Waking Up In The Middle Of The Night May Be Normal

woman lying awake in bedHow often do you find yourself waking at a ridiculous hour of the night, your mind flooded with every thought you’d rather not be having at that exact moment?

Whatever the reason is that you woke up, this barrage of unwanted thoughts then keeps you awake even longer. It’s a vicious circle and one which I’ve personally spun around in many times.

Sometimes called ‘sleep maintenance insomnia’ or ‘middle of the night insomnia’, the good news is that it might not actually be as bad for you as you fear.

Why does it happen?

In this article I’ll be looking at some of the common reasons why you may be waking up. Many of these reasons are things which you can then try to tackle.

As with most forms of insomnia, it’s often best seen as a symptom of another problem. And so the best approach is to work out what that first problem is and deal with it.

In addition I’ll look at a fascinating theory which suggests that there’s nothing wrong with sleeping in two phases.

The standard advice for adults has long been that 7-9 hours of solid sleep a night is best for the body and mind. But there’s growing evidence that this may not necessarily be true.

It may well be totally normal and even good for you to wake up in the night. If nothing else, it could be comforting to know that it’s natural and not doing you any great harm.

First let’s have a look at some common reasons why people wake in the night.

1) An underlying sleep disorder

You may have a sleep disorder which is causing the waking, such as a breathing disorder like sleep Apnea. If you or anyone else notices any kind of breathing problems in the night, then it’s essential you get yourself checked out by a doctor.

The sleep disorder Narcolepsy, which causes people to fall asleep uncontrollably during the day can lead to waking randomly too. If this happens to you then again it’s important to get checked out by a doctor.

2) An underlying mental health issue, anxiety or stress

There’s a range of mental health issues which can lead to sleep problems. People who suffer from anxiety or stress for example are often more likely to wake up. And when that flurry of thoughts and worries arrives it can be hard to fall asleep again.

3) Needing the toilet

There are several reasons why you may need to wake up to use the toilet. Some men, particularly middle-aged men, may have an enlarged prostrate leading to the need to urinate. More likely though it arises from drinking too much shortly before bed, with alcohol being a particular offender.

4) Alcohol

Alcohol can trigger a middle of the night awakening for several reasons:

  • Alcohol withdrawal can wake you up, particularly if you drink heavily on a regular basis.
  • The excessive liquid can lead to the need to run to the toilet.
  • Alcohol can disrupt your normal sleep patterns.

5) Noise

Whether it’s a partner snoring or sleep-talking, the traffic outside rumbling away or sudden noises, sound can wake you up at any hour. You may not even realise you were woken up by a brief noise. One of the best options available to deal with disruptive noise is to get some good earplugs for sleeping.

5) Hunger, thirst and indigestion

Hunger, thirst and indigestion can all cause problems. For that reason it’s a good idea to have a small drink before bed, but only enough to keep you hydrated.

Try to eat your main meal earlier in the day and only have a light snack before bed. And if you have eaten a heavy or rich meal before bed, perhaps eat a yogurt or take a calcium-based tablet to stave off any indigestion problems.

6) Bad dreams or other parasomnias

Children and adults alike can be woken up by nightmares or other disturbing events in their sleep. If this is an issue for you, take a look at the article about stopping nightmares which you may find helpful.

7) Travel and shift work

One of the hardest things to do is to have massive changes to your sleep schedule and adapt quickly. It’s very common for shift workers, airplane staff and travelers to have serious sleep disruption.

If this is the case, then you may find a supplement like melatonin can help regulate your sleep again.

Could it be a normal sleeping pattern?

The psychiatrist Thomas Wehr conducted a study in the 1990s which involved keeping people in darkness for 14 hours a day for one month. This was to follow as closely as possible the natural cycle of day and night, where we experience 14 hours of darkness in an average day.

Once they had managed to establish a sleep pattern, it became evident that they would sleep for 3-5 hours, then wake up for 1-3 hours, and then fall asleep once again for another 3-5 hours. It appears then that their natural sleep cycle was to wake up in the night.

Before electricity

candles in the darkOne interesting point of view is that before electricity was harnessed we had much more time available for sleeping at night. And the natural reaction to so much darkness was to have segmented sleep.

The hours of darkness have greatly reduced in the modern world due to the availability of lighting, as well as an ever-increasing drive towards efficiency.

