Waking up in the middle of the night is a common sleep problem. About a third of people experience nighttime waking at least three times a week. By understanding the reasons why this happens, you may be able to adopt habits that can help you sleep more soundly.
Why Do I Keep Waking Up at Night?
Repeated late-night wakings can indicate a health issue, or they may be due to lifestyle factors.
A pattern of sleeping throughout the night or waking up early and struggling to fall back asleep might indicate you have insomnia. Insomnia can occur on its own, or it can occur along with another sleep disorder or health condition.
Mental Health Conditions
Fragmented sleep and nocturnal waking may accompany mental health conditions such as anxiety, depression, or bipolar disorder. People with post-traumatic stress disorder often experience nightmares and nighttime awakenings that cause severe disruption to sleep. Even short-term or minor stress can cause heightened arousal levels that make it difficult to sleep soundly.
Sleep apnea is a sleep disorder that causes periods of shallow or halted breathing during sleep. The breathing difficulties are often accompanied by microarousals, and someone with sleep apnea may wake up feeling as if they have not slept well.
Restless Legs Syndrome and Periodic Limb Movement Disorder
Restless legs syndrome causes discomfort in the legs accompanied by a persistent urge to move them. Symptoms worsen at night, which can lead to difficulty falling asleep and nighttime waking. A similar disorder called periodic limb movement disorder causes involuntary twitching and jerking movements in the legs, which can awaken the sleeper in the middle of the night.
Nocturia is the scientific name for frequent nighttime urination, which may occur due to multiple reasons such as drinking too many fluids at night, taking certain medications, not exercising enough, or experiencing certain health conditions. Nighttime bathroom trips may also wake up a sleep partner.
Poor Sleep Hygiene
Certain habits are unproductive for sleep, such as drinking coffee or alcohol, smoking, or watching television right before bedtime. Other factors such as taking long naps or staying in bed for long periods while you are awake may also interfere with sound sleep.
Odd Sleeping Schedule
Consistent bedtimes are critical for sleep. Night shift workers and people with irregular sleep schedules have a higher risk of developing sleep problems, as they must sleep at times that are at odds with their biological clock.
Natural changes to the sleep-wake cycle as people age can lead to more frequent nighttime awakenings. Older adults spend less time in deep sleep and more time in lighter sleep stages, which are easier to wake up from. Evening naps, nighttime urination, and accompanying health conditions or chronic pain may also interfere with nighttime sleep.
Many physical health conditions can disrupt sleep. People with chronic pain may experience fragmented sleep with multiple nighttime awakenings. Acid reflux symptoms are often worse during sleep and may lead to arousals. People with neurological disorders such as Alzheimer’s disease often experience changes to the sleep-wake cycle that can manifest as fragmented sleep. Medications taken to treat these disorders may also contribute to sleep problems.
Tips on How to Stay Asleep Throughout the Night
It is important to get seven to nine hours of sleep each night. Follow these tips to help improve your sleep quality and minimize the risk of sleep disruptions:
Improve Sleep Hygiene
Seek out areas for improvement to your bedtime habits and sleep environment. Reducing the use of electronic devices in bed and keeping the bedroom cool, dark, and quiet can help ensure you get a good night’s rest.
Although regular exercise is beneficial for sleep, some people may find that vigorous exercise too close to bedtime interferes with sleep.
Reduce Alcohol and Caffeine Intake
Consuming caffeine or alcohol in the evening can cause sleep problems. Although alcohol may help you fall asleep at first, it often leads to sleep disruption in the second half of the night.
Do Not Drink Before Bedtime
Drinking large amounts of fluids right before bedtime may cause nighttime waking to use the bathroom. If you frequently wake up from the urge to urinate, consider cutting out fluids in the evening.
Adjust Your Nap Schedule
Although naps can be an effective tool for people who are short on sleep, late afternoon napping and naps that last too long can interfere with sleep.
Avoid Large Meals Before Bed
If you experience acid reflux, eating large dinners and snacks in the evening can increase symptoms during sleep and may lead to nighttime awakenings.
Develop a Regular Bedtime Routine
Limit Awake Time in Bed
Only go to bed when you are feeling sleepy. Lying in bed if you cannot fall asleep can be counterproductive. If you wake up in the middle of the night, consider leaving your bed to do something else for 20 minutes before laying back down to sleep.
Manage Light Exposure
To help regulate your sleep-wake cycle, try to spend time in the sunlight during the day and avoid too much bright light in the evening.
When to Be Concerned About Waking Up Frequently
Waking up in the middle of the night once in a while is not generally a cause for concern. However, experiencing frequent sleep interruptions and not feeling well rested each morning could indicate a sleep disorder or another health condition. Speak with a health care provider if you are experiencing sleep problems. They can work with you to address any health issues and determine a treatment plan.
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Michael Breus, Ph.D - The Sleep Doctor is a Diplomate of the American Board of Sleep Medicine and a Fellow of The American Academy of Sleep Medicine and one of only 168 psychologists to pass the Sleep Medical Specialty Board without going to medical school. Dr. Breus is a sought after lecturer and his knowledge is shared daily in major national media worldwide including Today, Dr. Oz, Oprah, and for fourteen years as the sleep expert on WebMD. Dr. Breus is the bestselling author of The Power of When, The Sleep Doctor’s Diet Plan and Good Night!