Can’t Sleep? — Causes, Symptoms & Solutions

Sleep Briefly Explained

Before we examine the causes, symptoms, and solutions to your difficulty sleeping, you should first briefly understand how sleep actually works and what it is important for.

From an evolutionary point of view, sleep initially seems disadvantageous: We are defenceless for hours and unable to search for food or ward off danger. Nevertheless, all animals (with the exception of insects, jellyfish, and crustaceans) need to sleep to stay healthy, including us humans. This fact illustrates how critical sleep is for your body.

Sleep is indeed essential for your health. During sleep, your cells regenerate, the brain processes and stores information, the immune system is strengthened and important hormones are released. In addition, tissue damage is repaired, and metabolic processes are regulated during deep sleep, while emotional experiences and memories are processed during the REM phases. These comprehensive regenerative and cognitive processes are crucial for keeping your body and mind healthy and efficient.

New studies show that there is a link between inadequate sleep and many NCDs (non-communicable diseases), such as type 2 diabetes, obesity, high blood pressure, a compromised immune system and cardiovascular disease. [1]

Why do we get tired?

1. The circadian rhythm

   The circadian rhythm, also known as the biological clock, controls many physiological processes, but above all our sleep-wake rhythm. In the evening, when it gets dark, the production of cortisol, the wakefulness hormone, is greatly reduced. At the same time, our body begins to release more melatonin, a hormone that promotes sleep. This process peaks around midnight and signals to the body that it is time to wind down and sleep.

2. Sleep pressure

   In addition to the circadian rhythm, sleep pressure also plays a decisive role in fatigue. From the moment we wake up in the morning, a chemical called adenosine begins to build up in our brain. The longer we are awake and the more we concentrate mentally or are physically active, the higher the sleep pressure becomes. This sleep pressure signals to our body that we need rest and prepares us for sleep. After a waking phase of 12 to 16 hours, the maximum level of adenosine concentration is reached and normally we can no longer escape the tiredness and fall asleep.

As soon as you are ready to go to bed, you will fall asleep within 10 to 20 minutes. However, if you have trouble falling asleep, this process can take much longer.

The time it takes you to fall asleep is known as 'sleep latency'. One study shows that your sleep quality is impaired if it takes you longer than half an hour to fall asleep. [2]

Some people not only take longer than half an hour to fall asleep, but lie awake for hours or only get two to three hours of sleep because they find it so difficult to fall asleep.

If you have trouble falling asleep at least 3 times a week for a month, this is called insomnia.

A disrupted circadian rhythm can upset this delicate sleep homeostasis and lead to problems falling or staying asleep.

Let's take a closer look at the causes of this.

Common Causes of the Difficulty of Sleeping

Sleep Disorders

Everyone has a bad night's sleep occasionally, but a sleep onset disorder is when your problems falling asleep become a persistent problem. These specific disorders are often chronic and require targeted treatment to improve sleep quality in the long term. Several million people around the world suffer from some form of sleep disorder. [3]

• Psychophysiological insomnia: This occurs when you are unable to rest due to stress or fear of not falling asleep. You lie awake constantly, thinking that you need to sleep, which further delays or prevents sleep.
• Behavioral insomnia: This is often caused by irregular bedtimes or poor sleeping habits, such as excessive media consumption before bedtime, especially in children and adolescents.
• Restless legs syndrome (RLS): With this syndrome, you feel a strong urge to move your legs, usually during rest periods, especially in the evening and at night. This prevents you from falling asleep in a relaxed manner. RLS is still being researched, as the causes are not yet fully understood.
• Sleep phobia: A fear of sleeping itself or of nightmares can cause you to delay or avoid falling asleep.
• Shift worker syndrome: Irregular working hours and shift work disrupt the sleep-wake cycle, making it difficult to fall asleep at unusual or highly variable times.

