Q&A: Can’t Sleep Due to Temperature Sensitivity

A reader named Gunjan recently asked a question about trouble sleeping due to temperature changes at night. Here it is, lightly edited:

“It seems my body is very sensitive to temperature while I am sleeping. Many times it has happened that I went to bed at an optimal temperature. But as soon as my body sleeps, I wake up feeling too cold. Then I go to bed after switching off the fan or covering myself with the bed sheet but then I can’t sleep because I’m too hot. This is quite frustrating. . . . Does anybody . . . have any help to offer?”

Insomnia sufferers may have increased temperature sensitivity at nightA reader named Gunjan recently asked a question about trouble sleeping due to temperature changes at night. Here it is, lightly edited:

“It seems my body is very sensitive to temperature while I am sleeping. Many times it has happened that I went to bed at an optimal temperature. But as soon as my body sleeps, I wake up feeling too cold. Then I go to bed after switching off the fan or covering myself with the bed sheet but then I can’t sleep because I’m too hot. This is quite frustrating. . . . Does anybody . . . have any help to offer?”

Insomnia and Thermosensitivity

Insomnia may have something to do with compromised thermoregulation, but the issue has not been fully investigated, say authors of a paper on sleep and thermosensitivity. Evidence shows that older adults may have an impaired ability to recognize the most comfortable temperature for sleep, and this may relate to abnormalities in the area of the brain that evaluates comfort. Not much else is known.

But I’m never surprised when people complain of trouble sleeping related to temperature sensitivity. I have the problem myself. I’ve gone to bed in very hot and very cold situations and lain awake for a good chunk of the night. Like Gunjan, I regularly have to make small temperature-related adjustments in the middle of the night. Now, with some nights warm and others cool, is the season when it’s trickiest to get it right.

Temperature Changes at Night

Core body temperature varies by about 1.5 degrees Fahrenheit over the course of the 24-hour day. From a temperature high in the evening, it descends and reaches its low point some 1 to 3 hours before normal wake-up time. If you keep the bedroom windows open at night (a cool bedroom is good for sleep), the room temperature will likely drop as well. The combination of internal and environmental temperatures falling could easily explain why you might wake up feeling cold at night.

Covering yourself with a blanket or a bed sheet is the obvious way to make yourself comfortable enough to get back to sleep. But what if, like Gunjan, you then feel too hot?

Covering up can create a closed system where, once the skin temperature has risen enough to dilate the blood vessels close to the skin, the body heat then released has no place to go. It’s similar to the situation created by an electric blanket. The blanket continues to add heat to the body, increasing skin and core body temperatures. The heat the body would normally throw off is then trapped underneath the blanket. You wake up feeling too hot to sleep.

Here are two ways to keep from overheating at night:

  • Use sheets and blankets made of a breathable fabric such as cotton. Fabrics like polyester are more likely to trap heat rather than allow for its release.
  • When you cover up, see if keeping your feet outside the covers helps. You lose lots of heat through your extremities, so keeping them uncovered, or partially covered, may make you comfortable enough to sleep through the night.

Help for Sleep Onset Insomnia

It’s easier to go to sleep when core body temperature is falling, and people who have problems falling asleep—sleep onset insomnia—may have trouble cooling down at night.

Ideally, the temperature in the bedroom should be a little lower than is comfortable during the day. But there are also ways to facilitate internal heat loss. Activities that increase skin temperature eventually help to cool you down. Warming the skin dilates blood vessels close to the skin. This enables the release of body heat and a lowering of core body temperature to occur for a few hours after the activity ends, in turn facilitating sleep.

Early in the evening these activities may trigger processes that help you fall asleep:

  • Take a hot shower or bath
  • Spend time in a sauna
  • Do a resistance workout or aerobic exercise

As you’re winding down on cooler nights, mild heating of the hands and feet may dilate the blood vessels enough to facilitate heat loss, lowering your core body temperature and inducing sleep. But this is a losing strategy on the warmer nights. Lightly clad and barefoot is the way you want to be.

If you’re sensitive to temperature changes at night, what have you found that helps?

Can’t Sleep in the Summer? Here’s What to Do

Sunshine and warm weather are a boost to the spirit after a long, hard winter. But they may not do much for your sleep. In fact, if you’re sensitive to light and heat, long days and warm nights can be a setup for insomnia.

Here’s how to get more sleep as we move into June and July.

