You follow all the sleep rules to the letter, but you're still not getting the rest you need. Here's why you're so tired.
By Corrie Pikul
1. All Your Clean Socks Are In The Wash
If you're like many women, you've probably noticed that your hands and feet are colder than your husband's when you climb into bed. This is because the nerves that control blood flow to these areas are more sensitive in women, and you were probably colder to begin with. The good news is that when our core body temperatures fall, our extremities tend to feel warmer as blood vessels dilate and the body radiates heat. To speed the process, try going to bed in clean, fresh socks (the ones you've been wearing all day are probably damp) and, if you need them, mittens. Instead of using your husband as a foot warmer, try using an actual hot water bottle, which won't protest or squirm away.
2. Your Favorite Position Makes Your Pelvis Crooked
Do you wake up with sore, achy knees? It could be due to the way you curl up at night. When we sleep on our side, both knees can rub against each other, or one knee will fall slightly forward, says Rick B. Delamarter, MD, co-medical director of the Cedars-Sinai Spine Center in Los Angeles. This puts the pelvis at an awkward angle, exacerbating existing knee pain. Delamarter suggests placing a small pillow between your legs. This will cushion the knees, level the pelvis, fix spinal alignment and even alleviate lower back pain.
3. You're Sleeping in a Trench
"If you can fit three fingers between your lower back and the mattress, then it's not giving enough support," says Karin Mahoney, director of the Better Sleep Council (the education arm of the International Sleep Products Association). She suggests rotating the mattress 180 degrees every six months. Sleep experts are always hesitant to recommend the perfect model, material or brand of mattress, but medium-firm has been shown in studies and through patient reports to be comfortable for most people, says Delamarter. He says that you'll know it's time to upgrade when you regularly wake up with stiffness, numbness and back pain. He frequently hears of patients who test-drive mattresses at hotel chains before committing to a purchase.
4. Your Pillows Need to Go on a Diet
Fluffy pillows angle the head forward and put a kink in the neck. This is why Delamarter says thinner pillows tend to be better than thicker. The position of your body in bed should be similar to your alignment when standing up straight: neutral spine, long neck. The small number of people who sleep on their stomach should look for very soft pillows, such as loosely packed down feather, to lessen the strain on their back. Delamarter points out that older people or those with a slight hunch or spinal curve will need a fuller pillow to tilt their head forward in sleep as it is when they're awake.
5. You're Going to Bed with the Wrong Man
Even though you've been warned against going to bed with the TV on, you feel the talk show host's voice helps you relax. But the sudden shift to loud or high-pitched commercials could be affecting your rest. The recently passed Commercial Advertisement Loudness Mitigation Act won't solve this problem either. Most commercials don't actually exceed the recommended volume limit, noted an article in the April 2011 issue of Wired magazine; they only sound louder. In a TV show, most of the noise comes from people talking, with a few bursts of, say, shouts, horns or crashes. During a commercial, though, the volume is elevated to just below the maximum limit for the entire 30 seconds. So you'll still be affected by those random, extended peaks of sound. For the best rest, say goodnight to Dave, Jay and Conan before getting into bed.
6. You're Sucking in Cold, Sooty Air
The optimal way to breathe in general is through the nose, says Nancy Collop, MD, president of the American Academy of Sleep Medicine. Our noses warm the air and filter out dirt and other particles. Breathing through the mouth, especially while sleeping, can lead to snoring, throat irritation, intense dry mouth and even abnormal respiration and sleep apnea. Another problem, says Collop, is that mouth breathing while lying on your back can cause the tongue to fall back and partially obstruct the upper airway. Nasal strips can help you get in the habit of breathing comfortably through your nose. If they don't, you may want to see an ear, nose and throat specialist.
