What can I do to get back to restful and uninterrupted sleep?
March 26, 2012 4:54 PM   Subscribe

Why do I keep waking up in the middle of the night?

Previously I had asked a question on AskMefi about how I could get into an ordinary routine sleep schedule, and thankfully, that's no longer a problem for me. Nowadays it rarely takes more than 15-30 for me to fall asleep. Unfortunately, over the past month I've developed a very consistent problem of waking up usually 4-5 hours after falling asleep, and sometimes having great difficulty falling back asleep. It's literally been happening every single day for the past month.

The official name for it seems to be Terminal Insomnia, but my research into that hasn't offered much help. Stress and anxiety are often cited as causes of the problem, but my life hasn't been notably stressful lately. I don't even really worry about this problem too much. It's just gotten annoying and persistent enough that I'd like to do something about it. It's not like I go to bed terrified about it or stressing myself out about losing sleep; I'll wake up earlier than I'd wanted to and casually think to myself, "Oh, it happened again." It is an issue of mild annoyance for me rather than stress or anxiety.

I doubt the problem has to do with my bedroom environment. It happens regardless of whether I'm feeling too hot/cold or just right, whether the sun has risen yet or not, and there aren't any unusual noises causing it. My mattress is pretty old, though, so I'm thinking dust mite allergies might possibly be a factor. As far as physical factors go, I doubt it's anything like a sleep apnea since I've looked into the risk factors for that and they're all off the mark; I'm only in my 20's with a slim build.

There are basically only a couple things I can think of that have correlated with my waking troubles: I've been taking fish oil capsules on most nights, and I've been doing around 10-20 minutes of interval training running at the gym and around the neighborhood 4-5 days a week. But correlation need not equal causation, of course.

Anybody else familiar with Terminal Insomnia issues? What can I do to get back to restful and uninterrupted sleep? While I've always been wary of taking sleep aids, I'm up for it if anything might help this.
posted by Ryogen to Health & Fitness (26 answers total) 14 users marked this as a favorite
Do you consume any caffeine? What time of the day do you work out?
posted by un petit cadeau at 4:58 PM on March 26, 2012

Tell us more about your diet, level of activity, stress levels, job/school, other medical conditions, any pharmaceuticals (including recreational) you are taking, alcohol/smoking habits.

You didn't mention much of that in previous question you referenced above, and I feel some of that data might help members fine tune their advice to you.
posted by karathrace at 5:02 PM on March 26, 2012

You may not think there are unusual noises rousing you from sleep, but you'd be surprised at what can get through. Try sleeping with earplugs (not the foam kind, the putty kind).
posted by These Birds of a Feather at 5:03 PM on March 26, 2012 [1 favorite]

Now you've adopted a better pattern for falling asleep, maybe you're just discovering that an uninterrupted night's sleep isn't your natural pattern. It isn't for many people. Obviously that doesn't fix your falling-back-to-sleep issues, but it may be that you're making things harder by imagining that the waking is a problem. Get up, read, do something else for an hour. When my sleep is at its most refreshing, 4 + 3 seems to be my natural pattern; the trick is not to let the 40 minutes or so in the middle get me down.
posted by oliverburkeman at 5:05 PM on March 26, 2012 [2 favorites]

Get some kind of noise machine if you don't already have one. I sleep with a loud humidifier and it really cuts down on waking up due to random noises. I also occasionally take a single Advil PM or Excedrin PM when I really need to sleep through the night, but those can sometimes lead to grogginess the next day and it's not really a long-term solution.
posted by jabes at 5:06 PM on March 26, 2012

It's actually normal to wake briefly throughout the night. Reading about sleep cycles and segmented sleep might be informative. More concerning is the fact that you're having trouble falling back to sleep, but telling yourself that this is largely a normal part of the sleep cycle (and that "uninterrupted sleep" is largely a myth) might help a little bit.
posted by PhoBWanKenobi at 5:07 PM on March 26, 2012 [1 favorite]

First, yea, the young & slim can certainly have apnea. Did doctors rule this out, or was it just something you decided? Might be worth it to get it checked out.

Do you have any back or other injuries? Pain that you don't register during the day can cause you to wake up at night, when you are asleep. I have learned this the hard way.

Maybe your bedroom is too dry? Try adding a humidifier, that may help a lot as well.
posted by kellyblah at 5:08 PM on March 26, 2012 [1 favorite]

I wake up every night around 3:30 or 4. Ever since I learned that Ben Franklin did this (and got up and read, usually naked, for an hour or so), and that it may have been pretty normal in the early days of industrialization if not before, I've just embraced it and learned how to self-soothe until I fall asleep again. For me that means no lights, no screens, no angst, no activity except bathroom and maybe straightening the covers or adjusting the climate situation if necessary. I think cozy thoughts until I'm down again. Occasionally I so suffer brain-churn, but I have a firm rule that you cannot fix your life at 4am so it needs to be put away. Mostly I enjoy the time and meditate or do relaxation exercises.