Insomnia may show up in the summer with longer days and hotter nightsSunshine and warm weather are a boost to the spirit after a long, hard winter. But they may not do much for your sleep. In fact, if you’re sensitive to light and heat, long days and warm nights can be a setup for insomnia.

Here’s how to get more sleep as we move into June and July.

 

Manage Your Exposure to Light

For people who live in northern latitudes, the daily dose of sunlight at the approach of the summer solstice is nearly double what it is at the winter solstice. Extra bright light in the morning may not be a problem. In fact, it can help synchronize circadian rhythms and give you the same lift as a cup of coffee. (If sunlight wakes you up too early, install light-blocking curtains on your bedroom windows.)

But daylight that extends past 9 and 10 p.m. can delay secretion of the hormone melatonin, postponing the onset of sleep. If you go to bed at your normal bedtime, you can’t sleep. You toss and turn rather than quickly drifting off.

Manage summer insomnia by cutting down on your exposure to bright light in the evening and at night:

  • Wear sunglasses when you’re outside
  • Draw shades and curtains around 8:30 p.m., and lower the lights in your home.
  • Sign off devices with screens an hour or 2 before bedtime, or wear blue light-blocking glasses
  • Put red lightbulbs in nightlights. (While exposure to white light at night may affect your sleep, exposure to red light likely will not.)

Cool Down

Heat can be a factor in summertime insomnia. Research shows that people tend to sleep more readily when their core body temperature is falling, and that extreme ambient heat may interfere with the internal cooling process that normally occurs at night. The ideal room temperature for sleep is a little bit lower than is comfortable with during the daytime, so to get more sleep in the summer,

  • Keep your shades drawn to block out heat from the sun.
  • Use air conditioning and fans to lower the temperature of your bedroom.
  • If air conditioning and fans are unavailable, consider sleeping in a lower level of your home.

There are other ways to facilitate internal heat loss and cool down. Research shows—paradoxically—that engaging in activities that increase skin temperature actually help to cool you down. Warming the skin hastens internal heat loss by dilating blood vessels close to the skin. This allows for the swift release of body heat and a lowering of core body temperature, in turn promoting sleep. So a few hours before you normally go to bed,

At times when you can’t do much of anything in the evening or control the ambient temperature (say you’re driving across country and the air conditioning is broken in the only motel room available at 10 p.m.), take a cool shower before hopping into bed and lie down with a cool washcloth on your forehead.

 

Insomnia That Feels "Almost Physical"

“I feel very anxious at night,” a reader recently wrote. “I tell myself that there is no reason to be anxious, but it feels almost physical. And it doesn’t matter what I do (meditation, relaxation), I still can’t sleep.”

Insomnia, many of us are told, is mainly a psychological problem. So the physical sensations that accompany it can be unnerving: the fluttering heartbeat, the muscle tension, the racing feeling radiating from torso to extremities, the overheating, the sweaty skin. Yet these sensations should tip us off that insomnia is not just in the head.

burgerA reader wrote to Ask The Savvy Insomniac over the weekend to describe her problem with insomnia.

“I feel very anxious at night,” she said. “I tell myself that there is no reason to be anxious, but it feels almost physical. And it doesn’t matter what I do (meditation, relaxation), I still can’t sleep.”

Insomnia, many of us are told, is mainly a psychological problem. So the physical sensations that accompany it can be unnerving: the fluttering heartbeat, the muscle tension, the racing feeling radiating from torso to extremities, the overheating, the sweaty skin. Yet these sensations should tip us off that insomnia is not just in the head.

A.L. Kennedy, writing about her insomnia in Sunday’s Guardian, remembers adolescence as the time when she first experienced the willfulness of her body: “The term ‘fast asleep’ promised I might be locked safely and quickly away from harm. But my body wouldn’t let me leave. Insomnia,” she says, “was my first intimation of my body’s unreliability.”

If sleep were available on demand, we insomniacs wouldn’t have a problem. Yet at least where sleep is concerned, the body seems to have a mind of its own. No matter how much we crave sleep, the body doesn’t necessarily fall in line.

Changing Habits and Mindset

Sleep therapists claim that insomniacs have more control over our sleep than we think. Sleep is a basic human need and it occurs naturally in everyone. The problem for insomniacs, they say, is that we adopt habits and attitudes that interfere with sleep (erratic sleep schedules, for instance, or a belief that we can’t survive on less than six hours a night). Change these habits and attitudes and our sleep will improve.