So in the fast-paced modern world, we’ve compressed how much time we allow for sleep and try to get it all done in one block.

Wehr’s study showed that we may actually prefer to sleep in 2 phases though. So if you have an inability to sleep through the night, all may not be lost.

This theory is further backed up in a book published in 2005 by the historian Roger Ekirch (At Day’s Close: Night in Times Past).

Nighttime wakings throughout history

Ekirch’s book contains hundreds of references to historical descriptions across the globe of sleeping in 2 phases. From the authors Homer, Dickens and Cervantes to medieval medical books and anthropological reports of the Tiv tribe in Nigeria, it’s a fascinating account.

And interestingly, there are descriptions of people doing all sorts of things in the early hours of the morning, such as relaxing, talking, reading and writing. Even getting up and practicing religious beliefs, visiting neighbors or trying to conceive.

Funnily enough, Ekirch also notes that the expression sleep maintenance insomnia first appeared during the industrial revolution at the end of the 19th Century, which is the time when references to segmented sleep all but disappeared.

Normal to be awake in the night

Sleep Psychologist Greg Jacobs has also said that it’s very normal for people to wake up in the night, and that this was how we slept naturally until recently.

He’s joined by a growing number of scientists who believe that it can be harmful for people to believe and be told that they need a solid 8 hours sleep. This can cause anxiety, panic and stress when they wake in the night and can’t get straight back to sleep.

Jacobs suggests that this period of an hour or two of sleeplessness during the night could well have been an important time for people to regulate stress. In the dark hours they were forced into a period of relaxation and meditation.

So what can we learn from this idea of sleeping in two phases? The first thing to take away is the concept of not worrying about sleeping right through the night.

Perhaps ask yourself the question ‘what use can I make of this time?’.

Presumably as long as you have enough sleep either side of this period of waking, it doesn’t matter if you find yourself awake. Especially if the quantity and quality of sleep is not having an adverse effect on your day-to-day life.

What to do when you wake in the night

man reading in bed at nightSo what should you do if you stir in the middle of the night? Well, that’s of course up to you to decide. But it may be a good idea to do something which is relaxing and not too stimulating for the brain.

Doing relaxation exercises, reflecting and meditating may be a good way to spend the time for example.

Alternatively, if you find that an hour or two is just too much time to lie awake in bed, then perhaps you could try experimenting with getting up and doing something quiet like reading or writing.

The main thing is not to worry about it so long as it’s not impacting on your quality of life and your well-being. Try not to allow this period of being awake to stress you out.

Often the fear of not being able to fall asleep, of having insomnia or not functioning well the next day makes it harder to sleep.

When to seek medical advice

If you’re genuinely worried that waking up regularly and for long periods of time is impacting on your life and well-being, you could talk to your doctor about it. They might want to check for an underlying sleep disorder or medical condition.

If they decide that you do have sleep maintenance insomnia, then they may prescribe you some medication such as Intermezzo. Or it may be that they discuss good sleep habits with you, often known as sleep hygiene.

Hopefully reading this article will have helped you to try to stay calm the next time it happens. The main thing is to try not to panic, and don’t allow it to become a time for dealing with all your worries and stresses in life.

Your thoughts

Do you suffer from sleep maintenance insomnia? Or do you know that something else is waking you up? What do you do to cope with it? Please share your thoughts in the comment below.

 

33 CommentsLeave a comment

  • Hi, I found your article very interesting especially when you say that waking up in the night is normal. When it happens to me, normally after 4-5 hours of good sleep, I read on my kindle with the black backlight so I don’t bother my husband. I read for 1 hour or so and go back to sleep when I feel my eyes start to close. I sleep for 2 or 3 more hours and I wake up rested and refresh. But this schedule is not really practical for me. I miss my early morning fitness class. The thing is I’m starting to like to wake up at night because I’m an avid reader and those hours are quite and I can really enjoy reading with no distractions!
    Should I stop reading in bed because it can be addictive?
    I also take melatonin before falling asleep. Should I take an extra one when I wake up to help me go right back to sleep?
    I heard about cognitive behavioral therapy. Is it effective?
    Thanks for your help!
    Loretta

