5 Reasons Why You Wake In the Middle Of the Night
If you talk to friends and family, you might think that everyone—not just you—wakes in the middle of the night, often at 3 a.m. Our primary care doctors in Delray Beach hear this complaint so often from our patients that it sometimes seems that way to us, too.
It’s not true, but if you’re one of the millions who experience this frustrating problem, we’d like to suggest some of the reasons it might be happening and offer some possible remedies.
It’s important because lack of quality sleep has been implicated in triggering or worsening numerous health issues, from diabetes and obesity to cardiovascular disease (CVD). Other recognized effects of sleep deprivation have particular relevance for older people: cognitive impairment, unsteadiness that can lead to falls, and even higher mortality rates.
Possible causes
The problem with trying to pinpoint a cause for your mid-night awakenings is that each person who experiences this may do so for more than one reason. Here are some of the most common causes.
- Sleep apnea
The number-one trigger of middle of the night awakening is obstructive sleep apnea (OSA). It’s also the one that is the most worrisome, because it can lead to so many dangerous health conditions, including high blood pressure, diabetes, and CVD.
Some possible signs include loud snoring, snorting, or gasping in your sleep, or daytime sleepiness or fatigue.
- What you ingest
If you drink alcohol at night, it may make you sleepy at first, but when it wears off—usually in the middle of the night—you may wake up. Caffeine’s effects can last for hours beyond that last cup of coffee. So can nicotine, which is also a stimulant. Many prescription and over-the-counter (OTC) drugs contain stimulants as well, which may make you feel jumpy or anxious.
- Medical conditions
Many medical conditions, from painful arthritis, to sinus congestion, to restless leg syndrome (RLS), can interrupt sleep. Women often experience middle-of-the-night awakenings due to fluctuating hormones, especially during menopause, when hot flashes can make it impossible to sleep.
Other health-related causes of middle-of-the-night insomnia can include heart failure, Alzheimer’s and Parkinson’s disease, or even heartburn. One of the most common causes in this category, of course, is nocturnal urination, which can become more frequent with age.
- Stress
This is one of the main causes of insomnia, and can keep you awake as your mind races to solve whatever problems you’re facing. Or you may not have a particular worrisome problem, but just have so many responsibilities that you can never really relax and “unplug” from them.
- Poor sleep hygiene
Blue light from the screens we’ve become addicted to can interfere with the body’s production of the sleep-inducing hormone melatonin. When we’re on our screens up until the time we fall asleep, our bodies don’t get a chance to drop into the natural rhythm of a good night’s sleep.
In addition, these days when so many have taken to working from home, the bedroom may serve double-duty as an office. Thus our bodies don’t recognize the bedroom as a relaxing place, and remain on hyper alert as we try to sleep.
Other possible factors could be irregular bedtimes, or a bedroom that’s too hot or too cold or not dark enough.
What to do
While most people wake up two to three times per night, it only becomes a problem when you can’t easily get back to sleep. Known as “sleep maintenance insomnia,” about 20 percent of Americans experience the phenomenon.
Knowing the cause(s) of your middle-of-the-night awakenings can be a start to solving them.
- For instance, you can turn off electronic devices at least an hour before bedtime, and don’t bring them into the bedroom with you.
- Lighten up on or cut out alcohol entirely.
- Cut back on caffeine, and don’t have any past 2 p.m.
- Keep your bedroom as dark as possible, and maintain the temperature between 60-67 degrees.
- Don’t work in your bedroom. Designate the room for sex and sleep only.
- Maintain a regular sleep schedule and avoid naps and sleeping late.
- Take steps to reduce anxiety. This could include regular exercise, meditation, or even cognitive behavior therapy (CBT).
- Write down worries or things that are keeping you awake; reassure yourself you’ll deal with them in the morning.
- If you suspect you have sleep apnea, you should have a sleep study done. These days, this can often be done at home.
Talk to us about any medical issues that might be interrupting your sleep. This includes such things as RLS, chronic pain, and any medications you’re taking.
Getting back to sleep
While chronic insomnia can lead to long-term health problems, in addition to making it difficult to function during the day, the main thing to do is not worry if you’re awake in the middle of the night.
Try progressive muscle relaxation; that is, tensing then relaxing each muscle group in turn. Or try deep breathing: Slowly breathe in through your nose to a count of four, hold it for a count of four, then breathe out through your mouth to a count of eight.
Get out of bed after 20 minutes if you can’t get back to sleep. Don’t watch TV or get on your phone. Read a hard copy book or magazine or listen to soft music.
If the problem persists, let us know. We can explore the causes and possible solutions.
pfrederick74@yahoo.com
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