Count me as a believer . . . up to a point. I’m all in favor of sleep restriction and other behavioral treatments for insomnia. I think it’s good to examine beliefs and attitudes that may be hindering sleep. There’s plenty of research showing that these strategies work, and they’ve certainly helped me.

Physiological Challenges

At the same time, it’s important to understand that our bodies and brains behave differently from the bodies and brains of people who sleep well. New research is turning up evidence that

  1. even when asleep, the insomniac brain tends to remain active in some areas. One is the precuneus, which plays a role in memory, visual processing, and self-reflection. Metabolic activity here “may contribute to the subjective experience of self-awareness” at night, researchers say.
  2. some insomniacs may be deficient in GABA, the neurochemical responsible for shutting the brain down at night.
  3. in insomniacs, physical exercise produces greater malleability in a part of the brain that controls movement. This suggests, says investigator Rachel Salas, that insomnia is not a nighttime disorder. “It’s a 24-hour brain condition, like a light switch that is always on.”
  4. a part of the brain called the left caudate nucleus is underutilized by insomniacs when we’re thinking. This condition can be reproduced in good sleepers by disrupting their slow-wave, or deep, sleep.

These studies are preliminary, yet they square with the hyperarousal theory of insomnia and suggest an imbalance in the arousing and calming forces inside insomniacs’ bodies and brains. If insomnia “feels almost physical,” that’s because it really is.

What are some of the physical sensations you experience at night when you can’t sleep?

Ease Insomnia by Changing Negative Thoughts

Could simply changing your thoughts about insomnia lead to better sleep? Some sleep therapists claim it works this way. They promote a process called “cognitive restructuring,” typically offered as part of cognitive-behavioral therapy for insomnia. It involves identifying negative thoughts about sleep and then challenging them. The goal is to wind up with thoughts that are more sleep friendly.

Sounds like a tall order, right? I agree. I’ll say up front that I had limited success with it myself. But the experts say this exercise is helpful for many who struggle with chronic insomnia. You may be one.

writing-bedCould simply changing your thoughts about insomnia lead to better sleep? Some sleep therapists claim it works this way. They promote a process called “cognitive restructuring,” typically offered as part of cognitive behavioral therapy for insomnia. It involves identifying negative thoughts about sleep and then challenging them. The goal is to wind up with thoughts that are more sleep friendly.

Sounds like a tall order, right? I agree. I’ll say up front that I had limited success with it myself. But the experts say this exercise is helpful for many who struggle with chronic insomnia. You may be one.

Take a Quiz

Do you find yourself thinking that

  • you must have 8 hours of sleep to function well during the day
  • you’ve lost control of your ability to sleep
  • one bad night wrecks your sleep for the rest of the week.

Thoughts like these create anxiety and make it harder to get to sleep and get back to sleep. These are the thoughts you examine during the process of cognitive restructuring.

Examine Your Negative Thoughts

Take a minute to download a Dysfunctional Thought Record right now (or do it after you finish reading the blog).

When you can’t sleep and you’re worrying about it, write your thoughts and feelings down in the Record. Then answer a series of questions, using the prompts at the bottom of the six columns. The goal of the exercise is to ease your worries about sleep.

Here’s an Example

Let’s say you can’t sleep one night and you start to grow anxious. Now would be a good time to get out the Dysfunctional Thought Record and set to work, asking yourself questions and writing down answers.

Situation. What led to the worry about sleep? “An early morning meeting where I have to make a presentation, the clock striking 12 and me not feeling the least bit sleepy.” What physical sensations do you have? “A racing sensation in my chest and feeling way too hot.”

Automatic Thoughts. What thoughts or images are going through your mind? “I won’t be at my best tomorrow. I’m going to bomb my presentation, and everybody’s going to ignore what I say.” How much do you believe that? “95 percent.”

Emotions. What emotions do you feel, and how intense are they? “Frustration that I can’t sleep! Fear that I’m going to do a poor job on the presentation. It’s pretty intense.”

Distortion. In what ways might your thinking be distorted? Are you catastrophizing? overgeneralizing? jumping to conclusions? “I’m probably catastrophizing.”

