Why you have trouble falling asleep

Stress
Unbridled stress causes difficulty falling asleep as well as sleep disruption (waking in the middle of the night with trouble getting back to sleep). People wracked with stress can't turn off the worry: when they lay down their minds race; or when they wake up in the middle of the night, their worries take hold and keep them awake. Researchers have begun to follow the destructive path of the stress hormones and other biochemical messengers that keep your neuroendocrine system hyperactive, even into the middle of the night.

Stress per se doesn't necessarily keep you awake, but worrying about stressful things can keep you awake. And because sleep deprivation mimics the effects of stress by elevating stress hormone levels and activating anxiety-promoting areas of the brain, you set up a vicious cycle: you're stressed so you can't sleep; then the lack of sleep makes your stress worse. You quickly become perpetually exhausted. Unremitting stress has also been shown to trigger nightmares, increasing demands on your nervous system.

The many negative effects that unbridled stress produces in your nervous system can have serious consequences during sleep. The early morning between 4:00 and 8:00 a.m. – when rapid eye movement (REM) is at its peak – is the time of day with the highest incidence of heart attacks (and this doubles on Monday mornings). This is largely due to stress-induced declines in your heart's ability to handle the shift from the calming, parasympathetic nervous system dominance of non-REM sleep to the stimulating, sympathetic nervous system dominance of REM sleep. As your nervous system starts to wake up, a stressed heart sometimes just can't take it. Clearly, cardiovascular problems need to be diagnosed early and treated by a specialist. Along with proper treatment, a conscious stress reduction program coupled with regular moderate exercise will help to protect the heart during times like the early morning when nervous system shifts require healthy flexibility of the heart muscle.

One further caveat has to do with managing stress when you actually do wake up. If you wake up, jump out of bed, and go straight into panic mode over your work responsibilities it can be tough on your ticker. Starting your day with your stress under control will keep it in better control all day and give more consistent energy.

Snoring
Scientists are undecided about the health consequences of general non­apnea snoring. Light to moderate snoring is not caused by any abnormality, but rather originates from vibrations of tissue in the throat and air passageways. Your own snoring episodes can cause blood pressure to rise (not to mention what it does to your spouse), but snoring is not considered a cause of daytime hypertension. My primary concern is what snoring does to your ability to get a good night's rest: The resistance that snoring produces in your airways can cause frequent arousal and fragmented sleep. It can throw off the normal balance of calming, parasympathetic nervous system domination during sleep. Snorers have an increase in stimulating sympathetic nervous system dominance during sleep, which consumes energy and can lead to daytime fatigue.

Snoring solutions are the same as for sleep apnea. Try reducing alcohol intake and changing your sleep position before making the bigger financial and lifestyle commitment of obtaining a prescription device like the CPAP. Sometimes helpful is a surgical procedure called a uvulectomy, removal of the small punching bag (uvula) that hangs at the back of the throat to prevent it from obstructing the airway.

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Excerpted from The Source, copyright 2008 by Woodson Merrell. Used by permission of Random House Canada. All Rights Reserved. No part of this excerpt may be reproduced except with permission in writing from the publisher.