Proper sleep is important, but for many Americans, a good night’s sleep is hard to come by. Approximately 30 to 40 million Americans have trouble staying asleep or falling asleep. Many report that they wake earlier than they want to and often can’t go back to sleep.
There are many causes of middle-of-the-night waking (MOTN), including the periodic bathroom visit. Lifestyle changes may help with some of these, but others require support from your doctor. Take a look at a few of the more common causes of waking up in the middle of the night to see if you can pinpoint your source of insomnia.
Abnormal Sleep Cycle
The average adult requires approximately seven to nine hours of sleep per night, while most children need around 9.5 hours per night. During this time, you dream for about two hours. It’s thought that this is the time when you process your emotions.
Sleep is controlled by sleep-wake homeostasis and the circadian rhythms. These internal biological mechanisms work as a team to help people get the sleep they need. When either is altered, your quality of sleep is affected, and you may not go through the necessary three stages of non-REM sleep and REM sleep.
Night shift workers are a primary example of how disregarding light cycles can make it difficult to sleep. The circadian rhythms encourage humans to sleep at night when it’s dark. Night shift workers have to sleep during the day, so their circadian rhythms are largely ignored, leaving them vulnerable to Shift Work Sleep Disorder. Complications of SWSD include lowered immune response and cognitive impairment.
Jet lag is another response to altered circadian rhythms. When you fly to a different time zone, it takes a while for your body to adjust to the light cycles in the new location.
Diet and Fitness
A poor diet and lack of physical activity may cause people to have difficulty staying asleep. Consuming foods, such as chocolate and coffee, which contain a stimulant (caffeine), in the hours leading up to bedtime is often a prime culprit of middle-of-the-night waking. Avoid heartburn-inducing foods, as well, since swallowing and esophageal motility is reduced during sleep. Insomnia is a frequent complaint among adults with GERD.
Working up to at least 30 minutes of physical activity per day may help you fall asleep and stay asleep. Exercise releases serotonin, which helps regulate the body’s sleep cycle. And if stress is contributing to your fatigue, give yoga a try as a way to relax and keep fit at the same time.
Be careful about exercising too close to bedtime, though, as it can rev up the cardiovascular system, leaving you primed and ready for action instead of a good snooze.
Mental Health Disorders
Anxiety, post-traumatic stress disorder, depression, Alzheimer’s disease, and other mental health conditions can all contribute to middle-of-the-night waking. Sleep disturbances often come from being unable to calm the mind during the night. Some of these disorders are also associated with nightmares, which can cause a person to wake during the night.
The constant worrying that comes with these mental health issues can also make it hard to sleep well. Individuals who feel as though they need to be on alert, including those who have PTSD, might wake up suddenly if they hear any noises during the night.
Certain physical ailments can also leave you more prone to sleeplessness. These are some of the more common medical conditions that can contribute to MOTN waking.
- Enlarged prostate
- Cardiopulmonary disease
- Nocturnal pruritus (itchy skin)
- Heart conditions
- Sleep apnea
- Overactive bladder
- Gastroesophageal reflux disease
- Restless leg syndrome
Waking in the middle of the night might also be attributed to the medicines you need to help with these and other medical conditions. If you have any concerns about your medications or health, ask your doctor if they might be triggering your sleepless nights.
Making Changes to Discourage Middle-of-the-Night Waking
Individuals experiencing a lack of quality sleep or insufficient sleep may benefit from a sleep study to determine the best course of action. In addition, even small lifestyle changes can boost your chances of a good night’s sleep and minimize middle-of-the-night waking.
- Limiting caffeine
- Avoiding alcoholic beverages before bedtime
- Creating a bedtime routine
- Cutting down on naps or taking them early in the day
- Keeping the bedroom cool and dark
- Setting a schedule for the time you go to bed and wake up
- Finding ways to relax after you eat dinner
- Establishing a plan, such as reading, when you can’t fall asleep or stay asleep
It’s possible that your middle-of-the-night waking could be a random event, but if it happens regularly or it’s negatively impacting your ability to function, a trip to your doctor is in order. Once you determine the root cause of your sleeplessness, you can develop a treatment plan that helps you get all 40 of those winks.