I’m not sleeping, should I be worried? Causes, symptoms and treatment

Sleep is generally linked to satisfaction, Be synonymous with rest and recovery both physically and mentally. Likewise, most people know how annoying it is not to get enough sleep.

And it is that sleeping is a fundamental human need, which if it is not satisfied can have consequences on health and even in the event of total absence during the sufficient time of death. Sleep disturbances are a very annoying thing for most human beings and some people can become restless when faced with this difficulty. It is not uncommon for thoughts such as “should something bad happen to me?”, “Why is it so hard for me to sleep?”. “I’m not sleeping, should I be worried?”.

In order to try to answer some of these questions, in this article we will try to think about the reasons for sleep deprivation, the problems it can cause and how to treat it.

    Difficulty getting enough rest

    “I don’t get sleep” is a phrase we use regularly and generally refers to the fact that our bodies he remains in such a state of activity that the urge to sleep does not appear, Or that even if these exist, we cannot be reconciled. Although this lack of sleep does not necessarily have to be pathological in general, it is associated with the existence of insomnia, which is defined as the inability to initiate or maintain sleep or the fact that it is not. not repairing for at least three nights. at least three months.

    Getting less sleep than we need (which is estimated to be around seven or eight hours a day in adults) has significant effects for us.

    In general, not sleeping at the right time will actually cause us to sleep less, which will make our bodies and brains unable to fully repair themselves, have problems finishing developing, have difficulty reorganizing and storing. The information acquired during the day i not being able to restore the body’s energy levels.

    In short, it can cause problems such as fatigue and daytime fatigue, a weakened immune system that makes us more vulnerable to infections, a physical and / or mental slowdown, a decrease in attention, judgment and reasoning. , and a state of irritability or depressed mood. too much increases the risk of developing diabetes and cardiovascular diseaseIn the long term, this can decrease cognitive abilities and even life expectancy.

    “I have no sleep”: causes of sleep problems

    There are many possible reasons why a person may not be able to sleep or have difficulty sleeping, which is usually a multifactorial phenomenon. Among the many causative agents that can participate in or directly cause sleep problems, we find the following.

    1. People with little need for sleep

    Each of us is unique and has a different configuration, there are people who naturally sleep less than others. It doesn’t mean they suffer from insomnia: They have no problem falling asleep or maintaining sleep or the difference in sleep hours compared to others does not generate any symptoms.

    Of course, this means that there is no sudden change in the ability to sleep, but that it remains broadly stable (beyond age changes).

    2. Anxiety, restlessness and worry

    Worry, stress, or anxiety are probably one of the most common causes of most difficulty sleeping.

    The nervousness generated by certain types of thoughts or situations we are going to have to face or with those we might encounter, it can cause the body and mind to remain active and present great difficulty falling asleep, appearing as insomnia.

      3. No association of the bed as a specific place to sleep

      Many people find it difficult to sleep because they are unable to associate sleep with the specific place they use for it: the bed. This may be because they generally use it for working or studying lying on it, having fun or performing various activities in addition to sleeping or having sex. like that, by not associating the bed with rest, our mind wanders and remains active, Which makes us sleepy when the time comes.

      4. Physical activation

      Everyone knows that regular exercise helps you sleep better. However, this effect only occurs if the exercise performed is not done right before sleeping, as physical activity can increase the activation of the body and cause problems falling asleep. This is why it is not advisable to exercise shortly before bedtime, as the body may have difficulty detecting that it is time to sleep before physical activation and the synthesis of neurotransmitters it causes.

      5. Mania

      Another common cause of sleep deprivation occurs in people with bipolar disorder, More precisely when they are in a manic or hypomanic phase. In this state, although they do fall asleep, they usually perceive a less need for sleep and stay awake much longer.

      6. Use of certain drugs

      Many drugs have some type of sleep disorder as a side effect. Although these effects usually involve drowsiness or sedation, other medications can cause difficulty falling asleep. Those that affect the functionality of the autonomic nervous system, such as certain psychotropic drugs, antihistamines or corticosteroids.

      7. Effects of substance use

      In addition to the above, another possibility of sleep deprivation can be found in the effects of substance use, being something secondary to their consumption.

      Lack of sleep is generally associated in these cases with phases of sleep deprivation intoxication with psychostimulants like cocaine or amphetamines, either in abstinence or in case of tolerance to depressive substances such as heroin or opium. Alcohol can also cause insomnia and difficulty sleeping after the first few hours after drinking.

      Likewise, making coffee, tea, soft drinks, or chocolate they can have activating effects that make it difficult to sleep.

      8. Possible brain damage

      One of the causes of the lack of sleep is damage to different parts of the brain related to waking up or sleeping. One of them would be the thalamus. Another is in the descending reticular system, a part of the brain that inhibits arousal and attention to environmental stimuli and allows us to sleep. Damage to these areas would cause severe difficulty in sleeping or even an inability to sleep. Excessive or even pathological activation of the amygdala can also cause these difficulties.

        9. Medical diseases

        Another possible reason for stopping falling asleep is suffering from a type of illness that secondarily generates sleep disturbances, including insomnia. Examples of this are those with people associated with pain or diseases of genetic origin.

        The clearest and most serious case is probably that of fatal familial insomnia, a strange genetic disease present in a few families that begins ensure that the patient has only microphones and little by little it causes the total cessation of sleep, something which ends up bringing death to the one who undergoes it. However, this disease is extremely rare, so in the vast majority of cases there is no cause for alarm.

        10. Inadequate circadian rhythms

        There is not always real insomnia, but sometimes the problem can be more in the fact that our circadian rhythms are out of tune, and can conflict with our social and professional obligations and demands. that’s why nighttime insomnia and daytime sleepiness may occur.


        The treatment for sleep deprivation or difficulty will depend greatly on the type of causes that generate them. In general, one of the basic steps will be to first assess where one considers this lack of sleep, and if necessary do a polysomnigraphy to check if during sleep we enter all the phases of sleep or have some kind of difficulty in some in particular.

        At the level of the therapy itself, at the psychological and behavioral level, it is common to perform sleep hygiene, analyzing and using different guidelines through which to promote through our behaviors and habits the existence of a dream of quality. These would include regulating meal or sports times according to bedtime, controlling light and sound, or using the bed only for sleeping or having sex. too much learning relaxation, mindfulness or meditation techniques can be helpful.

        In the event that the cause is anxiety, the above therapies may be helpful, as well as training in anxiety, frustration and stress management, cognitive restructuring, or biofeedback. It’s common to think and worry about your own inability to fall asleep, which makes it even more difficult, facilitating techniques that interrupt active sleep research.

        In addition, it can also be useful occasional or temporary use of some type of psychotropic drug indicated by the doctor to facilitate sleep, being generally used hypnotics-sedatives such as zolpidem or benzodiazepines. If the cause is organic or derived from drug use, you should treat the condition or ask your doctor about changing the treatment. As with drugs, intoxication or withdrawal syndrome should be treated.

        Bibliographical references:

        • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Masson, Barcelona.
        • American Sleep Disorders Association Diagnostic Classification Steering Committee. (1990). International Classification of Sleep Disorders: Diagnostic and Coding Manual. Rochester (MN): American Association of Sleep Disorders.
        • Sants, JL; Garcia, LI; Calderon, MA; Sanz, LJ; of rivers, P .; Left, S .; Román, P .; Hernangómez, L .; Navas, E .; Lladre, A and Álvarez-Cienfuegos, L. (2012). Clinical Psychology. CEDE PIR preparation manual, 02. CEDE. Madrid.

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