Why Can’t I Stay Asleep?

It’s still dark when you wake up. You check the clock. There’s 3 more hours before your alarm clock is set to ring, but you can’t fall back asleep.

Regularly waking up throughout the night is a form of insomnia. Not only can it leave you feeling exhausted the next day, but it can also take a toll on your mood.

So how can you sleep soundly throughout the night? The first step is to understand what’s causing these interruptions.

Q. Why do I always wake up to pee?

You may be drinking too much in the evening, says Sanjeev Kothare, MD, director of the pediatric sleep program at NYU Langone Medical Center. Scale back on how much you sip before bedtime.

Those nighttime urges may also be because of a medical problem, like a bladder infection or a medicine. Talk to your doctor. He can treat the medical problem or adjust your medicine.

Q. Will drinking alcohol help me sleep?

At first, those glasses of wine or cocktails will make you feel drowsy. But this effect lasts only a few hours.

“After it wears off, alcohol has a stimulating effect,” says Jeffrey Barasch, MD, the medical director for the Valley Hospital Center for Sleep Medicine. This can cause you to toss and turn. So stop drinking alcohol at least 4 hours before bedtime.

Q. What should I do if heartburn is keeping me up?

That's a common problem. When you’re lying down, it’s easier for your stomach juices to flow back up, says Amy Meoli, MD, medical director of the Penn State Hershey Sleep Research and Treatment Center.

Try these moves to avoid and treat the burn:

  • Have dinner 3 to 4 hours before you hit the hay. Also, keep your meal light -- a full stomach increases your chances of heartburn.  
  • Avoid heartburn triggers, like spicy and fatty foods.
  • Raise your upper body with a pillow to help keep the acid down.
  • Try an over-the-counter medicine. Let your doctor know if you have heartburn often.

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Q. How can I keep my pain from bothering me at night?

The pain from a condition like arthritis can hurt your shut-eye, too. Tell your doctor if the throbbing keeps you up. She may want to adjust your pain medication or prescribe a sleep aid.

Q. How does caffeine affect my sleep?

That afternoon cup of coffee or tea can lead to a restless night.

“Avoid caffeine within 8 hours before bedtime,” Kothare says. “So if you go to sleep at 11 p.m., don’t have any after 3 p.m.”

Also, limit your caffeine to about two cups of coffee per day.

Q. Could my tossing and turning be caused by a sleep disorder?

Let your doctor know if you think you have a sleep condition. He may refer you to a specialist.

Two common sleep disorders include:

  • Sleep apnea. Your breathing stops for a short time, so you partially or completely wake up. You may not even realize it, Barasch says. Symptoms include heavy snoring (your partner may notice pauses in your snoring) and daytime sleepiness.
  • Restless leg syndrome. As many as 10% of people have this condition, where you have an intense urge to move your legs. This movement can keep you from falling asleep or wake you up.

Q. What can I do if I wake up because of stress?

Forty-three percent of adults say stress has caused them to lie awake at night. To ease the tension, exercise and meditate during the day. In the evening, spend some time winding down before bedtime.

“If you can’t get back to sleep because of racing thoughts, get out of bed,” Kothare says. “Find a dimly lit area and do something relaxing, like listening to music, until you feel sleepy again.”

Q. Could my bedroom be interrupting my sleep?

You could wake up because you’re too hot or cold during the night. Most people sleep best in a slightly cool environment, around 60 to 67 degrees.

Also remove any potential nighttime distractions, such as light or noise. You may need to put up blackout curtains or banish your night-owl cat from bed, for example.

“If you wake up in the middle of the night, resist the temptation to check your phone,” Kothare says. Electronics give off a type of blue light that can make you more alert.

WebMD Feature Reviewed by William Blahd, MD on November 19, 2015

Sources

SOURCES:

Sanjeev Kothare, MD, professor of neurology; director of the pediatric sleep program, NYU Langone Medical Center.

Cleveland Clinic: “Nocturnia.”

Jeffrey Barasch, MD, medical director, Valley Hospital Center for Sleep Medicine, Ridgewood, N.J.

Amy Meoli, MD, medical director, Penn State Hershey Sleep Research and Treatment Center.

Finan, P. SLEEP, November 2015.

Fujiwara, Y. American Journal of Gastroenterology, December 2005.

American Psychological Association: “Stress and Sleep.”

National Institutes of Neurological Disorders and Stroke: “Restless Legs Syndrome.”

National Sleep Foundation: “Men, Women, and Sleep.”

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