of certain types of sleep stages you need to prevent memory loss and keep the brain healthy) and have now been proven to be dangerous when used long-term (ie more than a few weeks) causing increased risk of death, permanent memory problems and thinking impairment, heart problems and even certain cancers!  They are also  habit forming and lead to worse insomnia when stopped.

It’s So Confusing!

Being tired but can’t sleep is confusing for people because their bodies are tired–aren’t they supposed to be able to sleep more easily when this happens?  The answer is that the mind is the most important thing that must be in a peaceful mode in order for sleep to come easily.  Often, before people go to bed, in addition to having very poor sleep hygiene (please see my article on Sleep Hygiene for details!), they have not ‘wound down’ their minds for the night and they jump into bed, willing themselves to fall asleep and then wonder why the mind will not cooperate!

Sleep Hygiene

The first step is the basics: Sleep Hygiene.  This means making sure your sleep space is ideal for slumber, and not much else!  This means making it super dark, quiet, cool but not cold, and not watching TV before bed.  It also means making sure you get to bed before midnight to get the peak  ofyour body’s natural sleep hormone, melatonin.  Bright lights, computer screens and other ‘screen time’ before bed is also bad sleep hygeine and shuts off your brains sleep hormones so you have trouble falling asleep

But I’ve Already Tried all That and I Still Can’t Sleep!

IF you’ve had a long time sleep problem, sleep hygiene along often isn’t enough to fix the problem.  Often, you are suffering from something called HPA axis hyperactivity, when your body’s danger system goes into 24 over-alert mode and prevents your brain from being able to shut off before sleep. The first step to help shut off this overactive danger alert system so you can sleep is using relaxation techniques as part of your nighttime routine every night–it’s ultra important, and although it is not an overnight magic pill,  it will help train the mind to prepare for sleep and lead to you sleeping deeper and feeling more refreshed in the morning so you have loads of energy to get through your day.

Relaxation training can be done in a comfortable sitting position in a chair, or lying down in bed if sitting is uncomfortable for you without getting poor posture or slouching.  I use a number of different techniques for this practice including Yoga Nidra, Cognitive Behavioral Hypnotherapy, guided imagery for sleep and yogic techniques.

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