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Can't Sleep

By: Dr. Jeremy Fink, LCSW, Psy.D.  |  June, 19th, 2017

Sleep is essential for good health; however, we know very little about it. We spend a third of our lives sleeping, there isn’t a single activity that humans do more of, yet we don’t fully understand its purpose. There is no “normal” amount of sleep, one person’s 9 hours may be equivalent to another’s 6. Whatever amount of sleep one needs, it is estimated that as much as 50% of people aren’t getting enough of it.


Insomnia is a lack of quantity and quality of sleep that interferes with normal daytime functioning. Suffering from insomnia can mean a difficulty falling asleep, or staying asleep, or both, and it’s effects can be debilitating.


Causes of insomnia vary; psychological conditions such as depression and anxiety, sleep disorders including apnea, restless leg syndrome, medical illnesses such as acid reflux, asthma, arthritis, and chronic pain, and overuse of stimulants including caffeine and nicotine, even use of sleeping pills and alcohol can impair sleep.   


The first step to tackling insomnia is to visit your physician’s office. It is important to rule out any underlying medical condition that may be causing your insomnia. However, if your physician is quick to prescribe sleep medication, having found no physical ailment, it is worth some careful consideration. Short term use of these medications may be effective, but long term, they can be habit forming and even worsen the condition.  


Insomnia can occur at any age; in my practice in Malibu I see people of all ages suffering from sleep disorders. The most common cause of sleep disorders are depression, anxiety, and stress. Though most people experience short episodes of insomnia, often related to a temporary stressor in their lives, those with a more chronic condition suffer from poor school or workplace performance, relationship dysfunction, and physical injury and accidents. The debilitating effects of insomnia compound the problem, exacerbating the symptoms of depression and anxiety, which in turn, leads to more insomnia.


Attending weekly psychotherapy sessions can help stop this cycle, but often lifestyle changes and adopting healthy sleeping habits are necessary as well. Though not exhaustive, here is a list of helpful tips to improve sleep.


  • Eat healthy. I could write an additional article on just this topic alone; however, in short, make sure your body is getting what it needs, such as healthy fats, vegetables with vitamins and minerals, whole grains, etc. Be mindful about what your body is craving and try to eat a more balanced diet. Don’t substitute meals with sugary juices, supplements, bars, or powders. Eating disorders, including restricting foods and bingeing on foods can exacerbate a sleep disorder, for which psychotherapy is necessary.

  • Drink water. Drink enough throughout the day. Again, don’t go overboard. Too much water can be detrimental to your health. Be mindful of your thirst and hunger. The guideline used to be 8oz of water 8 times per day, which is just under 2 liters. Everybody’s needs are different, and although creating an exact guideline for everyone would be impossible, water is your body’s principal chemical component, and every system depends upon it to function.

  • Exercise. The caveat to this is again to not go overboard. Exercise early in the day, avoid exercising close to bedtime, and try for 20 minutes each day. Blowing yourself out at the gym, tracking calories burnt, and moreover engaging competitively in your workout regimen may be a stress relief; however, in and of itself, it is not necessary for a healthy lifestyle and for some may be contributing to sleep problems. Sore achy muscles and the potential for injury are not a recipe for good sleep.       

  • Many people use their beds as an activity center. What better place to plug into your laptop or tablet and relax. Especially for teenagers and those with depression and anxiety, the bed is a popular place. Only use your bed for sleep. And if you can’t sleep, get up out of bed and do something else until you’re tired and try again. Do not lay in bed all night restless.

  • Get enough daylight. Working under fluorescent lighting from dawn to dusk is bound to cause a sleeping problem. For those suffering with depression and anxiety, isolating and staying indoors watching Netflix all day, results can be just as bad. Of course use common sense, don’t start tanning, follow dermatological guidelines for sun exposure, but getting some sunlight is essential for sleep.

  • Make sure your bedroom is dark, cool, and sound controlled. Use a noise machine or fan that makes a steady white noise.

  • Avoid stimulants such as coffee and nicotine.

  • Avoid alcohol.

  • Try to make bed and wake time the same each day so that you develop a rhythm.