    • Hi Loretta
      Thanks for your comment, and I’m glad you found the article helpful. Perhaps you could just limit how long you read for? I think reading is fine, but perhaps set yourself a limit of 30mins if you can. And if you force yourself to go to your fitness class in the morning, hopefully that will get your sleep pattern into shape, even if it’s difficult at first to make yourself go. It’s a classic technique to keep a stable wake up time though, as that’s easier to control than the fall asleep time. Taking melatonin in the night won’t help, so I wouldn’t do that. You might like to read this article about cognitive behavioral therapy for insomnia.
      Regards
      Ethan

  • Hi I wake 2-3 times a night I’m assuming I come into my light sleep but seem to manage to go straight back to sleep I also dream a couple of times a night I don’t always remember them when I wake up but I do remember I’ve dreamt. I am being treated for anxiety and have just increased my medication I was sleeping like this before I started medication then it was getting better until the night before I increased it. When I wake up I’m not feeling anxious or panicking but could this be happening due to my anxiety and the side effects from it and the medication??? I started on 5mg Lexapro was on that for 9 days and increased to 10mg on day 10 im now on day 11. Any advice would be greatly appreciated. Oh and I generally fall asleep around 9:30/10pm and get up for my day around 5:30/6am and I wake up feeling ok, it’s not a struggle to get out of bed.

    • Hi Mel
      Thanks for your comment. It’s difficult to say, but if you noticed a definite change in your sleep after the change in treatment and anxiety levels, it’s possible it’s affecting your sleep. However, it’s actually quite common to wake up briefly in the night a couple of times. If you fall asleep again easily afterwards, it’s nothing to worry about really. You could mention it to your doctor next time you see them, but if you don’t have any trouble during the day with your energy levels, then it’s probably all good.
      Regards
      Ethan

  • I am so happy to find your site today, you have pinpointed the issues and have explained it in a way that is reassuring, that I don’t need pills right away and I can work on my healing , will soon work out on breathing exercise and mindfulness and to not to worry about not be able to sleep enough, and sure with lots of prayers!

  • Ethan, have you ever explored the organ clock in traditional Chinese medicine? The idea is that waking up in the hour associated with an organ means that this organ needs. attention.

  • I have had very bad tinnitus for five years and it has disrupted my sleep pattern. I have got better at getting to sleep but wake up after about two to three hours and then find it hard to get back to sleep. I feel exhausted all day. There is no therapy , either NHS or private in the Scottish Borders re tinnitus. Any ideas ?

    • Hi Mary
      Thanks for your comment. Sorry to hear you’ve been bothered by the sleep problems and tinnitus. I also have tinnitus, but over time have learned to accept it – more or less! Probably the best advice I ever got was from an audiologist who told me to try and see it in a positive way. She said I can use it as a kind of ‘early warning system’ that I’m ill, stressed, sleep deprived etc since it gets worse with these things. In that way I can try to use it and take action, rather than feel it’s a problem in itself. Perhaps seeing it that way might help you to worry less about it?
      As for the waking in the night, again, as I say in the article accepting it is one of the best things you can do! If you learn to relax and not worry that you’re awake, you’re more likely to fall asleep again quicker.
      I hope that helps a little.
      Regards
      Ethan

  • ya..dear informer I would like to say that I have know very well and much. what’s the real psychology of the sleep. and how can we aware of this real fact. our routine busy life create this nusiones.I like happy to say that reading following commenter reading this. tnk u.

  • Hi Ethan,

    I have a terrible sleeping problem where I sleep walk but I also eat! I have tried so many different thing’s to stop myself and I’m at the point now where I’m fed up! My doctor gave me sleeping tablets for 2 weeks, some days were better than others, I lost weight and this was great. The thing’s I eat in the night aren’t stuff like an apple or a healthy option.. it’s cake, crisps and fizzy pop. I’ve tried taking Nytol and it doesn’t even knock me out. My doctor has now given me Anxiety tablets, they aren’t making my sleep any better. It’s like I’m awake when I’m getting up but I can’t control what I do!? You’re my last resort right now and if you have any advice that could help I’d really appreciate it.

