When to Get Help for Middle-of-the Night Awakening

Reviewed by Melinda Ratini, DO, MS on May 08, 2015
From the WebMD Archives

You set the alarm for 6 a.m., but for the third day this week you wake up at 1 a.m. instead. You know you need more rest, but it takes a long time to fall back asleep. When you finally doze off, before you know it, your alarm clock is ringing.

If that sounds familiar, you may have a common form of insomnia that makes it hard for you to stay asleep. The good news is that there are steps you can take get a better night's rest.

Good Sleep Habits

You can change your daily routine to improve your sleep. For instance, during the daytime you should:

  • Avoid naps.
  • Get regular exercise.
  • Make sure you go outside during the day. The natural light helps you keep up a healthy sleep-wake cycle.

In the evening you need to watch out for a few common sleep busters. Some tips to remember:

  • Avoid caffeinated drinks.
  • Skip alcohol.
  • Don't use tobacco products.
  • Try not to eat a large meal close to bedtime.
  • Avoid emotional discussions before going to bed.

It's also important to keep up a regular sleep-wake schedule -- during the week and on weekends, too. Try to go to bed and wake up the same time every day.

When to Call the Doctor

Clinical psychologist Theresa Lengerich, PsyD, recommends a "rule of threes" to help you decide whether to see a doctor:

  1. Are you waking up at least three nights a week?
  2. Does it take longer than 30 minutes to get back to sleep?
  3. Has this been going on for 30 days or more?

If you can say "yes" to these questions, make an appointment with your doctor. You'll work together to figure out why you can't get the rest you need.

In the meantime, they may prescribe a sleep medication. You can also check with your doctor to see if an over-the-counter drug is useful. The medicine can help treat insomnia while you try other kinds of treatments.

Your doctor may recommend a sleep study. This can be done at a local sleep clinic or sometimes in your home.

During the study, experts monitor you while you sleep to see if you have sleep apnea, restless legs syndrome, or other treatable disorders.

If your insomnia isn't linked to a physical health problem, your doctor may refer you to a psychiatrist, psychologist, or other therapist. They can provide relaxation training, behavior therapy, and other methods to help you get better sleep.

WebMD Feature



National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): "Taking Care of Your Diabetes Every Day."

American Diabetes Association: "Top 10 Benefits of Being Active."

CDC: "Insufficient Sleep is Public Health Epidemic," "Key Sleep Disorders."

National Sleep Foundation: "Facts about Excessive Sleepiness," "Sleep Hygiene," "Debunking Sleep Myths."

Institute of Medicine: "Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem."

Harvard Women's Health Watch: "Too Early to Get Up, Too Late to Get Back to Sleep."

National Sleep Awareness Roundtable: "Why Sleep is Important."

Theresa Lengerich, PsyD, director of behavioral sciences, Bethesda Family Medicine Residency Program, Cincinnati.

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