Combating Sleeplessness: What’s Keeping You Awake at Night?

Are you getting enough sleep?

The National Sleep Foundation's 2010 Sleep in America poll found that one-fourth of those surveyed said their work schedule did not allow adequate time for sleep. One-third of those surveyed reported that they didn't get enough sleep to function at their best.

People who don't get enough sleep and wake up feeling tired or not well-rested often have trouble focusing on tasks. According to the National Institutes of Health, older adults who don't sleep well at night are more likely to have problems with memory and attention. In some jobs, such as healthcare or those involving operating heavy machinery, lack of sleep has been associated with errors and increased risk of accidents.

Sleep-deprived people of all ages may pose a risk to themselves and others while driving. The National Highway Traffic Safety Administration conservatively estimates that driver fatigue is the direct cause of 100,000 police-reported crashes each year resulting in an estimated 1,550 deaths.

And, if there weren't compelling enough reasons for focusing on sleep, numerous studies have associated prolonged or chronic sleep deprivation with medical issues ranging from obesity and mood disorders to diabetes and heart disease, and may lead to a shortening of life expectancy.

How Much Sleep is Enough?

According to the Centers for Disease Control, sleep needs vary by person and age:

Your body also has an internal 24-hour clock that causes you be to be sleepy and less alert during the nighttime and mid-afternoon hours. Most people go through several cyclic sleep stages, each stage about 90 minutes long, every time they sleep.

When you disrupt your sleep cycle, either by getting insufficient sleep or poor quality sleep, you accumulate a "sleep debt" that causes additional sleepiness and fatigue. While sleep debt can be paid down, it may not happen overnight. Some studies suggest it takes longer to recover from extended sleep disturbances than one good night's sleep.

"If you're feeling alert and well rested, you're probably getting enough sleep," says Liz Ferron, senior EAP consultant for VITAL WorkLife. "Some people need very little sleep, but for others the inability to sleep is a serious problem."

Common Causes of Sleeplessness

The most common cause for sleeplessness is insomnia. Other people may be suffering from more serious sleep disorders such as sleep apnea or restless leg syndrome.

• Insomnia: A condition that can make it hard to fall asleep, hard to stay asleep, or both.
• Sleep Apnea: A condition that causes short pauses in breathing while sleeping which may happen many times during the night. If not treated, sleep apnea can lead to other problems such as high blood pressure, stroke or memory loss.
• Restless Leg Syndrome: A condition in which your legs feel extremely uncomfortable, typically in the evenings while you're sitting or lying down.

Does Your Sleep Need to Be Evaluated?

The National Sleep Foundation suggests asking yourself the following questions to determine whether you might benefit from a sleep evaluation:

• Do you regularly have difficulty getting to sleep or staying asleep?
• Do people tell you that you snore? Has anyone ever told you that you have pauses in breathing or that you gasp for breath when you sleep?
• Are your legs "active" at night? Do you experience tingling, creeping, itching, pulling, aching or other strange feelings in your legs while sitting or lying down that cause a strong urge to move, walk or kick your legs for relief?
• Are you so tired when you wake up in the morning that you cannot function normally during the day?
• Does sleepiness and fatigue persist for more than two to three weeks?

If you answered yes to more than one of those questions, you should talk to your physician. Sleep apnea and Restless Leg Syndrome typically require medical treatment—but many people manage insomnia with simple changes in behavior.

Insomnia: Symptoms & Risk Factors

Temporary insomnia is common and is often brought on by stressful situations such as work, family pressures or a traumatic event. A National Sleep Foundation poll of adults in the United States found that close to half of the respondents reported temporary insomnia in the nights immediately after the terrorist attacks on September 11, 2001.

Chronic insomnia is defined as having symptoms at least three nights per week for more than one month.

If you're suffering from insomnia, you may:

• Lie awake for a long time before you fall asleep
• Sleep for only short periods
• Be awake for much of the night
• Feel as if you haven't slept at all
• Wake up too early

According to the National Institutes of Health National Heart, Lung and Blood Institute, insomnia is a disorder that affects women more than men and can occur at any age. People at risk for insomnia may:

• Have a lot of stress
• Be depressed or have other emotional distress, such as divorce or the death of a spouse
• Work at night or have frequent major shifts in their work hours
• Travel long distances with time changes
• Have one or more medical conditions
• Have an inactive lifestyle

Behaviors that may contribute to insomnia include:

• Engaging in vigorous exercise just before going to bed
• Consuming large meals late in the day
• Consuming caffeinated beverages throughout the day

Environmental factors that may contribute to insomnia include:

• Noise
• Light
• Extreme temperatures (hot or cold)
• Mosquitoes and other pests

You may have one or more risk factors—but which one is keeping you awake? The National Sleep Foundation recommends keeping a sleep diary where you keep track of:

• The time you went to bed last night
• How long (number of minutes) it took you to go to sleep
• The number of times you woke up during night
• The number of hours you slept
• Anything that disturbed your sleep (mental, physical, emotional, environmental)
• How you felt when you woke up (refreshed, somewhat refreshed, fatigued)
• The number of caffeinated drinks you consumed the day before
• The minutes of exercise you got the day before
• What you did in the last 2 to 3 hours before you went to bed

"A sleep diary can help you pinpoint the factors that are causing you to lose sleep," says Ferron. "You may see some obvious patterns with obvious solutions. You may also see areas where you can use some help—and we're here 24/7 to provide that support."

Getting a Good Night's Sleep:

We Can Help!

Stress is a major cause of sleeplessness—and if you're experiencing unusual levels of stress at work or at home, VITAL WorkLife can help! Access your resources by calling 800.383.1908 or through your VITAL WorkLife App. 

Your EAP benefit includes free and confidential professional support services from VITAL WorkLife—24 hours a day, 365 days per year—to help you and your family members address the challenges that are keeping you awake at night, such as:

• A change in job or job responsibilities
• Interpersonal conflict at home or work
• Marital and relationship troubles
• Legal and financial problems
• Preparing for your own or your spouse's retirement
• Children moving away from or returning home

Working with an EAP consultant, you can sort through the stressors that are causing anxiety and sleeplessness—and help you assess whether medical help is needed.

Senior EAP consultant Jody Bertram recalls working with a young father who was exhausted from lack of sleep. In addition to home and family conflicts, he was also suffering from sleep apnea and major depression.

Through the EAP, he was referred to doctors who prescribed a CPAP machine for his sleep apnea and medication for depression. Through EAP counseling he was able to address work and family stresses with improved work/life balance and communication skills.

Bertram said, "He's not only enjoying a better night's sleep, he's also enjoying greater life satisfaction during his waking hours."