I do find my waking period seems to be shorter when I take fish oil, but I take it in the morning with breakfast. Might be worth a try? Alcohol makes it worse, caffeine may affect me getting to sleep in the first place but doesn't seem to have anything to do with 3am. Blood sugar might, I try not to have carby meals in general but it is worse if I've had some starchy treat in the evening. I always have to pee, but that's true when I'm awake, too, I'm just a frequent flyer.
posted by Lyn Never at 5:09 PM on March 26, 2012 [6 favorites]

4-5 hours of sleep might be all you need some days. How do you feel the rest of the day when that happens?
posted by lizbunny at 5:19 PM on March 26, 2012

Melatonin. I used to have sleep troubles and my doctor recommended it. He said 2-5 mg half an hour before bed. Now I have no sleep troubles, and actually stopped taking it about a year ago. My mom and my aunt both take it if they wake up in the middle of the night and say it helps (their sleep issues are menopausal related, I believe).

The other thing is, when you wake up, is it because you need to go to the bathroom? (This is pretty common). If so, drink less water before bed.
posted by DoubleLune at 5:20 PM on March 26, 2012

Also what time do you exercise? When I was having trouble sleeping, my doctor gave me a whole list of things not to do at night, including exercise.
posted by DoubleLune at 5:21 PM on March 26, 2012

Clinical Manual for Evaluation and Treatment of Sleep Disorders - it might be of some use to you.
posted by leigh1 at 5:47 PM on March 26, 2012

A calcium/magnesium before bed helps me stay asleep. You don't say your gender (does "build"= boy? I am not sure), but the menstrual cycle can affect how much calcium you need on a given night.
posted by Riverine at 5:50 PM on March 26, 2012

You say a dust mite allergy is a possible cause...does this mean that when you wake up, you have the symptoms of allergy (congestion, headache, sore throat)?

If so, I have had this same problem. A combination of a mattress cover and a clear air filter have made my sleep so much more restful, with the bonus that I now wake up with a clear head instead of grogginess.
posted by houndsoflove at 6:05 PM on March 26, 2012

This actually happens to me if I consume any alcohol, even just a glass of wine with dinner. (I'm not only person I know who is more comfortable drinking when I do have to get up early in the morning...)
posted by cessair at 6:09 PM on March 26, 2012 [1 favorite]

I struggle with terminal insomnia sometimes. I rarely have trouble falling asleep, and I only ever had coffee in the mornings, but I still found that cutting out caffeine helped me get more solid sleep and makes it easier to fall back asleep if I do wake up before it seems time to get up. The fix wasn't instantaneous--I think it took a week or two without caffeine in my system.

Also, I know you say it doesn't seem to have anything to do with sunrise, but try blackout curtains. I didn't think light had much to do with my issue either, but I found it was better when I was in places that had either blackout curtains or small windows that didn't let in much light. (I was moving around a lot at the time.)
posted by needs more cowbell at 6:40 PM on March 26, 2012

This can happen to me if I eat too much starchy/sugary stuff for dinner or later in the evening. It usually happens around 3 AM and keeps me awake for a couple hours. I figure it's the late night equivalent of a sugar crash. A few times I've experimented with a low glycemic index snack before bed, and usually have had good results.
posted by DarkForest at 6:49 PM on March 26, 2012 [1 favorite]

Seconding the calcium/magnesium. I was also having the waking-up-in-the-middle-of-the-night thing and that helped a lot -- it also seemed to help however much sleep I got be better QUALITY sleep, so even if I did only get 4 hours once in a while at least it was a good 4 hours.
posted by EmpressCallipygos at 6:54 PM on March 26, 2012

Just chiming in to second the "second sleep" phenomenon. I've struggled with falling asleep and staying asleep, and realizing that it just might not be in my nature to sleep eight hours straight has made a world of difference. Learning to self-soothe through the wakeful period has allowed me to get a full night's rest, even if that's not the same thing as a full night's sleep.
posted by peanut_mcgillicuty at 7:04 PM on March 26, 2012 [1 favorite]

Yes, second sleep. I did this all through college, happily: nap from 3-5 pm, then up till 2 am and sleep till 8. 8 hours of sleep, just spread out the way my body wanted it. (I keep joking that I need to move to Spain, where the afternoon siesta and a late night are a part of the national culture.) If your schedule allows it, stay up as late as you want, sleep until you wake up in the middle of the night, putter, read, do some homework, and then go back to sleep for a good two hour nap later in the day.
posted by elizeh at 7:32 PM on March 26, 2012

If you're only recently transitioning to a more normal sleep pattern, then this could well be just a phase you'll grow out of. But the timing is interesting to me. You say it's not being caused by any unusual noises, but sometimes a noise can start your waking-up process, and you actually become conscious 10-20 minutes later, with no actual memory of the noise.

