Nearly everyone has experienced the struggle: you lie in bed, turn off the light, and try to fall asleep, but thoughts race through your mind, refusing to let go. You toss and turn, trying again, but sleep doesn’t come. The next day, you wake up tired, craving alertness that never arrives. Everything feels difficult—caring for the children, managing at work, handling daily tasks, and dealing with yourself. You lose patience in an instant, then feel frustrated with everyone around you. "Just get some sleep," those who slept soundly might suggest. This exhausting, endless cycle takes a severe toll on our quality of life and our ability to function.

 

Struggling to sleep? Here’s some important information to help you decide how best to address the challenge.

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Key Questions:

• What causes sleep difficulties?

• What is a sleep disorder versus sleep difficulties?

• Why is it so important to address sleep problems?

• How does emotional state impact sleep quality?

 

Why is it so important to address sleep problems?
Sleep issues significantly affect our emotional, mental, and physical health:

• Emotional impact – Mood swings, irritability, emotional sensitivity, impatience

• Cognitive impact – Reduced concentration, memory loss, impaired learning

• Physical impact – Weight gain, diabetes, weakened immune system

 

What Causes Sleep Difficulties?
The causes of sleep difficulties fall into three categories:

• Physiological sleep disorders

• Poor sleep hygiene

• Emotional difficulties

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Physiological Causes – Common Sleep Disorders
Insomnia (lack of sleep) is the most common sleep disorder and can affect all ages, though it is more prevalent in post-menopausal women.

• Sleep apnea – Most common in middle-aged individuals, particularly those with excess weight and more frequent in men.

• Circadian rhythm disorders – Sleeping at unusual hours, or extreme cases where one sleeps entirely during the day.

• Hypersomnia – Excessive sleepiness, manifesting in long nighttime sleep and daytime drowsiness.

 

These disorders and others of physiological origin are best treated by a sleep specialist. It’s recommended to start with a family physician to rule out other conditions affecting sleep quality, then follow the guidance provided. In contrast, emotional sleep difficulties can often be effectively addressed without medication through emotional therapy.

 

Environmental Factors

• New Parenthood – Adjusting to irregular sleep is one of the most significant sleep disruptors for new parents, especially when breastfeeding requires frequent nighttime waking. Distinguishing between psychological and situational sleep issues, as well as possible postpartum depression, is essential, as these are often underdiagnosed.

• High Humidity – Recent studies indicate that high humidity negatively impacts sleep quality.

• Noise Pollution – Common in busy cities, noise pollution includes sounds from nearby businesses, early morning construction, or emergency sirens.

• Light Pollution – This includes smartphone screens, clocks, TVs left on, or any artificial light that disrupts the darkness necessary for sleep.

• Random Disruptions – Examples include nearby construction or a late-night party from a neighbor.

 

Poor Sleep Hygiene
Sleep hygiene involves a set of practices aimed at improving sleep quality and continuity. Key recommendations include:

1. Go to bed only when you’re tired.

2. Can’t sleep after 15-20 minutes? Get up and return when truly sleepy.

3. Unsure you’ll fall asleep? Don’t go to bed yet.

4. No naps—if necessary, limit to 30 minutes and avoid after 3:00 PM.

5. Reduce alcohol, caffeine, and nicotine intake before bed (alcohol at least four hours, caffeine six hours, nicotine an hour before sleep).

 

Emotional Factors
Emotional issues are the most common cause of sleep difficulties. At night, when our defense mechanisms lower, the body expresses our struggles, often resulting in sleeplessness.

• Intrusive Thoughts – Lying in bed exhausted, but thoughts won’t stop. Tomorrow’s to-do list, reflections on the day, missed tasks, and memories from a morning meeting with a client flood your mind. Worries and regrets disrupt sleep.

• Stress and Anxiety – Academic or work pressures, life crises like divorce or job loss, or even thoughts about the current situation in the country can disturb sleep. Anxiety affects arousal levels, resulting in physical symptoms like a rapid heartbeat, shortness of breath, headaches, and other somatic pain, all preventing relaxation.

• Depression – Often associated with low energy and motivation, depression can make getting out of bed difficult. While it may seem like someone with depression is always sleeping, they often struggle with sleep disturbances and don’t wake up feeling refreshed.

• Trauma Response – Following a traumatic event, individuals may experience nightmares, flashbacks, and intrusive thoughts, creating an ongoing fear of sleep.

Sarit
Sarit, a mother of two young children aged 6 and 3, struggles with sleep. This lack of sleep leaves her exhausted, short-tempered with her children, underperforming at work, and feeling disconnected from her relationship. She lies in bed, bombarded by thoughts, plagued with guilt since her younger son was born. She worries about not giving her eldest the attention he once had while also feeling she cannot give the younger child the same focus. Her husband doesn’t fully understand her struggles. Through therapy, Sarit was diagnosed with postpartum depression, which had gone unrecognized after her first birth. She learned to view herself with compassion, accept her current imperfections, and embrace self-love. As Sarit allowed space for difficult feelings and stopped fighting them, her intrusive thoughts subsided, and she began sleeping better.

 

Yuval
Yuval, a 52-year-old father of two adult sons, found himself sleepless after his wife ended their 25-year relationship. When he discovered that she had hired a private investigator, he was deeply disturbed and unable to sleep. This sleep deprivation exacerbated his mental state, leading to anxiety attacks. Through therapy, he learned mindfulness and guided imagery techniques, helping him strengthen his self-confidence and develop a sense of agency. He arranged regular meetings with his children, improving their relationship, and his sleep transformed from a disruptive element into a crucial resource.

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Note: All identifying details have been changed to protect client confidentiality.