It is normal to wake up a few times during the night as the brain goes through various phases of deeper and lighter sleep. Older people also often have to get out of bed once or twice at night to use the toilet. Waking up at night is usually harmless. Most people have no problem getting back to sleep and may not even remember their nightly awakenings the next morning.
However, if you frequently wake up in the middle of the night and have trouble getting back to sleep, this could be an underlying problem. If this happens at least three times a week for at least three months, it could be chronic insomnia, said Dr. Kannan Ramar, a sleep physician at Mayo Clinic in Minnesota and past president of the American Academy of Sleep Medicine.
Two of the main causes of insomnia are stress and anxiety. If you wake up and look at the clock and then worry about getting rested for work the next day, paying your bills, or experiencing other life stresses, it could activate your sympathetic nervous system, called the fight-or-flight response . The adrenaline level, the so-called stress hormone, rises, increases the heart rate and leads to a state of increased excitement, which makes it particularly difficult to fall asleep again.
“You might ask, ‘Is this the same time I woke up last night? Why does this always happen? ‘”Said Dr. Ramar. “These thoughts are not helpful in getting back to sleep.”
If you find that you’ve been awake for 25 minutes or more, experts advise you to get up and do some quiet activity that calms your mind – all to suppress the stressful thoughts that were keeping you awake. Gentle stretches or breathing exercises can help, as can meditation, which has been shown in studies to help combat chronic insomnia. You can sit on the couch and knit or read a book or magazine in low light. Experts recommend not reading on smartphones, as the blue light these devices emit can suppress the production of melatonin, the hormone that makes us sleepy. However, you can pull out your phone to use a calming app like Calm or Headspace that is designed to help you sleep and meditate.
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When you finally feel tired, go back to bed and try to doze off. Then, the next day, perform the following sleep hygiene habits to increase your chances of getting a good night’s sleep.
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Limit your evening alcohol consumption. In small amounts, alcohol can act as a sedative and make you fall asleep faster. But it can also cause you to wake up in the middle of the night as your body metabolizes it. Studies show that consuming alcohol before bed can lead to poor quality sleep.
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Avoid consuming caffeine after 2 p.m. as it can linger in your body well into the evening. If you have a cup of coffee at 3:30 p.m., about a quarter of the caffeine may still be in your system 12 hours later.
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Avoid napping late in the day as it can make it difficult to fall asleep and stay asleep at night. Taking long naps will reduce what scientists call your homeostatic sleep drive, which is essentially the pressure on your body to fall asleep in the evening. If you want to take a nap during the day, do it in the morning or early afternoon and keep it short, no more than 30 minutes. “The closer you get to bedtime or the longer you nap, the more likely you are to get into trouble,” said Dr. Sabra Abbott, Assistant Professor of Neurology in Sleep Medicine at the Feinberg School of Medicine at Northwestern University in Chicago.
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Keep a strict sleep schedule. Waking up and going to bed at irregular times can mess up your body’s circadian rhythm, the innate 24-hour cycles that tell our bodies when to wake up and fall asleep, making it difficult to stay asleep. Try to get up at the same time each morning (aim to get at least 15 minutes of morning sun, which will help stop melatonin production) and go to bed at the same time in the evening. Studies show that people with irregular sleeping schedules are more likely to develop symptoms of insomnia.
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If you get up to use the toilet frequently, try to limit the amount of water or other fluids you drink two to four hours before bedtime.
If these measures don’t help, a sleep specialist can assess whether you may have a more serious underlying problem, such as sleep apnea or restless legs syndrome, that needs medical attention. A sleep clinic could also put you in touch with a cognitive behavioral therapist who could help you identify and treat specific behaviors that could be causing your chronic insomnia.
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