I am a curious monkey. If it were me, I would set my alarm one night for about an hour before when I'm usually waking up. And then I would just read quietly until well past when I'm usually awake. Just to see what's going on at that hour of the night.

Having worked night shift for many years, I can tell you that the night time is much more alive than daywalkers give it credit for. When you're up all night at home on the weekends, you hear all sorts of things. Someone comes home from the night shift and slams their car door. Someone else gets up early to go jogging, and stomps past your door. A dog down the street barks at the newspaper delivery person. Airplanes fly overhead. A large truck drives by.

Any of these could be happening every morning at (say) 3AM, causing you to find yourself lying awake at (say) 3:15AM.

When I find myself awakened, first I get up and go to the bathroom. (Because I am old, and we have to pee a lot, us old folks of "almost 40.") Then I get cozy in bed and start thinking about the last thing I can remember dreaming. It seems to transition me right back into sleep.
posted by ErikaB at 7:43 PM on March 26, 2012 [2 favorites]

Chiming in with those saying you're probably falling into the normal sleep-rouse-sleep cycle. It's been the same for me - I used to take hours to fall asleep, and then maybe get six hours on a GOOD night. Started taking rozerem and started falling asleep at a more human time....only to then begin experiencing what you're getting. Dr prescribed Mg, thinking it might be muscle spasms, but no real luck with that, either. When I'm off the rozerem and back to my insane, sleep-deprived self, I don't have this issue.

....so yeah, I think it's pretty normal. Actually, I'm trying to plan a bit for it nowadays - going to bed as *soon* as I get home from work and then a few hours later getting up and getting dinner and cleaning....and then back to bed for a bit.
posted by Lt. Bunny Wigglesworth at 9:09 PM on March 26, 2012

This can happen to me if I eat too much starchy/sugary stuff for dinner or later in the evening. It usually happens around 3 AM and keeps me awake for a couple hours. I figure it's the late night equivalent of a sugar crash. A few times I've experimented with a low glycemic index snack before bed, and usually have had good results.

I notice this too. A nice starchy meal is often great for making me sleepy, but my quality of sleep suffers and I toss and turn or experience what you do.

If you smoke, it could also be nicotine withdrawal. Or as you mentioned, the allergy slowly builds congestion throughout the night until both nostrils close up and you have a momentary apnea.
posted by gjc at 5:41 AM on March 27, 2012

Response by poster: I rarely have caffeine or alcohol, and mostly only exercise in the morning or early afternoon. Don't smoke either. I had noticed having to wake up to go to the bathroom a few times at first, but since then I've reduced any drinking before bed and the waking in the middle of the night has still persisted. If I'm able to get right back to sleep soon after waking, I tend to go right into REM sleep and get some intense dreams and feel generally well-rested for the first few hours after getting out of bed. But I'll almost always end up feeling really lethargic later in the day. If I'm not able to get right back to sleep and just lay in bed trying to, I usually end up feeling like crap for the rest of the day.

If this is normal though, I suppose I could get used to it and learn to get out of bed and read or take naps more often.
posted by Ryogen at 8:00 AM on March 27, 2012

Since the sleep you are getting is not leaving you rested, it doesn't sound healthy. Are you under any major stressors? Sometimes those leave you too wound up to relax enough to get adequate sleep.

Also, have you spoken to your doctor? Mine was very helpful in my "can't sleep/feel like crap waking up/heavy dreaming but not deeply sleeping" issues.
posted by DoubleLune at 8:29 AM on March 27, 2012

If I skip dinner, my blood sugar craters overnight and I wake up because my body thinks its starving. Don't eat a big meal right before bed (that can disturb sleep too) but do make sure you have SOMETHING for dinner around 5 or 6 PM (depending on your bedtime).

Frequent waking + unrefreshing sleep = something is wrong. It could be apnea or it could be Upper Airway Resistance Syndrome which is hard to diagnose and some insurers balk at treating. Push hard for a sleep test. Young, fit, thin folks of all genders can have apnea - it's not just for fat older guys. Waking up to pee in the middle of the night is one of the hallmarks of sleep apnea, btw - it can be a clue to the condition if someone otherwise doesn't snore loudly.

I'm a chronic insomniac and this book - Sound Sleep, Sound Mind by Barry Krakow has changed my life. In particular regarding your situation, he talks about "sleep maintenance insomnia" - that is, waking up during the middle of the night - and how it can be a symptom of sleep-disordered breathing - your body is waking up because it thinks its suffocating.

See a doctor, get a sleep test.
posted by Rosie M. Banks at 7:10 AM on March 28, 2012

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