7. Microscopic Creatures Have Invaded Your Bedroom
You know those tiny particles that float by on window-filtered sunbeams? At night, they can trigger allergies and asthma flare-ups. Air purifiers banish dust and other allergens (like dry-cleaning chemicals from the bag hanging on your closet door), and dehumidifiers may also help by taking moisture out of the air. "More moisture means more allergens," says Collop. But at the opposite extreme, desert-dry air can cause a parched throat and itchy eyes, especially if you have a cold. Take into account the levels in your home, the climate where you live and the season when deciding how you should treat the air around you. The EPA recommends a household relative humidity of 30 to 50 percent, and you can test yours using a hygrometer (some thermostats have them built in, or you can buy an inexpensive one at a hardware store).
8. You're Allergic to Your Snuggle Partner
Like dust, pet dander can exacerbate mild allergies. What's more, 17 percent of women say they are awakened during the night to care for their pet, according to a 2008 poll by the National Sleep Foundation. That doesn't include those who are pushed out of a deep sleep into a lighter, less-satisfying stage by a pet purring, snoring, jumping off the bed or using the litter box or doggie door. Help your pet learn to appreciate having a bed of his own, and if you can't bear to banish him from yours, at least try to keep him away from your face.
9. You're Throwing Off Your Internal Thermostat
Cold temperatures make us drowsy, and a falling core body temperature helps us get to sleep faster, says Collop. Help this process along by turning down the heat and keeping your bedroom cool (ideally, around 60 to 68 degrees). Opening the windows also helps bring in fresh, oxygen-rich air (unless you live near a freeway), which can contribute to your rest, says John Dittami, an Austrian sleep researcher, biologist and neurologist. However, there's a certain period of REM sleep during which your internal heating and cooling systems change and you become more sensitive to the temperature of the air around you. If you wake up at that point, a once comfortably cool room may now feel chilly. Keep extra blankets within reach so that you won't have to get up to search for them.
10. Your PJs and Sheets Are Underperforming
Even if you sleep in a cool room, you may wake up soaked with sweat. Night sweats are commonly associated with perimenopause and menopause, but they can also be triggered by menstruation, medications for depression, diabetes and other conditions. Check with your doctor to make sure this isn't a symptom of a serious condition or disease (such as an infection or cancer). Then try sleeping with a fan to evaporate the moisture from your skin, and always wear loose, breathable clothing. Several new products address this problem: "performance" sheets made from the same wicking fabric as athletic shorts; soft, towel-like nightgowns to absorb moisture; and pillows covered in Coolmax fabric to prevent dampness.
11. The Trains Are Off-Schedule and So Is Your Night-Shift-Working Neighbor
We're generally able to adapt to a regular noise like a nightly 3 a.m. train whistle, says Collop, but we have trouble after being awoken by random, unfamiliar or unexpected sounds. There are some noises you can't control, like the clanging of a furnace or the backyard brawling of stray cats. If you feel these are consistently getting in the way of your sleep, consider a sound machine that emits white noise, crashing waves or soothing music to block out the sudden audio interruptions.
12. You're Popping Uppers Without Realizing It
The chemicals in some types of asthma pills are related to caffeine, and that could contribute to insomnia and daytime jitters. Medications for other conditions -- depression, high blood pressure, heart disease -- can have similar effects. Diuretics (also commonly prescribed for high blood pressure) can make you have to go to the bathroom more frequently, which is a major sleep disruptor. To identify what's keeping you up, talk to your doctor about what you're taking and when you're taking it.
13. You'd Rather Sleep Alone
Collop says this is a frequent complaint from sleep center patients -- and their spouses. Here's how to keep your partner's shifting, snoring, snuggling or other habits from keeping you awake.
14. Your Sleep Hormones Are out of Whack
Darkness causes the release of the hormone melatonin, which is a highly effective all-natural sleep aid. Even a small amount of light can throw off your melatonin levels, and it takes only a few minutes for this to happen. Dim the lights about 30 minutes before bed, and turn off all electronic devices, including smart phones, computers and iPads. Block outside light from the moon and streetlamps with opaque blinds or curtains. Night-lights with red bulbs have less of an effect on melatonin than white ones, and alarm clocks with red numbers are less disruptive than ones with white or blue digits.