When it comes to sleep, the mind is often more willing than the body.
A host of things can keep us awake, from twitching legs to vivid nightmares. UCI Health sleep medicine expert Dr. Rami Khayat weighs in on some common obstacles to getting restful sleep and how to overcome them.
A good night of rest involves adequate time in the rapid-eye movement, or REM, stage of sleep. When your sleep is disrupted, REM time suffers — and so does your health. REM sleep is associated with better mental health, a stronger immune system and an overall feeling of alertness when you wake.
When you’re not tired at bedtime
It’s not unusual to feel wide awake even though it’s time for bed, says Khayat, medical director of UCI Health Sleep Medicine Services and a nationally recognized sleep disorder expert.
One contributing factor is the amount of time we spend sitting at work and at home.
“As we have become more sedentary, we are less physically tired by the end of the day, which does not help with initiating sleep,” he says.
To counteract that, Khayat suggests a regimen of mild to moderate intensity exercise in the evening. A short jog or brisk 30- to 45-minute walk a few hours before bedtime can help prepare your body for rest.
“Exercise does stimulate us for a short period immediately afterwards, but it also promotes tiredness by bedtime.”
Twitching legs can disrupt sleep
Restless leg syndrome (RLS) is a sensory motor disorder that causes unpleasant feelings in your arms or legs along with an uncontrollable urge to move or stretch the affected limb.
It affects up to 10% of Americans, including an estimated 1 million school-age children, according to the National Institutes of Health.
Exercise can also help relieve RLS, Khayat says. He recommends mild to moderate exercise about four or five hours before bed to promote muscle relaxation in the evening.
“Exercising the muscles increases adenosine, which appears to facilitate deep sleep.”
Another intervention some may find helpful is a warm bath or submerging the legs in warm water close to bedtime. Khayat says some patients also report relief after a massage or stretching before bedtime.
When dreams disturb
Dreams are normal. Remembering them, Khayat says, is often a function of awakening during or shortly after one.
Other disruptions to the sleep cycle occur for a variety of reasons.
Sleep disorders such as sleep apnea can result in a person waking up numerous times during the dream stage of sleep. “That’s why patients can remember their dreams vividly,” says Khayat.
Consuming alcohol and caffeine before bed can also lead to fitful sleep and vivid dream recall.
Depression and more serious mental health conditions such as post-traumatic stress disorder can also disrupt sleep, he notes.
Two things can help foster a solid night of rest, according to Khayat: “People should maintain a regular sleep-wake schedule and avoid alcohol or caffeine close to bedtime.”
Wide-awake in the middle of the night
Most people have woken up and found themselves unable to fall back to sleep. It’s normal, says Khayat.
“If this happens occasionally or for a short period of time in association with work or personal stress, it is transient, and nothing to worry about.”
But when sleep disturbances are a regular occurrence, it’s called insomnia, a worrisome condition estimated to affect about 20% of adults.
Khayat recommends not fighting it too much. If you can’t fall asleep after 20 minutes, get out of bed and engage in a quiet activity like reading, meditating or a crossword puzzle. It’s best to avoid bright lights, noise and electronics — think cell phones or video games.
“Go back to sleep only when sleepy,” Khayat says. “And avoid watching the clock during these awakenings.”
To promote better rest, he also suggests thinking about all of the next day’s tasks and resolving any worries before going to bed.
“Schedule a time in the evening before going to bed to go over the typical things that keep us up at night and write them down before going to sleep.”