Tired of Waking up in the Middle of the Night? We Can Help

You've had a non-stop day from morning to night, and you're exhausted. Falling asleep was so quick you barely remember it. But approximately four hours later, you wake up and start to worry: Why do I keep waking up in the middle of the night? What if I can’t fall asleep again? How will I have energy to get through the day tomorrow if I don’t get a good night’s sleep?

Although not unusual, waking up during the night can be frustrating, and worries about the amount of sleep you could lose are understandable. The good news? Adopting good sleep hygiene habits can help. 

In this article, we’ll share insights about what might be waking you up in the middle of the night and tips for helping you sleep through the night. Just as important as what you do — your daily and nightly habits — is when you do it. The key is to construct a schedule and sleep routine that coincide with your body’s internal clock, or circadian rhythm, as much as possible. Because doing everything you can to get the sleep you need is the key to staying asleep at night and having ample energy for your day.

Is Waking up in the Middle of the Night Normal?

Despite having no awareness or memory of them, most of us experience micro-awakenings — sometimes 10-20 per hour! — while we’re asleep at night. (For a more detailed account of your own micro-arousals, you’d need to spend the night at a sleep center hooked up to an electroencephalogram machine to monitor your brain’s electrical signals as part of a sleep study.)

But is it normal to completely wake up in the middle of the night? In short, yes. In fact, according to some sleep experts and historians, in many parts of the world, waking up (and getting up for an hour or more) in the middle of the night was just part of the regular rhythm of human life for much of recorded history. Biphasic sleep — or sleeping in two roughly four-hour segments separated by a period of wakefulness — was very common in preindustrial times before the advent of artificial illumination.

While it might be somewhat comforting to learn that the tendency to wake up during the night could be considered normal, the pace, timing, and demands of our modern lives can be especially challenging for people who have trouble sleeping through the night and struggle with daytime sleepiness and low energy levels.  

In the short term, sleep loss and sleep deprivation can cause cognitive impairment, poor mood, and increased susceptibility to accidents and injuries. Over the long term, sleep loss can increase your risk for high blood pressure, diabetes, weight gain/obesity, depression, heart attack, and stroke.

The best way to measure your short-term sleep loss and sleep deprivation is by tracking your sleep debt. Sleep debt is a running total of the hours of sleep you’ve missed compared to the amount of sleep your body needed over a roughly 14-day period. Getting enough sleep to keep your sleep debt at or below five hours helps with more than just improved health outcomes, it will also help you feel and perform at (or close to) your best. The RISE app keeps track of your sleep debt for you and shows the progress you make toward reducing it.

What’s Causing You to Wake up during the Night?

If you’re having a hard time sleeping through the night, it’s probably time for a little “light” discussion. When you wake up in the morning, do you keep the curtains drawn for hours? Are there days when you don’t go outside or feel sunlight on your face until the afternoon? Do you keep the overhead lights on throughout your house all night and just switch everything off right before you go to bed? If any of that sounds familiar, what you think is a sleep problem might really be a light problem. 

Ideally, you should expose yourself to light soon after you wake up and avoid light (as much as possible) 90 minutes before bed. Being strategic about the timing of your light exposure can improve your sleep and next-day energy levels. Why? Because light is the most important external influence on your body's internal clock, or circadian rhythm. In the RISE app, we refer to this body clock as your Energy Schedule because it dictates the predictable peaks and dips in energy you experience during each roughly 24-hour cycle. 

Stepping outside or opening the curtains to let the daylight in when you wake up in the morning helps calibrate your body’s internal clock by signaling the end of the sleep phase and the beginning of your waking hours. It also sets the stage for restful sleep at the end of the day. When you expose your skin and eyes to sunlight soon after waking, it can help increase your body’s production of serotonin. Approximately 12 hours later, the serotonin gets converted into the sleep-inducing hormone melatonin.

Darkness is a cue for your brain to ramp up production of melatonin, and light will disrupt the process. That’s why avoiding light in the hour or two before bedtime can make it easier to fall and stay asleep. Because it’s not always possible to avoid light altogether, try using fewer and dimmer lights and/or wearing blue-light blocking glasses — as the blue light that’s emitted from the screens of our electronic devices is especially problematic. 

Other common sleep disruptors include caffeine — because it stays in your system for up to 10 hours — and alcohol, which can put you to sleep quickly but often results in shallow, fragmented sleep. (The RISE app can help you determine when you should cut off your caffeine and alcohol consumption based on your unique biology. Go to the “Habits” tab to set up daily reminders of these cut-off times.) Jet lag and napping too late in the day can also be problematic because they tend to disrupt normal sleep patterns.

