Staying Asleep and Getting Back to Sleep

Many people find that their sleep issue lies in being able to stay asleep during the night rather than in getting to sleep. In fact, you’re in plentiful company if you find that you can drift off happily and easily when going to bed, yet find yourself eyes-wide-open a few hours later, unable to fall asleep again with hours left to wait until the morning. Or perhaps you’re among those that can get back to sleep when they awaken in the middle of the night but find yourself repeatedly waking throughout the night, feeling as if you’ve spent most of your night somewhere between being fully awake and fully asleep.

With around 40 million Americans suffering from some type of insomnia, you’ve got plenty of company.

What causes it?

There are a wide variety of reasons, from the easily solved to the more complex, as to why you might wake up during the night and not be able to get back to sleep. For starters, your body naturally moves into lighter stages of sleep, during which it’s easier to be roused, as the night wears on. This is the reason why you are more likely to awaken in the early morning hours.

Having poor sleep hygiene can also cause you to awaken during the night. This includes doing things like:

  • Drinking a caffeinated beverage, such as coffee or soda, in the afternoon or evening which can prevent you from achieving deep sleep.
  • Having a “nightcap” or alcoholic beverage before sleep may help you relax and make you fall asleep quickly, but it can rob you of deep sleep and REM sleep, and cause you to wake up in the middle of the night when the effects of the alcohol have worn off.
  • Trying to sleep in a less-than-ideal sleep environment; noises, bright lights, an uncomfortable bed, warm temperatures, and distractions from electronics can lead to nighttime awakenings, too.

Various sleep and medical conditions can also be to blame for nighttime awakenings. Examples of these conditions include:

  • Chronic obstructive pulmonary disease, or COPD
  • Chronic pain
  • Chronic stress or anxiety
  • Depression
  • Deviated septum or chronic sinus condition
  • Enlarged prostate in men
  • Heartburn or a chronic cough associated with gastroesophageal reflux disorder (GERD)
  • Hormonal fluctuations due to menopause or menstruation
  • Indigestion, acid reflux, or other gastrointestinal issues
  • Low blood sugar
  • Restless leg syndrome
  • Sleep apnea (central sleep apnea or obstructive sleep apnea)

These are all serious conditions, so if you suspect that you might have one of them, speak to your doctor right away.

If you consistently find yourself wide awake at 3:00 or 4:00 in the morning, you may have a condition known as sleep maintenance insomnia. This condition can be very frustrating and troublesome, but there are a variety of ways you can manage this annoying and stressful sleep disturbance.

Possible solutions

It’s important to know that over-the-counter sleep aids don’t typically offer any kind of significant or sustained relief from problems with staying asleep and getting back to sleep during the night. However, there are a variety of things you can do to adjust your sleep hygiene to manage it.

  • Start by sticking to a consistent sleep schedule – aim for roughly the same bedtime and wake-up time each day. You should also follow good sleep hygiene recommendations. After you awaken, you can also try some of these strategies to help you fall back asleep:
  • Get up and do something for 10 minutes – If you wake up and can’t get back to sleep within 15 minutes or so, get up and go to another room and do something relaxing, like reading or listening to music until you are tired enough to get back to sleep; just be sure to stay away from the TV and digital screens.
  • Switch pillows – Sleeping on the wrong type of pillow for your preferred sleep position could be the cause of your awakenings thanks to the discomfort and chronic back and neck pain they can cause.
    • Use pillows to properly position your body – If aches and pains are waking you up, using pillows to provide better support to your body can greatly improve your chances of achieving restful sleep.
    • Prefer sleeping on your back? Place a pillow beneath your knees to keep them supported and slightly bent in order to take stress off your lower back.
    • Prefer sleeping on your side? Try placing a pillow between your knees to achieve better alignment of your hips, and help keep your lower back from twisting, which is better for your spinal discs, joints, and soft tissues.
    • Prefer sleeping on your stomach? Use a flat pillow to support your head and maintain proper neck alignment. You can also place a relatively flat pillow beneath your hips/abdomen in order to maintain the natural inward curve of your lower back.
  • Try out a more comfortable mattress – Sometimes the cause of your trouble sleeping through the night is simply your mattress.  While any type of mattress can work for you, it must provide the right balance of both support and comfort. If you can see a compression in some part of the mattress, find yourself shifting positions a lot, or have back, shoulder, or any other type of joint pain waking you up, it’s time to look for a new one.
  • Change sleeping positions – Try sleeping in a different position if you tend to awaken when sleeping in a particular position, such as when you’re sleeping on your back. Many people find issues are resolved by moving to their left side.
  • Make your room colder – In order to fall asleep and stay asleep, your body temperature needs to lower. Give it a hand by turning on a fan, opening a window, or turning up the AC to make your room cooler. You may find that the combination of a heavy blanket or comforter and a cold bedroom has a soothing, swaddling feeling that nurtures sleep.
  • Keep a notepad and pen by your bedside – When you wake up in the middle of the night with your mind racing with thoughts of brilliant ideas or things you need to get done or forgot to do, take a moment and write them down. This will let free your mind from fixating on them, allowing you to drift back to sleep.
  • Try a breathing exercise to calm your mind and cue your body to relax – When you’re feeling anxious, taking deliberate, calming breaths can help you relax. Breathe in deeply through your nose until your lungs are full and then exhale through your mouth. Repeat as needed. You can also try taking a deep breath and holding it for a count of four, then release it for a count of four.
  • Keep pets and kids out of your room – Co-sleeping or allowing a pet on the bed can seem like a wonderful idea, but it can make it really tough to stay asleep. The additional noise, movement, heat, and even discomfort can keep even the best sleeper awake. If you just can’t give up the sleeping arrangements, consider scaling up a bed size to give everyone more wiggle room.

Why get treatment?

In some cases, trouble staying asleep and getting back to sleep is caused by a medical condition such as depression, restless legs syndrome, sleep apnea, or chronic pain. Getting treatment for these types of underlying conditions may be necessary to resolve your problems. Also, treating your sleep problems can help depression symptoms improve faster.

If your trouble staying asleep and getting back to sleep is chronic or recurring and is preventing you from feeling rested and healthy, talk to your physician. Seeing your physician or getting a referral to a sleep specialist can help you to determine if your sleep problems have an underlying physical or psychological cause that responds well to a specific kind of treatment.

Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. This article is for informational purposes only and does not constitute medical advice; the Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.