Why Can't I Stay Asleep?

It’s normal to wake up a time or two in the night. But when you can’t get back to sleep quickly, you won’t get enough good-quality sleep to be refreshed and healthy. It’s important to figure out what’s waking you up so you can address the problem and restore your sleep.

Sleep Stages

In general, adults need about 7-9 hours of sleep a night for optimal health and well-being. That’s divided into periods of light, deep, and rapid eye movement (REM) sleep, when you dream. You cycle through these stages several times during the night. Most of your deep sleep happens early in the night. Toward morning, you’re mainly in REM and lighter sleep, when it’s easier for noise or something else to wake you up.

Physical Causes

Many health conditions have symptoms that seem worse at night, such as:

  • Pain, especially from arthritis, heart failure, sickle cell anemia, or cancer. Tell your doctor if you hurt too much to stay asleep. You may need a different medication or dosage schedule.
  • Breathing trouble from asthma, bronchitis, or another lung disease.
  • Digestive problems, especially pain and cough from acid reflux or symptoms of irritable bowel syndrome.
  • Hormones. Women often wake up at night when levels change around their periods or during menopause. Hot flashes and night sweats also disrupt sleep.
  • Brain and nerve diseases, including Alzheimer’s and Parkinson’s.
  • Needing to go to the bathroom in the night.

Medications you might take to treat these conditions, including beta-blockers, antidepressants, ADHD drugs, decongestants, and breathing treatments that have steroids, can also affect how well you sleep.

If your health issues often interrupt your sleep, it’s important to let your doctor know. It may mean you need to start or adjust your treatment so you can get your symptoms under control.


Psychological Causes

Stress is one of the main reasons people wake up in the night. It makes you sleep lighter and keeps you from getting deep and REM sleep. You can learn techniques to help you relax. Regular exercise may help, too, as long as you don’t do it too close to bedtime.

Other mental health problems can also cause interrupted sleep, including:

  • Anxiety disorders, such as posttraumatic stress disorder (PTSD)
  • Bipolar disorder
  • Depression
  • Schizophrenia

If worries or another mental health condition wake you up often, it’s time to get help from your doctor or a mental health professional.

Your Sleep Habits

You may not even realize it, but some of the things you do every day can keep you from sleeping well at night.

  • A changing sleep schedule: Try to go to bed and get up about the same time every day, and don’t take long naps.
  • Electronics: The light from your phone and computer can wake up your brain, so turn off your devices an hour before bed. And if you wake up in the night, resist the urge to grab your phone while you try to get back to sleep.
  • Poor sleep environment: If your bedroom is too loud, too bright, or too warm, it’s easier to wake up when you move into a lighter stage of sleep. Use dark shades, turn down the thermostat, and try earplugs or a white noise machine.
  • Alcohol: A drink before bed may make you fall asleep quickly, but you’ll wake up in the night as alcohol wears off.  And it doesn’t let you get to the deep or REM sleep stages.
  • Caffeine: It’s a stimulant that can take 8 hours to wear off.
  • Smoking: Nicotine is another stimulant that can make you sleep less soundly. Many smokers wake up too early as their bodies start to crave a cigarette.

Sleep Rhythm Disturbances

Your body has a natural cycle of sleepiness and alertness that’s controlled by hormones and daylight. When that gets thrown off, you will have trouble sleeping.  Causes include:

  • Age. Your body’s sleep rhythms change as you get older. You get tired earlier in the evening and wake up earlier in the morning. You also spend more time in lighter stages and less in deep and REM stages.
  • Jet lag
  • Working nights and rotating shifts

There’s not much you can do about some of these issues. Focus on doing what you can to improve the things you can control that affect your sleep, like your daytime and nighttime habits and any health conditions you have.


Sleep Disorders

Other types of sleep problems can affect your ability to stay asleep, such as:

  • Sleep apnea: If you snore loudly and often, you may have obstructive sleep apnea. Tissues in your mouth and throat close off your airway, which stops your breathing many times a night. Your brain rouses you enough to breathe again, and you may wake up completely. The most effective treatment is to sleep with a breathing machine that keeps your airway open.
  • Restless legs syndrome is a tingling or prickling feeling that makes you want to stretch or move your legs. It can be especially bad at night.
  • Many people with restless legs also have what’s known as PLMD, or periodic limb movements in sleep. Your arms and legs jerk uncontrollably and wake you up.

If you have one of these conditions, make sure you work with your doctor on a good treatment plan so you can get the sleep you need to be healthy.

WebMD Medical Reference Reviewed by Brunilda Nazario, MD on May 01, 2019



National Sleep Foundation: “Surprising Reasons You’re Not Staying Asleep,” “How to Wake Up Less Frequently at Night,” “Interrupted Sleep: What Happens to Your Body,” “Nocturia or Frequent Urination at Night.”

Harvard Women’s Health Watch: “Too early to get up, too late to get back to sleep.”

American Academy of Sleep Medicine: “Sleep and Growing Older,” “Insomnia – Symptoms & Causes.”

National Heart, Lung and Blood Institute: “Your Guide to Healthy Sleep.”

National Institute of Neurological Disorders and Stroke: “Brain Basics: Understanding Sleep.”

Harvard Men’s Health Watch: “Insomnia: Restoring restful sleep.”

Medscape: “Management of Chronic Sleep-Maintenance Insomnia.”

Mayo Clinic: “Insomnia: How do I stay asleep?”

American Urological Association: “What is Nocturia?”

© 2019 WebMD, LLC. All rights reserved.