Good Sleep Hygiene Helps Minimize Restless Sleep

Bottom line? Better sleep — falling asleep and staying asleep — starts with better sleep hygiene, the upkeep of behaviors that influence the way you sleep. Follow these guidelines to optimize your sleep and next-day energy levels: 

• Do a sleep reset if you wake up during the night: To help get your mind and body back in the mood for sleep after 15 minutes or more of wakefulness during the night, get out of bed and read a book or listen to calming music. Just don’t do anything that will encourage you to feel more alert. When you start to feel sleepy, get back in bed. Repeat as needed.
• Get some sun: Expose yourself to light (preferably sunlight) soon after waking.
• Embrace the darkness: Removing most light, especially blue light, 90 minutes before bedtime helps ramp up your body’s production of the sleep-inducing hormone melatonin. If you must use electronic devices in the evening, try wearing blue-light blocking glasses.
• Go to bed during your Melatonin Window: Keep a consistent bedtime that correlates with your dim light melatonin onset (DLMO), the circadian phase marker that signals the start of your Melatonin Window, the time of night when your body produces its highest levels of melatonin. Missing this window can make it more difficult to fall asleep and stay asleep.
• Take time to unwind: Because mental stimulation can make it difficult to fall and stay asleep, instituting a nightly wind-down period can help you disconnect from the stress and busyness of the day. Listen to calming music, read a chapter of a novel, or practice your preferred relaxation technique. 
• Add a warm bath or shower to your bedtime routine: When you get out of the warm water, the blood vessels under your skin that were dilated by the heat are exposed to cool air, and your core temperature drops, which helps the body prepare for sleep. A warm bath will also help activate the parasympathetic nervous system, our built-in stress relief response, reducing levels of cortisol, which is essential for falling asleep. 
• Keep a consistent wake time: The RISE app will pinpoint your best wake-time window based on your habits and biology.
• Move your body: In addition to providing cardiovascular benefits, regular exercise can also make it easier to fall asleep at night.
• Avoid sleep-disrupting consumption: Starting in the afternoon or in the hours before bedtime, avoid alcohol, caffeine, and late-night eating that can cause digestive discomfort. The RISE app can tell you the exact time you should start limiting each one.
• Make your bedroom a sleep sanctuary: The ideal sleep environment is cool (65-68 degrees), dark, and quiet. Blackout curtains, an eye mask, a white noise machine, and earplugs can help.

Good sleep hygiene will help you keep your sleep debt low. 

Other Causes of Waking up in the Middle of the Night

As we’ve demonstrated, when most people say they have sleep problems, they usually really have a problem with light exposure (and poor sleep hygiene).

However, for nighttime wakefulness that persists without an obvious explanation, consider seeking medical advice to rule out or address underlying health issues or medical conditions that could be interrupting your sleep. Your specific symptoms and medical history might hold clues. Whether it’s heartburn, acid reflux, chronic pain, frequent nighttime urination (nocturia), or night sweats associated with menopause — your doctor may be able to offer treatment options that can help alleviate these sleep-disrupting symptoms.

Sleep disturbances have also been linked to high blood pressure, Alzheimer’s disease, anemia (and iron deficiency), mental health disorders, and some antidepressant medications. In addition, some people may experience sleeplessness as a side effect of certain antibiotics, steroids, or over-the-counter cold medicines.

To screen for sleep disorders, your doctor may refer you to a sleep specialist or recommend a sleep medicine clinic that can offer the best testing and treatment. You may be suffering from sleep maintenance insomnia or one of the following sleep disorders:

• Sleep apnea is a common but potentially serious disorder that causes multiple nighttime awakenings that can result in excessive daytime sleepiness, or hypersomnia. With obstructive sleep apnea, the upper airway becomes blocked repeatedly during sleep, reducing or completely stopping airflow, which can lead to low blood oxygen levels. Certain lifestyle changes (e.g., exercise, weight loss, quitting smoking, etc.) can help, as can wearing a continuous positive air pressure (CPAP) machine while sleeping.
• Restless legs syndrome (RLS) is another condition that can make it difficult to fall asleep and stay asleep. Classified as both a sleep disorder and a movement disorder, RLS is characterized by an uncontrollable urge to move your legs that gets worse when you’re sitting or lying down.
• Narcolepsy, a neurological disorder that affects the brain’s ability to control sleep-wake cycles and causes excessive daytime sleepiness, can also cause patients to wake up frequently during the night.

Get Caught up in the Right Cycle

One of the worst things you can do when you wake up in the middle of the night is to freak out about it. The added stress might be what keeps you from getting back to sleep. Instead, simply remind yourself that it won’t last forever, try a sleep reset, and give yourself credit for the steps you’re taking and the habits you’re adopting to get the kind of sleep that will contribute to your overall wellness.

Maintaining circadian alignment and low sleep debt is the best way to get caught up in a virtuous cycle of sleep and energy optimization. Following your circadian rhythm and meeting your sleep need helps you keep your sleep debt low, which will help you feel and function your best during the day and make it easier to sleep through the night. And the cycle repeats. 

If it sounds complicated, it doesn’t have to be. An easy-to-use tool can help simplify things. The RISE app will calculate your sleep need, keep track of your sleep debt, and help you get to know and follow your circadian rhythm.