Disturbed Sleep-Wake Cycle

A disturbed sleep-wake cycle can be a major cause of difficulty falling asleep. The circadian rhythm is your internal biological clock that regulates sleep and wake phases over approximately 24 hours.

If you frequently go to bed at different times or disrupt your natural rhythm through shift work, travelling across time zones (jet lag), or irregular sleeping habits, it can be much more difficult to fall asleep. Your body finds it difficult to adapt, and you do not get tired at the right time, which leads to long periods of lying awake and difficulty falling asleep.

Caffeine Consumption

If you can’t sleep, you might want to evaluate on your caffeine consumption. Caffeine can cause issues falling asleep by blocking the effects of adenosine, which builds up in your brain throughout the day. Adenosine is a neurotransmitter that triggers feelings of drowsiness and relaxation when it binds to the receptors in your brain. The amount of adenosine in your brain naturally increases by the evening to make you sleepy and prepare your body and brain for sleep. [4]

When you drink caffeinated beverages (coffee, energy drinks, etc.), the caffeine blocks the adenosine receptors and prevents the adenosine from docking onto them and making you sleepy. Instead, more and more adenosine builds up in your brain because it can't dock.

While you sleep, your brain breaks down the accumulated adenosine in your brain. If you have a large or excessive amount of adenosine in your brain that has not been able to dock, then this excess adenosine cannot be sufficiently broken down during sleep, and you wake up sleepy in the morning.

Stress & Worries

Stress can also cause problems falling asleep by increasing the production of stress hormones such as cortisol, which increases your alertness and makes it harder for you to relax. [5]

Constant tension prevents you from calming down mentally, making it harder to fall asleep. Chronic stress can also disrupt the natural production of sleep hormones such as melatonin, disrupting your sleep-wake cycle and making it harder to fall asleep.

Stress and a lack of sleep can also lead to the so-called cortisol belly — an increased fat storage in the abdominal area. [5]

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What Symptoms Can Occur with Chronic Insomnia?

The following symptoms can occur with chronic problems falling asleep:

1. Fatigue and exhaustion: persistent sleepiness and a feeling of sluggishness during the day.
2. Difficulty concentrating: Difficulty focusing or staying alert.
3. Memory problems: Deterioration of short and long-term memory.
4. Irritability and mood swings: Increased irritability, mood swings and even a depressive state of mind.
5. Decreased performance: Decreased physical and mental performance.
6. Headaches: Frequent occurrence of tension headaches or migraines.
7. Weakened immune system: Increased susceptibility to infections and illnesses.
8. Changes in appetite & weight gain: Irregular appetite that can lead to weight gain or unexplained fat deposits in the abdominal area.
9. Cardiovascular problems: Increased risk of high blood pressure, heart disease and other cardiovascular problems.
10. Gastrointestinal problems: Digestive problems such as upset stomach or irritable bowel syndrome.

What Helps if You Can’t Sleep? 7 Tips for Healthy Rest

Would you like to finally sleep through the night again and wake up feeling fit and fresh the next day?

We have put together seven practical and science-based tips on how to counteract your problems falling asleep and regain access to slumber land.

Sleep Aids & Dietary Supplements

Use natural sleep aids such as melatonin supplements or essential oils (e.g., lavender), which have a calming effect and can help you fall asleep.

Essential oils such as lavender have calming properties that reduce stress and promote relaxation by influencing the nervous system's activity. A study has shown that inhaled lavender oil (e.g., through a diffuser) positively affects sleep quality. [6]

Passionflower (Passiflora incarnata) is a medicinal plant and a proven household remedy that is traditionally used in the form of tea to promote sleep and relieve anxiety. Its calming properties make the medicinal plant a natural remedy to combat issues of falling asleep. [7]

Passionflower contains compounds such as flavonoids and alkaloids that act on the central nervous system by increasing GABA (gamma-aminobutyric acid) activity. GABA is a neurotransmitter with a relaxing and anxiolytic effect. It prepares the body for sleep and can shorten the time it takes to fall asleep.

