When to Get Help for Overnight Awakening

Reviewed by Neha Pathak, MD on October 21, 2020

Is Waking Up at Night Normal?

You may think that a good night's sleep means your head hits the pillow and you don't stir until morning. But many of us wake up multiple times during the night as we cycle through different stages of sleep. Most of the time, you won't even notice these little waking moments. But if you have trouble falling back to sleep, it can be frustrating -- and possibly cause for concern.

 

What's Waking You Up?

There are common reasons people wake up in the night, including:

You're too hot. The ideal room temperature for sleep is between 60 and 67 degrees. If you're prone to night sweats -- maybe you're menopausal and deal with hot flashes -- try using a fan and layer your blankets so you can pull them on and off as needed.

You need to pee. Waking up to pee is called nocturia. It can happen if you drink too much water (or alcohol) right before bed. It can also be caused by a health issue like untreated diabetes or a bladder problem. See if it helps to cut down on your beverages a few hours before bedtime.

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You're snoring. Sawing logs isn't always a problem. But it can sometimes be a clue that you have obstructive sleep apnea, a condition in which you repeatedly stop breathing throughout the night. Sleep apnea can wake you up, and it also has a link to health conditions like high blood pressure.

You drank too much alcohol. A glass or two of wine may seem like a nice way to relax at the end of the day. But alcohol can mess with your sleep. It can make it easier to fall asleep at first, but you're more likely to wake in the middle of the night or early in the morning. Alcohol also cuts the amount of restorative REM sleep you get. And booze makes you have to pee more. The more you drink, the worse the effects on your sleep. It's best to limit yourself to one drink several hours before bed.

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You're a smoker. Just like alcohol, nicotine is linked to insomnia and can lower the amount of time you spend in restful REM sleep.

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You're anxious or depressed. Anxiety and depression can disrupt your sleep, and not sleeping well can make mental health problems worse. If you have anxiety or depression, reach out to your doctor for help.

You're in pain. Roughly 2/3 of people who have chronic pain, such as back pain or the side effects of cancer treatment, also deal with sleep problems. If pain is keeping you from getting your rest, your doctor can come up with a treatment plan.

You took a nap. For most people, a short nap (10-20 minutes) before 3 p.m. won't mess with your nighttime sleep. But if you have insomnia, you may be better off sticking to a strict sleep schedule and avoiding naps.

You have heartburn. Acid reflux, hunger, and being full can all cause you to wake up during the night.

You had caffeine in the afternoon. Drinking a caffeinated beverage even 6 hours before bed can affect your sleep.

What to Do When You Can't Sleep

If you're still tossing and turning after about 20 minutes, experts say you should get out of bed and leave the room. Head to another part of the house for a quiet activity like meditation, reading a book, or knitting. Go back to bed when you feel drowsy.

When to Call a Doctor

For example, you might feel drowsy when driving, find it hard to concentrate at work, feel extra emotional, or have memory issues. If this happens to you, call your doctor. They'll check for underlying medical issues like sleep apnea or a thyroid problem. If it's a mental health issue like anxiety or depression that's impacting your sleep, your doctor can refer you to a mental health professional. They can provide counseling and possibly medication.

WebMD Medical Reference

Sources

SOURCES:

Johns Hopkins Medicine: “Up in the Middle of the Night? How to Get Back to Sleep,” "How Does Menopause Affect My Sleep?"

The Ohio State University Wexner Medical Center: "Why do I wake up at the same time every night?"

Cleveland Clinic: "What Is the Ideal Sleeping Temperature for My Bedroom?" "Nocturia," "Do You Wet the Bed After a Night of Drinking? Here’s Why," "How to Beat Insomnia When You Have Chronic Pain," "Why Do You Always Wake Up at 3 a.m.?" "Sleep Disorders: When to Seek Help."

National Institute on Aging: "Hot Flashes: What Can I Do?"

Urology Care Foundation: "Nocturia."

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