What’s Keeping You Up at Night? Breaking the Cycle of Sleeplessness
A good night’s sleep is undeniably refreshing and revitalizing and is also essential to overall health and well-being. Sleep experts continue to emphasize that healthy sleep is just as important as proper nutrition and regular exercise. Consistently poor sleep has been linked to an increased risk of type 2 diabetes, high blood pressure, cardiovascular disease, depression, anxiety, and weakened immune function. Sleep also plays an important role in memory, concentration, mood regulation, and long-term brain health.
While the sleepless nights and drowsy days experienced during the pandemic reached historic highs, sleep difficulties remain widespread in 2026. According to recently released national data, nearly one in three U.S. adults still report getting fewer than the recommended seven hours of sleep per night, and sleep difficulties continue to affect millions of Americans. Approximately one in six adults reports trouble falling asleep, while one in five struggles to stay asleep through the night. Women are more likely than men to experience sleep disruptions and wake feeling unrested. These findings reflect national sleep survey data current through 2025-2026.
Sleep disturbance is closely intertwined with mental health concerns such as anxiety and depression, with each condition capable of influencing and worsening the others. Because of this relationship, it is not always possible to determine which issue began first. Chronic insomnia can contribute to feelings of being overwhelmed, difficulty concentrating, irritability, nervousness, restlessness, and heightened worry or a sense of impending doom. Sleep disorders are also highly prevalent among individuals with mood disorders. Research continues to show that insomnia is one of the most common symptoms of depression, with a substantial majority of people diagnosed with depression reporting persistent sleep difficulties. Obstructive sleep apnea, a condition in which breathing repeatedly pauses during sleep, may also coexist with depression and anxiety, further affecting energy, cognition, and emotional well-being.
Similarly, anxiety can make it more difficult for the body and mind to relax enough to fall asleep. It may also disrupt rapid eye movement (REM) sleep, increasing the likelihood of vivid or disturbing dreams that interrupt rest. Completing the cycle is sleep anxiety, apprehension or fear about going to sleep, which is commonly seen in individuals with insomnia, narcolepsy, sleep apnea, or restless legs syndrome. Recognizing and addressing sleep concerns early is important, as effective treatment can significantly improve both physical and mental health. Although insomnia may feel like a never-ending cycle, effective strategies can help improve sleep and restore restful nights.
Support can include:
- Cognitive behavioral therapy for insomnia (CBT-I) remains the first-line treatment for chronic insomnia. This evidence-based approach helps individuals identify and change thoughts and behaviors that interfere with sleep, while building healthier sleep habits and routines. CBT-I may include strategies such as stimulus control, sleep scheduling, relaxation techniques, and reducing sleep-related anxiety. Results often take several weeks, but research shows benefits are long-lasting and frequently more effective than medication alone.
- Prescription sleep medications may be appropriate in select situations, particularly for short- term use or when insomnia significantly affects daily functioning. Medications such as zolpidem (Ambien) or eszopiclone (Lunesta), as well as certain low-dose antidepressants or newer sleep agents, may be considered alongside CBT-I. Because sleep medications can carry risks such as daytime drowsiness, dependence, tolerance, falls in older adults, or next-day impairment, close medical supervision is important.
- Light therapy and circadian rhythm support can be especially helpful for individuals whose internal body clock is out of sync with their schedule. Strategic exposure to bright light in the morning, limiting evening light exposure (particularly from screens), and maintaining consistent sleep and wake times may help reset circadian rhythms and improve sleep quality, particularly for night owls, shift workers, or those adjusting to schedule changes.
If restless or wakeful nights are becoming more frequent, please let us know. Persistent trouble falling asleep, staying asleep, waking too early, or feeling unrefreshed during the day may signal an underlying sleep issue that deserves attention. Keeping a sleep diary for several weeks can help identify patterns and habits that may be affecting your ability to get restorative rest, including bedtime routines, caffeine or alcohol intake, screen time, exercise, stress, and sleep consistency. In some cases, additional evaluation may be recommended, including a sleep study (polysomnography) or home sleep apnea testing, depending on your symptoms. These studies assess factors such as breathing patterns, oxygen levels, heart rate and rhythm, body movement, sleep stages, and snoring to help identify conditions such as insomnia, obstructive sleep apnea, restless legs syndrome, or other sleep disorders.
Finally, remember that sleep needs vary from person to person. While most adults are encouraged to aim for at least seven hours of sleep nightly, quality matters as much as quantity. A helpful measure is how you feel during the day: if you wake feeling rested, remain alert, and function well throughout daily activities, your sleep needs are likely being met.
The foundation begins with basics:
- Turn off TV, tablets and phones at least 30 minutes before bed.
- Limit large meals, caffeine and alcohol close to bedtime.
- Keep a consistent wake-up time seven days a week.
- Reserve your bedroom for sleep by keeping it dark, cool and quiet; turn around your clock so
you can’t see the time if you’re tossing and turning in the middle of the night. - Seek support for persistent sleep difficulties lasting three months or longer.
Sources: American Academy of Sleep Medicine; National Institutes of Health