    Regards,
    Abby

    • Hi Abby
      Thanks for your comment. I can understand your distress. You might actually find some ideas in the article I wrote about sleep walking rather than here. As a practical solution, I guess if it’s going to keep happening, you could try keeping the goodies locked up and the key somewhere safe, and then have healthier food easy to find in the kitchen. And more radically, just don’t buy any more things you wouldn’t like to be snacking on in your sleep until you get a handle on this.
      Did your doctor refer you for a sleep study? That might be useful as you’d also get access to professional advice and support.
      And if you think that anxiety is playing a role, there are lots of good self-help options you can try. My personal favourite, which I think is great for anxiety is mindfulness. I wrote about it in terms of helping you sleep, but it actually has much wider benefits. So it could be a winner for you if you give it some time.
      All the best
      Ethan

  • I wake up throughout the night – I can usually get right back to sleep. It is worse with alcohol (even a little glass of wine!) but it happens anyway, I roll over – wake up, my husband snores – wake up, the dog moves – wake up, pillow shifts – wake up – thirsty, need the bathroom etc etc – maybe 10 times a night – I go right back to sleep but am I ever getting good rejuvinating sleep? I have my sleeeping ears out for my kids so that might be part of the conditioning but I have done this for a long time. My concern now is I feel my memory is getting way worse and I think there is a link to loss of rejuvinating sleep. I am 53… cant take sleeping pills as I have high anxiety the next day if I do…. help

    • Hi Michelle
      Thanks for your comment. Sorry to hear you’re having sleep problems and now the memory problems too. The two could well be connected. It’s thought that one of the main reasons we sleep is to process memories. However, many people often do sleep more than they think they do, something known as sleep state misperception. So it might not be quite as bad as you fear, especially if you do generally fall asleep again. It’s likely that you’re just waking up when you cycle through the lighter sleep stages naturally during the night. That doesn’t mean that you’re not getting the more restorative sleep which comes with other stages in the cycle.
      I think it’s very common for parents to have an ear out for their kids. But it’s a shame you’re waking up from so many different things. One idea is that you could agree with your husband that some nights he has to keep an ear out. Then you could perhaps put some earplugs in, shut the world out and get some less disruptive sleep, and make sure you don’t drink that evening. I also think it’s important not to stress about it. I used to worry terrible about the fact that I woke up so much. Now I just accept it, and try not to allow stress about sleep to add another level of worry. Finally, if you’re really worried about your memory, then you could always talk to your doctor about it. They might be able to give you some peace of mind that it’s just sleep deprivation and suggest ways to tackle it.
      Regards
      Ethan

  • Hi Ethan! I just stumbled upon your site today and was so happy to find it! You have such an incredible amount of helpful information here. I have had sporadic times of insomnia throughout my adult life but for the last month or so it has been a nightly occurrence. Some issues with headaches have started at the same time as the insomnia and I seem to be in a vicious cycle with both. I have found the sleep hygiene section helpful and plan to be more consistent with my sleep/wake times. If I sleep 2-4hrs, wake, but never fall back to sleep is this still considered sleep maintenance insomnia?
    Thank you!

    • Hi Jessie

      Thanks for your comment, and for your kind words. I’m really pleased you found the site helpful. Sorry to hear you’ve been having slep problems and headaches. Perhaps one is causing the other? Or maybe something else is causing both. Are you under a lot of stress at the moment?
      It could be sleep maintenance insomnia, yes. Regardless of the name, the important thing is to get enough sleep every night, and waking so soon clearly isn’t going to do that. When I go through bouts of that problem, it’s usually because I’ve been doing less exercise and spending too much time in front of my computer working on this site. A few days of serious exercise usually does the trick! As for the headaches, my advice with that is always to make sure you drink lots of water. Many headaches are caused my dehydration. If it continues though, perhaps get yourself checked out by your doctor just to be sure.

      Regards
      Ethan

  • hi!
    I’m 16 and I’ve been having this problem for a while now. for at least eight months now, I’ve been waking up in the middle of the night for absolutely no reason. usually between 1 am and 4 am. I go to bed around 9:30 almost every night. when I wake up, I can not fall back asleep to save my life. I have to wake up every morning at 5:30 am for school, and I usually don’t fall back asleep until maybe an hour before I need to wake up. I’ve tried going to bed earlier, and going to bed later so maybe I wear myself out and I can stay asleep. but it just never works. I really don’t know what it could be. I’ve read that this can happen from stress, and I feel like that’s a factor. it’s been happening every single night for almost a year now though. any thoughts??