Alternative Thoughts. Here’s your chance to do a kind of reality check to see if your negative thinking is realistic or not:

  • Q: So, what are the chances you’re not going to sleep at all tonight?
  • A: Low. I usually get some sleep.
  • Q: How did you sleep last night?
  • A: Pretty well.
  • Q: So how realistic is it to think that a single short night’s sleep is going to incapacitate you tomorrow morning?
  • A: Probably less realistic than I thought.
  • Q: Have you prepared for this presentation, or is it something you’re doing on the fly?
  • A: I’ve been preparing for two weeks.
  • Q: How realistic is it to think that a short night’s sleep is going derail a presentation you’ve worked on for two weeks? . . . And so on.

Outcome. How much do you now believe your automatic thoughts (that you’re going to be wasted tomorrow and give a lousy presentation)? “Maybe it’s down to 40 percent.” What are your emotions now, and are they less intense? “I’m feeling less tense and maybe a little more confident . . .”

You get the idea. Feeling less tense and more confident can only make it easier to get to sleep.

After going through this process a few times, you may be able to dispense with the paper and pencil and simply talk yourself out of catastrophizing in your head. With luck you’ll eventually develop a more positive attitude toward sleep—at least, that’s what you’re aiming for.

Parting Thoughts

I can’t say this exercise has worked well for me. (Other therapies—such as sleep restrictionhave helped.) But the American Academy of Sleep Medicine says cognitive restructuring is beneficial for some insomnia sufferers—and I’d guess they know what they’re talking about.

If you haven’t yet tried cognitive restructuring and are open to experimentation, have a go at it. Then please write in and tell me how things turn out.

Can’t Sleep? Exercise May Help

“Doesn’t everybody hate exercise?” a friend said as we were talking about ways to manage insomnia. It made me stop and think. I’ve known some couch potatoes in my day. Either they’re bored by anything not cerebral or they’re in thrall to their digital devices. Exercise can’t compete with their fascinating sedentary pursuits.

In this video book trailer, I talk about how I came to realize that exercise helps me sleep.

“Doesn’t everybody hate exercise?” a friend commented as we were talking about ways to manage insomnia. It made me stop and think. I’ve known some couch potatoes in my day. Either they’re bored by anything not cerebral or they’re in thrall to their digital devices. Exercise can’t compete with their fascinating sedentary pursuits.

I’ve also known some lifelong jocks. Karate black belts who get up at 5 a.m. to crew and, oh, by the way, they’re training for a marathon, too. These folks love exercise: it’s a pleasure and a craving rather than a chore.

The truth is, most people I know fall somewhere in between, like me. Sure, we like a weekend bike ride. We’re big on walks. But vigorous daily exercise? The idea is faintly jarring. It sounds too much like work.

But my habits have changed since I realized how much exercise helps my sleep. If you’ve got the kind of insomnia where you have trouble calming down, listen to this book trailer and see if exercise has a bit more appeal.

Can’t Sleep? Exercise May Help

Sleep Restriction: Up Close and Personal

Some insomnia sufferers who visit my website head straight for the posts on sleep restriction. So I decided to create a video trailer where I could talk about my own experience of sleep restriction: how off-putting the idea was at first, and the results I later achieved.

Some insomnia sufferers who visit my website head straight for the posts on sleep restriction. So I decided to create a video trailer where I could talk about my own experience of sleep restriction: how off-putting the idea was at first, and the results I later achieved.

I posted the video on Facebook last week and got an interesting comment from a friend (who does not have insomnia himself). To him, the idea of restricting sleep time, and then increasing it bit by bit, did not sound counterintuitive at all. He compared it to the building of strength and dexterity that occurs with physical training, and the development of musical ability that occurs with daily practice on an instrument. The idea of improving sleep through the disciplined restriction of time in bed sounded perfectly reasonable to him.

There’s logic in what he says. Yet to those of us with insomnia, sleep restriction can sound daunting and downright scary. We know what it’s like to struggle with the daytime symptoms of insomnia: the fatigue, mood swings, and days when we can’t put two and two together or remember names. Why choose to subject ourselves to a treatment that involves slogging through a period when our symptoms may get worse?

Yet my own experience—and the experience of other insomniacs I went through group therapy with—suggests the bad days are numbered. By the second week we were already noticing improvements in our sleep and daytime stamina. Some of us found relief even sooner. Watch the video and see if you’re convinced.

As usual, I’d love to hear your comments.

Footbaths to Fight Insomnia?

Dr. Oz’s tip for curing insomnia—wearing heated rice footsies to bed (see my blog last March)—may have led to second- and third-degree burns for TV viewer Frank Dietl, but Oz is not responsible for the injuries, the New York Supreme Court ruled on Oct. 3. Moral of story? Take the advice of tele-evangelist health gurus with a grain of salt.

