Having a hard time falling asleep?

If so, you’re not the only one. Research indicates one in four Americans suffer from acute, or short-term, insomnia each year. This common sleep disorder includes symptoms like daytime fatigue, having a difficult time concentrating, and frequently waking up during the night. But insomnia is notorious for its best-known symptom: sufferers often have an incredibly hard time falling asleep at night.

Insomnia has been on my mind lately considering the emotional stress many people are dealing with as a result of the coronavirus outbreak.

Stress is often a catalyst for insomnia, and the weight of the stay-at-home orders, coupled with fears a loved one could potentially be affected by COVID-19 or an outcome of it, can be incredibly taxing.

I won’t be surprised at all if data later indicates cases of acute insomnia increased during this time period.

There are a number of ways insomnia can negatively impact your health, but the one thing I keep coming back to lately is how important quality sleep is — especially during a pandemic.

You might remember this stat from earlier this year: people who get 6 hours of sleep or less each night are 4.2 times more likely to catch a cold than those who get 7 hours or more.

In other words: not sleeping isn’t doing your immune system any favors.

I know it sounds like I keep beating the same drum but sleep is vital right now and I can’t say it enough.

That’s why this week I wanted to run through 5 surprising sources of insomnia you might not know about. Watch out for these pitfalls, and you should give yourself a better chance of avoiding a bout of insomnia.

Bed Confusion

This might be a new one for you.

Bed confusion is when your body fails to associate your bed with going to sleep. This typically stems from doing too many activities in your bed that are not directly related to sleep. Whether it’s reading, doing a crossword puzzle, having a late night snack, or surfing your favorite social media app, you’re better off not doing it in bed.

We are creatures of habit and we also learn cues. Remember Pavlov’s dogs? After some conditioning around cues, when he rang a bell they salivated.

We are not different. When we lay in bed, watch TV, scroll social media, and eat (often mindlessly, especially now), our brain and body start to respond to bed as a place to be activated, not a place to rest.

As a general rule, you want to reserve your bed for two primary reasons: getting sleep, and, sex. Do that, and you’ll help your body avoid bed confusion and creating behavioral anchors that don’t help you sleep.

Back Pain

Anyone who has dealt with back pain before knows it’s the worst. One small turn in the wrong direction can suddenly have your body feeling like it’s been stuffed into a trash compactor.

That lingering and often searing pain that accompanies back injuries can make it incredibly difficult to fall asleep and stay asleep — one of insomnia’s trademarks.

Two quick tips to avoid having back pain derail your sleep: for those not suffering from back pain currently, remember to stretch. Stretching each morning for five minutes, especially as you get older, can loosen up your back muscles. This will give you a head start on making sure your back doesn’t keep you up later at night. And for those who do suffer from back pain, try placing a small pillow behind your knees when you go to sleep. This should help alleviate some of the pressure on your spine.

And now that I mention it, your pillow plays an important role in curbing back pain, too. You should change your main pillow every 12-18 months, so if you’re looking for a new one, I recommend the pillow I sleep on, Everpillow.


To all female readers, please keep in mind: you are especially susceptible to insomnia when going through menopause.

This has to do with menopause being driven by a drop in hormone production, including estrogen and progesterone.

Estrogen is known for being a hormone that regulates women’s reproductive function and menstrual cycle, but it also contributes to better sleep; higher estrogen levels are connected less sleep arousals during the night, as well as an easier time falling asleep.

Progesterone, on the other hand, helps prepare women for pregnancy. It also regulates mood, protects against anxiety, and contributes to a sense of calm. I often refer to progesterone as the “feel good” hormone; it’s been linked to increased production of GABA, a neurotransmitter that promotes better sleep.

Overall, hormones perform a delicate balancing act to help regulate mood, energy levels, libido and sleep — among other functions. Understandably, when there’s a decline in hormone production, it can throw off sleep patterns.

Maybe the most disturbing part of menopause for many women is hot flashes and bedtime and sleep is when they are often noticed most. It’s even worse when your bed partner is as hot as a heater too! One of the most useful sleeping accessories for hot flashes and hot sleepers is the Chilipad, I can’t tell you how many of my patients and friends swear by them.

(For more information, read my blog post on how menopause affects sleep.)

Your Diet

What you eat also impacts how you sleep.

Researchers from Columbia University earlier this year found diets high in refined carbohydrates have been linked to a higher risk of developing insomnia. That means soda, sugary foods, white rice and white bread are all foods you should eat in moderation.

But what is the temptation when we are bored and stressed? Refined carbohydrates and sugar!

How do these interfere with quality sleep? The reason refined carbs can be a problem, the study indicates, is that the body releases insulin when blood sugar increases rapidly; when blood sugar drops, hormones like adrenaline are released, which may make it harder to fall asleep.

On the opposite end, diets that include a large amount of fruits and vegetables did not increase a person’s risk of insomnia. While containing sugar, the fiber in fruit helps better moderate blood sugar spikes than refined carbs.


Let’s be clear from the get-go: naps aren’t bad for you. In fact, a well-timed nap comes with a number of health benefits, including giving you an energy boost, helping elevate your mood, and improving your physical performance.

But the old phrase “everything in moderation” certainly applies here. You don’t want your nap interfering with falling asleep at night, but that can often be the case.

To make sure that doesn’t happen, you want to watch out for two things. First, keep your naps to the early afternoon, if possible. Anything after 4:00 p.m. threatens to make it harder for you to fall asleep at a “normal” hour. And second, stay away from taking long naps. Anything past 90 minutes, when REM sleep starts to take place, is too much time. You run the risk of not feeling like you need to go to sleep at night, even though your body isn’t completely rested.

Instead, 20-30 minute “power naps” are a great alternative. (Read my blog post on napping from January to learn more about the power of napping).

Spend some time focused on eliminating or treating these sources of insomnia and you’ll find yourself sleeping better and feeling more rested in the morning.

This post originally appeared on The Sleep Doctor on April 4, 2020. It is republished with permission.