Establish Sleep Hygiene

Practicing sleep hygiene has been shown to improve sleep. [8] Provide a comfortable sleeping environment with a good mattress, cool room temperatures and dark, quiet conditions.

A cool temperature helps to lower your body's core temperature, which aids the sleep process. Darkness promotes melatonin production, and a quiet environment reduces distractions that could make it difficult to fall asleep.

You can also introduce a bedtime ritual, where you perform certain routines (e.g., a skincare routine) before going to sleep, signalling to your body that it can now settle down.

There are also certain apps with special bedtime stories or relaxing sounds (note: switch on night mode to avoid exposure to blue light) or white noise devices that you can incorporate into this ritual.

Create a Sleep Routine

Set up a fixed sleep routine by going to bed at the same time every night and getting up at the same time in the morning. This consistency strengthens your sleep cycle, which regulates the times you sleep and wake up.

Drink Tea

Before going to bed, drink a cup of tea with calming herbs such as chamomile or lavender. These herbs contain compounds that calm the nervous system and promote muscle relaxation.

Chamomile contains apigenin, an antioxidant that binds to certain receptors in the brain and promotes sleepiness, while lavender is known to reduce anxiety and stress. [6]

Moon Milk

This drink promotes relaxation and can help prepare the body for a restful sleep. Do you like a glass of wine before you go to bed? Then try switching to Moon Milk. Because it's a real sleep aid without any unhealthy side effects!

Ingredients:

• 1 cup plant milk (e.g. almond milk, oat milk or coconut milk)
• 1/2 teaspoon ashwagandha powder
• 1/2 teaspoon cinnamon
• 1/4 turmeric
• 1 pinch of nutmeg
• 1/2 teaspoon vanilla extract (optional)
• a pinch of ground cardamom (optional)
• 1 teaspoon honey (optional, depending on taste)

Preparation

1. Heat up: Heat the plant milk in a small saucepan over a medium heat. It should be hot, but not boiling.
2. Mix: Stir the ashwagandha powder, cinnamon, turmeric, nutmeg and cardamom (if using) into the hot milk. Stir well until all the ingredients are completely dissolved.
3. Sweeten: If desired, add honey and vanilla extract and stir again.
4. Serve: Pour the Moon Milk into a cup and enjoy slowly before going to bed.

Reduce Screen Time

Avoid using electronic devices such as smartphones, tablets and computers for at least an hour before bedtime. The blue light from these screens inhibits melatonin production and makes it harder to fall asleep, affecting your body's circadian clock.

Reducing screen time supports natural melatonin production, which helps you fall asleep faster and experience deeper, more restful sleep. [9]

Exercise Regularly

Incorporate regular physical activity into your daily routine, but avoid intense exercise just before bedtime.

Sport helps to reduce stress and improve sleep quality by stabilizing your circadian rhythm and supporting the production of sleep-promoting hormones such as endorphins. [10]

Eat Healthy

Your diet also plays an important role in good sleep. Foods rich in tryptophan, such as milk, yogurt, bananas and nuts, promote the production of serotonin and the sleep hormone melatonin, which support sleep.

Low-carbohydrate meals in the evening can keep your blood sugar levels stable and reduce nighttime interruptions.

Avoid caffeine and alcohol. These substances affect sleep quality by reducing deep sleep stages and causing nighttime awakenings.

Similarly, heavy, fatty or spicy foods before bedtime can cause digestive problems and discomfort, making it difficult to fall asleep or causing problems sleeping through the night. A balanced diet, therefore, promotes restful sleep.

Sleep Medicine

Sleeping pills (sleep medicine) can also help with severe sleep problems in the short term but should only be used in the most severe cases as they often have side effects and can even lead to addiction.

Sleeping pills usually only treat the symptoms and not the causes of problems falling asleep, which can exacerbate your insomnia in the long term. A more sustainable solution is to change some of your lifestyle aspects and sleeping habits to improve the quality of your sleep.