But let’s get back to the notion that heating the extremities might help to promote sleep. For some of us, this may be a useful strategy.

Foot-bathDr. Oz’s tip for curing insomnia—wearing heated rice footsies to bed (see my blog last March)—may have led to second- and third-degree burns for TV viewer Frank Dietl, but Oz is not responsible for the injuries, the New York Supreme Court ruled on Oct. 3. Judge Saliann Scarpulla dismissed the lawsuit against Oz, saying that there was no “duty of care between a television talk-show host and his vast home-viewing audience.”

Moral of story? Take the advice of tele-evangelist health gurus with a grain of salt. Frankly, some of Dr. Oz’s tips on insomnia sound pretty lame. Eat lots of gelatin to combat sleeplessness? Puh-lease!

But let’s get back to the notion that heating the extremities might help to promote sleep. Particularly in people who normally can’t sleep until late at night, this may be a useful strategy.

Body Temperature and Sleep

The rhythm of your core body temperature has a strong effect on when you feel sleepy; you start feeling sleepy when your temperature is going down. People who have trouble falling asleep until very late may have internal clocks that run on a 25-hour day, a recent study in the Journal of Sleep Research shows, delaying the downturn in temperature and the onset of sleep.

Light exposure in the morning and melatonin supplements in the evening may be the best remedies for people with longer-than-normal circadian temperature periods. But a warm footbath before bed may also help.

Why It May Work

Most heat loss occurs through the hands and feet, and heating the extremities hastens heat loss by dilating blood vessels. This allows for the swift release of body heat and a lowering of core body temperature, in turn helping promote sleep. So hot footbaths and warm socks may be a good idea for people who struggle to fall asleep at a reasonable hour.

But a new study from Taiwan confirms the results of an older study showing that footbaths prior to sleep do not alter sleep patterns in older adults. Heating the extremities may only help with sleep if you’re young or middle aged.

Do you bathe at night and/or wear socks to bed? Have you noticed it has any effect on your sleep?

Twenty-Something and Can’t Sleep

Statistics show that the incidence of insomnia increases with age.

Yet new research suggests it is more common among Americans aged 20-39 years than is generally believed. In a study released in July by the Harvard School of Public Health, 42 percent of the nearly 2,400 young adults surveyed reported having insomnia.

girl-studyingI was talking with my publicity consultant about likely markets for my book about insomnia. Like me, she’s getting on in middle age.

“It’s people our age and older,” she said. “We’re the ones who can’t sleep.”

Statistics do show that the incidence of insomnia increases with age. Yet new research suggests it is more common among Americans aged 20-39 years than is generally believed. In a study released in July by the Harvard School of Public Health, 42 percent of the nearly 2,400 young adults surveyed reported having insomnia.

Other highlights of the survey are these:

  • More young women reported having insomnia than young men.
  • More young people born in the United States had insomnia than their foreign-born counterparts.
  • Trouble sleeping was significantly associated with low health-related quality of life.

Am I surprised by these findings? Not at all. By the time I hit my 20s, I had a longstanding membership in the insomnia club.

The nights of two young women I interviewed sound frustrating and difficult:

Aziza, 24, a violinist: “I can tell whether or not I will be able to fall asleep. There are nights that I don’t even bother getting into bed. I just stay up reading all night and watch the sun rise. It is very frustrating but there is really nothing I can do. . . .When bouts of insomnia hit, I either fall asleep very early in the morning or more commonly I don’t sleep at all.

“My father is also an insomniac. He averages about four hours of sleep a night. . . . He wears a chain around his neck with Egyptian charms. I could hear the charms clinking around all night as he paced the house and smoked cigarettes, worrying about patients. I could hear him because I was up, too.”

Christie, 26, a bank teller: “Falling asleep is the problem—I have a hard time getting there.

“Once I didn’t sleep for more than a week. I would lay there with my eyes open. I’d break down and start crying because it’s really, really tough. . . . After nine days of not sleeping, I called my church and spoke with a preacher, and he prayed with me over the phone.

“I get depressed and I do feel lonely. Though my fiancé is very supportive and sympathetic, I still feel like I’m alone with the problem, like it’s something I’m going to have to figure out on my own.”

Insomnia may be more common among older adults, but it can be just as big a burden when it strikes the young.

How old were you when you started having trouble with sleep?