After a long day, there is nothing more refreshing than a full night’s sleep. Your body has been working all day and you need that seven to nine hours of quality rest. That said, if you’re here, you’re probably having a difficult time staying asleep throughout the whole night. 

But fear not friend! We’ve all been there, cursing the alarm clock in those pre-dawn hours and stressing about how to get back to sleep. Thankfully, there are some things you can do to combat the dreaded middle-of-the-night (MOTN) awakening.

Are there different types of insomnia?

That’s right, there are multiple ways insomnia can rear its ugly head. Most people are familiar with sleep onset insomnia, a.k.a. early insomnia or initial insomnia, which is defined as difficulty falling asleep or staying asleep. Insomnia can also be chronic or acute. Acute insomnia can last for a few weeks, while chronic insomnia often lasts for months at a time. 

When insomnia is a result of other health conditions, this is referred to as secondary insomnia. This is in contrast to primary insomnia, where your sleep problems are independent of any other condition. Common conditions that can give rise to secondary insomnia include anxiety, depression, cancer, chronic pain conditions, and even heartburn. 

Let’s get back to your middle-of-the-night awakenings.

What is causing my middle-of-the-night insomnia?

This is the first question most sleepers suffering from this form of insomnia ask themselves. If you can find the cause of your insomnia, then that’s a great first step. 

Some common causes of acute insomnia are:

  • New stresses in your life (moving, work, divorce, loss of job)
  • Illness
  • Physical or emotional pain
  • Environmental factors (lighting, noise, temperature)
  • Certain medications
  • Sleep schedule interruptions (jet lag, moving, switching work shifts)
  • Stress
  • Anxiety

Causes of Chronic insomnia:

  • Mental health disorders 
  • Trauma
  • Respiratory conditions such as asthma, COPD, and sleep apnea
  • Certain medications
  • Chronic stress
  • Chronic pain

Chances are, you’re still reading because you think you might have MOTN insomnia.

Don’t worry, there are plenty of things you can do to improve your chances of getting a solid seven to nine hours of uninterrupted sleep. 

Exploring your sleep hygiene is a good place to start. Also, it’s worth thinking about if you are doing something new at work. Is there a change or something new in your home life? These can be common triggers for insomnia. 

If you have been suffering from insomnia for months, then your problem may be more difficult to identify. Look back to when your sleep schedule changed. Were there any changes in your life?

If nothing stands out to you, it might be time to get a professional medical opinion. In some cases, your healthcare provider might want to talk to your significant other, or you might be asked to participate in a sleep study. 

You might be comforted to know that you are not alone. Around 25% of sleepers suffer from acute insomnia annually, and 75% recover without developing any persistent sleep problems.[1

Why Can’t I Stay Asleep?

When you’re tossing and turning in bed, you’re probably wondering why you can’t sleep. It seemed like everything was fine when you went to bed, but then you woke up a few hours later and couldn’t get back to bed. There are some common causes of middle-of-the-night-insomnia, which include: 

  • Your room: Your bedroom is the gateway to successful sleep. If your sleep environment is too noisy, bright, or too hot, you could find yourself waking up in the middle of the night. Make sure to turn down your thermostat a few degrees before climbing in bed and get rid of any light (especially blue light). Even smartphone screens lighting up can interrupt your sleep schedule. Finally, make sure that the curtains in your room block out the light from outside. Sleep masks can be helpful for this too. 
  • Noise: Even if you live on a busy street, there are steps you can take to make your bedroom quieter. White noise machines are one way that you can drown out outside noise. You can also wear earplugs, or sleep with gentle music in your ears. 
  • Anxiety: Did you know that insomnia is one of the main symptoms of anxiety? In fact, there are some people that have panic attacks in their sleep. If you think that your anxiety is keeping you awake, you might need to seek help from a professional. 

If you are currently on medication, it might need to be updated or changed. If you use natural alternatives to treat your anxiety, you should add in more relaxing activities before bed (i.e. meditation, reading a book, yoga, etc.).

  • Trips to the bathroom: Your bladder will not wait for you to have a full night’s sleep. Sometimes the art of a full night’s rest comes down to the strategic cutting back of fluids in the hours before you go to sleep. 
  • Alcohol: Some people think alcohol helps them sleep better, but this isn’t the case. You might fall asleep more easily, but your sleep isn’t as restful. When you drink alcohol before bed, you end up spending most of your night in the non-REM (NREM) phase of  sleep. Since alcohol blocks REM sleep, it can interfere with learning and forming new memories as well as emotional regulation. Everyone is different with alcohol, so you will have to determine how your alcohol intake is affecting your sleep. For some it can be the cause of MOTN awakenings. 

Also, drinking alcohol close to bedtime might affect your need to use the bathroom during the night. So, make sure you aren’t drinking too much too close to bed. 

  • Sleep apnea: If you wake up short of breath or gasping for air, you might be suffering from sleep apnea.  With this disorder, your breathing temporarily slows and stops during sleep. There are a few types of sleep apnea. Obstructive sleep apnea is a more serious condition, because your throat relaxes causing oxygen levels to drop. Central sleep apnea occurs when your brain isn’t sending the right signals to your throat muscles, also causing oxygen levels to drop. It’s even possible to have a combination of the two, which is called complex sleep apnea. 

  • One of the tricky parts about sleep apnea is that it’s difficult to self-diagnose. Diagnosis is done by a specialist and involves a sleep study. Those who are diagnosed with sleep apnea usually treat it with nightly use of a continuous positive airway pressure (CPAP) machine to regulate breathing throughout the night. 

