Despite feeling very sleepy, some people find it difficult to fall asleep. Some want to go to bed early but end up staying up late. Some fall asleep but wake up at three or four in the morning. As night falls, many people suffer from various sleep issues. Melatonin, naps, and catching up on sleep over the weekend have become common remedies for those battling insomnia and fatigue.
Why is it difficult to fall asleep even when tired? Does sleeping late and waking up late count as staying up late? Can naps or weekend catch-up sleep help if you don’t sleep well? Is melatonin effective? China News Health interviewed Dr. Meng Fanqiang, associate chief physician and director of the Psychological Testing Department at Beijing Anding Hospital, Capital Medical University.
Changes in the Sleep Disorder Population
Doctor: Trending Younger
Poor sleep is becoming a health concern for more people. The “Healthy China Action (2019-2030)” report shows that the average daily sleep time for adults in China is 6.5 hours. According to the China Sleep Research Society, the insomnia rate among Chinese adults is 38.2%.
Dr. Meng Fanqiang has noticed an increase in patients seeking treatment for sleep disorders. In the past, there was low awareness and concern about sleep problems, but now more people recognize insomnia as a disease and seek medical help.
The age composition of patients has also changed. Among those with sleep disorders, the proportion of middle school, high school, and university students is increasing. Factors such as high academic pressure, fast-paced life, and extensive use of electronic devices can all contribute to sleep problems. Additionally, middle-aged and elderly individuals, pregnant women, chronic disease patients, those who are chronically over-fatigued, and those with irregular eating habits are more likely to experience sleep issues.
Dr. Meng explains that sleep disorders cover a wide range: “difficulty falling asleep, difficulty waking up, and poor sleep quality” are the main manifestations. He warns that besides difficulty falling asleep, those who fall asleep quickly but often wake up early may also have sleep disorders, potentially linked to anxiety or depression.
Why is it difficult to fall asleep when tired?
Doctor: Established a Wrong Connection with the Bed
Many people feel tired but can’t fall asleep once they lie down. Dr. Meng Fanqiang explains that sometimes the body feels tired, but the brain is still active and not ready for sleep, so it may take some time to fall asleep.
He points out that excessive daytime stimulation, frequent use of electronic devices before bed, and overeating at night can make it hard to relax in bed. Some people focus too much on “falling asleep immediately,” which makes it harder to sleep. Others like to think about things before bed, and excessive thinking can also lead to sleep problems.
“People without insomnia feel secure when they see the bed, forming a good connection with it. But if you often think about problems in bed, you’ll subconsciously start thinking when you lie down, creating a bad connection,” says Dr. Meng.
He suggests planning and thinking about things in places like the study and even making notes. Once you close the notebook, leave those thoughts for tomorrow and avoid thinking in bed.
Is Sleeping Late and Waking Up Late Considered Staying Up Late?
Doctor: Depends on Sleep Duration and Regularity
Some people habitually sleep late and wake up late but get enough sleep. Does this count as staying up late?
Dr. Meng Fanqiang states that the general definition of staying up late involves deliberately sleeping late and not getting enough total sleep. “If someone usually sleeps at 11 pm and changes to 1 am for a long time but also wakes up later, maintaining a regular sleep schedule without frequent nighttime awakenings, this situation doesn’t significantly impact the body.”
Regarding the “8-hour sleep as a standard of good sleep,” Dr. Meng explains that sleep needs vary among individuals. Most adults need about seven hours of sleep. The main criterion for good sleep is whether you feel refreshed and rejuvenated after waking up, not just the duration.
Is Melatonin Effective for Treating Insomnia?
Doctor: Not Very Helpful, Avoid Blind Use
Many people with sleep disorders choose to buy and use melatonin. However, Dr. Meng Fanqiang advises against blindly using melatonin. He explains that melatonin is a supplement, not a replacement for medication or non-drug therapies.
“Occasional melatonin use is fine for people working night shifts or adjusting to jet lag, but it doesn’t help much with chronic insomnia. Long-term use can cause side effects like headaches and dizziness. Currently, no authoritative guidelines in China recommend melatonin for treating insomnia,” Dr. Meng says.
When should you seek medical help for sleep problems? Dr. Meng notes that pure insomnia is rare; it often results from other factors like emotional issues, irregular lifestyle, or sleep apnea.
He suggests identifying the cause of sleep problems and trying self-adjustment first. If the situation doesn’t improve or significantly affects daily life, it’s advisable to see a doctor.
Are Naps or Weekend Catch-Up Sleep Helpful?
Doctor: Not Advisable for Insomniacs to Overcompensate Sleep
To mitigate the damage from sleep deprivation, some people take naps or catch up on sleep over the weekend.
Dr. Meng Fanqiang explains that naps can relieve fatigue and improve afternoon work efficiency but aren’t suitable for everyone. Insomniacs should limit nap time to 30-40 minutes to avoid deep sleep.
For weekend catch-up sleep, Dr. Meng advises moderation. “If someone wakes up at 7 am daily, waking up at 8 am on weekends is acceptable. Midday naps should also be limited to 30-40 minutes, not half the day. Long catch-up sleep is fine for those with good sleep quality, but for chronic insomniacs, it can disrupt their sleep rhythm for the next week.”
Which is Worse: Difficulty Falling Asleep or Deliberate Late Sleeping?
Doctor: Emotional Distress Might Be Greater for the Former
Dr. Meng Fanqiang states that both difficulty falling asleep and deliberate late sleeping result in reduced overall sleep time, impacting immunity, memory, and health. However, those who struggle to fall asleep might experience more emotional distress, such as anxiety and unease, compared to those who deliberately stay up late.
Tips for Better Sleep
Dr. Meng Fanqiang offers three tips for good sleep. First, maintain a regular sleep schedule. Wake-up time is easier to control than bedtime, and a consistent wake-up time can improve sleep onset and quality.
Second, use the bed only for sleeping. Avoid activities like phone browsing in bed to create a good connection between the bed and sleep. Allow yourself 30 minutes to an hour of downtime before sleep, putting away your phone and relaxing.
Lastly, moderate exercise can aid sleep by regulating emotions, relieving stress, and relaxing the body. However, avoid exercising two to three hours before bedtime, as your body needs time to wind down before sleep.
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