    • Hi Kayla,
      Thanks for your comment. I can understand the frustration, believe me. It can be caused by stress I think, yes. And even more so when you wake up and then get stressed because it’s happened again!
      Having read this article, you might find that you start to feel a little less worried when it happens. And that in itself can make a big difference to how much it affects you. When I first worked out that I was my own worst enemy by getting upset when I could’t sleep, it made a massive difference almost immediately.
      My advice would be to think about the concept that it’s ok if it happens. Maybe have a couple of relaxing things you can do during that time, which in itself might help you fall asleep again sooner. For example, have a look at the article discussing relaxation techniques for sleep.
      If it continues to be a problem and is affecting your ability to study or lead a normal life, then you could speak to your doctor about it. They might take a medication approach, or they might try and help you find out why it’s happening and see if there is another cause.
      Regards
      Ethan

  • Hi there,
    This is a great article. It is hard not to stress about waking up at 3 am, however, when your alarm is set for 6.45 because one has a Full time job to get up for. I know not being able to sleep is made worse by worrying about it, but its hard to not get frustrated…when to chill for an hour or so…means there is ‘hardly; any time left for PRECIOUS sleep. I dread the 3 am wake up…! Any tips for those that need to get up to work..?!
    Thanks

    • Hi Oona
      Thanks for your comment. Yes, I completely understand how frustrating it is. I’ve been in that situation many times, waking up at some horrible hour, knowing that I only have a few hours to sleep before waking up early for work. It’s stressful, I know.
      I think really there are two key things to do.

      First, try to work on everything possible to improve your sleep – have a look at the sleep hygiene section for lots of valuable advice about that.

      Second, work on accepting the fact that it does just sometimes happen to you. I know this probably sounds easier said than done, but I do feel it’s very important. Personally, since I found about this whole thing about it actually being ok to wake up, I found that helped me stress less. And that in turn has shortened the time I wake up for. I used to wake up, get stressed by calculating how much time I had left to sleep, then stay awake for an hour or two. Nowadays, I simply get up, have some milk and a banana, or a cup of herbal tea, read for 20 mins then close my eyes again. And 9 times out of 10 I find that I drift off again without problems.

      I won’t lie and say it was an overnight change, but it has happened to me. So I think with time, you might be able to get to the same point as well.

      Regards
      Ethan

  • Thanks, Good article.

    I am having same issue, sleeping at around 11:00pm waking at around 2-3 am. I can feel that its sudden and fully wake. Miles away from getting into sleep again. My eyes always swelled in the morning. if I try to sleep again, then i fall into a situation where you are not either sleeping or awake.

    Regards

    • Hi Nizaam
      Thanks for your comment, and I’m glad you liked the article. I can understand the frustration if this happens to you regularly and its affecting you the next day. Perhaps reading this will help you to not worry about it so much. If you try getting up and doing something relaxing for a while, then going back to sleep, you might find that by accepting it’s quite normal, you do fall asleep again.
      All the best
      Ethan

  • I find myself waking up every night at 3-4am after having shifted my sleep schedule heavily, i.e going to bed at 4-7am in the morning.. I expect this behavior to pass as i get back in my normal schedule.

    • Hi Nikolai,

      Thanks for your comment. Hopefully yes, once you get back into your normal rhythm things will settle back down. Keeping a stable sleep schedule is very important for getting a good night’s sleep!
      Regards
      Ethan

  • I have consistent, constant sleep maintenance insomnia. I wake after 5 hours, and lately not able to fall back asleep. Sometimes I do fall back to sleep but it’s very light sleep. I still feel extremely tired the next day. Have felt tired every day for 4 weeks.

    • Hi Jules

      Thanks for taking the time to comment. Sleep maintenance insomnia can be quite disruptive, so I’m not surprised you’ve been feeling tired. Hopefully reading this article will help a little and you’ll perhaps be able to relax better when you do wake up, knowing that it’s not such an unusual thing to happen.
      All the best
      Ethan

    • Thanks Ryan

      Sorry it’s taken me so long to reply – I have no idea how your comment escaped my attention!
      Anyway, I hope you’ve found a way of dealing with your sleep problems now and thank you for the compliment.
      Regards
      Ethan

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