  • Overactive thyroid: If you consistently wake up sweating in your sleep, you could have an overactive thyroid. When your thyroid creates too much of the hormone thyroxine, you could have interrupted sleep, anxiety, an increased heart rate, and tremors. A blood test can determine if your thyroid is functioning properly. 

  • Eating right before bed, or skipping dinner: Eating a heavy meal before you go to bed can cause you to wake up in the middle of the night. You could also find that you have trouble going to sleep right after you’ve eaten. If your stomach is full, lying down can aggravate acid reflux, stomach pains, or gas. 

  • On the other hand, if you go to bed hungry, your empty stomach can keep you awake. A growling stomach can wake you up from a deep sleep. Also, if you don’t eat enough your blood sugar level can drop. When your sugar is low, you can experience restless sleep. Make sure that you are fueling your body the right way to get better sleep. 

    • Caffeine: Many of us depend on caffeine to get us through our day, but it can seriously impact our sleep schedule causing a vicious circle of caffeination to manage the daytime sleepiness the next day caused by lack of sleep. 

    Caffeine can remain active in your system for more than six hours after you take it. So, make sure you aren’t ingesting any caffeine at least six hours before your bedtime. Better yet, try switching to decaf all afternoon or all together. 

    How to fall asleep and stay asleep

    Now that you know what’s causing your insomnia, you can start working on good sleep habits. Make sure that you are:

    • Not napping during the day.
    • Maintaining consistent sleep patterns
    • Getting enough water.
    • Regularly exercising
    • Going outside during the afternoon. 
    • Avoiding caffeine in that six-hour pre-sleep window.
    • Limiting or skipping alcohol. 
    • Not drinking too much of any liquid before bed.
    • Not eating close to bed.
    • Limiting your stress.
    • Practicing relaxation techniques before bed.

    These are some tools that you can use to maintain a healthy sleep schedule and help you stay asleep for a solid eight hours. It might feel like you’ll never conquer your insomnia, but don’t give up. It could take several weeks for you to begin to see a difference. 

    Most adults were never taught how important it is to maintain a bedtime routine. We get caught up in our days, and never learn how to wind down and destress before bed. Being conscious of healthy sleep habits is your first step toward a full night of sleep. 

    What are some relaxation techniques?

    Stress is a part of most people’s lives, and it often manifests during sleep. For most of us, stress is something that can’t be totally eliminated. So, the best thing to do is to learn how to manage stress in a healthy way. Practicing relaxation techniques is one of the best ways to combat the negative effects of stress. Some of the most common relaxation techniques are:

    • Focused Breathing: Before bed, take some time to focus on your breathing. Start with long, deep breaths. Breathe slowly and feel the air move in your nostrils, filling your lungs, focus on tightening your abdominal muscles, and then releasing the breath. Doing this for 5-10 minutes before bed can put you in a more relaxed state. Try our guided breath meditations...
    • Guided Imagery: Close your eyes and focus on images that soothe you. Imagine putting your stresses away into a make-believe drawer for the night. Visualize falling directly to sleep. What does that look like?  Try our guided visualization meditations...
    • Wind-down, pre-sleep meditations and returning to sleep meditation: Meditation comes in many different forms and can be applied in various strategy ways. At Remrise, we’re mostly interested in it’s applications for sleep. To this end, we like to group meditation into a few sleep categories.  We like to think about calming the body and mind about an hour before sleep as a starting point for the pre-sleep routine. 

    Then we like to apply meditation to falling asleep as well, to help keep the mind clear of stressors as you drift off to sleep. Finally, for those of us who wake up in the middle of the night, we like to help you prepare for MOTN awakenings so that you can have a couple meditations up your sleeve should you wake up at 3:30am. Check out our sleep meditation options...

    • Yoga and Stretching: Yoga before bed can help you center your thoughts. Even if you don’t know yoga, simple stretching can help you relax. Put on some peaceful music and focus on your breathing while you stretch. 

    I’ve woken up, now what?

    Even if you practice good sleep habits, you could still wake up in the middle of the night. One of the worst things you can do is remain in bed tossing and turning. If you find yourself waking up in the middle of the night: 

    • Don’t look at the clock: It will only stress you out.
    • Go to the bathroom or get comfortable: Is your room cool enough?
    • Get up: If it has been 20 minutes, get up and go read a book or listen to music. Relax. Don’t turn on a lot of lights. Soon enough, you’ll find yourself yawning. Do not stay in your bed while you’re awake, as your brain will begin to associate your bed with being awake. 

    Sleep is one of the most important activities in our lives, so it can be frustrating when you aren’t getting restful sleep. Thankfully, following these tips will have you sleeping through the night in no time. Don’t get discouraged, anyone can sleep through the night; it’s just a matter of finding what works for you.  

    Try some of these solutions. For even more recommendations of ways to give yourself the best chance for getting full nights of sleep, check out this article on sleep hygiene. Another option for more personalized solutions is to speak with a sleep coach, who can recommend personalized solutions to your specific sleep difficulties. 

     

    References 

    1. https://www.webmd.com/sleep-disorders/guide/insomnia-symptoms-and-causes#1
    2. Insomnia stats: https://www.sciencedaily.com/releases/2018/06/180605154114.htm
    3. Night panic attacks: https://www.self.com/story/waking-up-at-night-reasons
    4. Relaxation Techniques: https://www.health.harvard.edu/mind-and-mood/six-relaxation-techniques-to-reduce-stress
    5. Things to do when you wake up: https://www.hopkinsmedicine.org/health/wellness-and-prevention/up-in-the-middle-of-the-night-how-to-get-back-to-sleep