How to Get Back to Sleep After Waking Up at Night.

How to Get Back to Sleep After Waking Up at Night

Waking up throughout the night is normal.

Most adults do it between two and six times per night and if you’re a good sleeper, these wakings will be so brief that you likely won’t remember them, says Lynelle Schneeberg, a sleep psychologist and assistant professor of psychiatry at Yale Medicine.

But for some people, nighttime wakings are so intrusive that they experience what Schneeberg calls “the download.”

“You wake up and think, Why am I awake? How long have I been asleep? How much longer do I have to sleep?” she says.

You might start worrying about something that’s been on your mind, whether it’s a big presentation at work or a conflict with a family member.

After the download, you’re up.

Even people who have no trouble falling asleep can struggle with night wakings.

These expert tips will help you figure out what’s waking you up and how to get back to sleep.

Rule out medical conditions

One good first step is to rule out intrinsic sleep disorders, says Dr. Venkata Mukkavilli, a psychiatrist specializing in sleep medicine at UT Southwestern Medical Center’s O’Donnell Brain Institute.
These can include obstructive sleep apnea a condition in which a person’s airway becomes blocked, pausing their breathing, and restless leg syndrome, a nervous system disorder characterized by an urge to move one’s legs at night.
Signs of obstructive sleep apnea include snoring and waking up gasping.
Other chronic medical conditions can also contribute to difficulty staying asleep at night, Mukkavilli says.
These include depression, bipolar disorder, post-traumatic stress disorder (PTSD), anxiety, fibromyalgia, cancer, autoimmune diseases, and arthritis.
Menopause can also cause night wakings due to hot flashes, as can an enlarged prostate, as it often leads men to urinate more frequently at night.

Cut out alcohol and limit your caffeine

Even though alcohol might seem like it’s helping you sleep well, it’s probably doing the opposite.
“It increases your sleepiness, but decreases your quality of sleep,” Mukkavilli says.
People who drink alcohol regularly might fall asleep quickly, but they’ll often wake up in the middle of the night because alcohol can inhibit the body’s ability to enter a deep stage of sleep.
It’s also a diuretic, so it can cause people to urinate more.
It should come as no surprise that you should limit your coffee, tea, and soda intake as well, since caffeine is a stimulant.
Schneeberg’s recommendation is to have no more than three or four eight-ounce cups of caffeinated beverages a day, preferably all before noon.
“Caffeine has a half-life of three to five hours, so if you have coffee too late in the day, you might still have some caffeine in your bloodstream around bedtime,” she says.

Watch what (and when) you eat

If you find yourself waking up multiple times a night, consider moving your dinnertime earlier, says Dr. Vishesh Kapur, a professor and director of sleep medicine at the University of Washington School of Medicine.
If you eat a very large meal too late at night, the digestion process could wake you up.
Spicy foods, acidic foods, and fatty foods are particularly troublesome.
Schneeberg agrees she often tells patients to have no large meals within three hours of bedtime.
But she’s all in favor of a small bedtime snack, such as toast with peanut butter or oatmeal cookies with milk.
“Often it’s comforting, relaxing, and doesn’t give your body too much to digest,” she says.
Many people who wake up at night head to the kitchen for a middle-of-the-night munch, but Schneeberg warns against doing this.
“This is a terrible idea actually, because then you set an alarm to get up and eat in your body,” she says. Eating crackers at 2 a.m. will teach your body to expect them.

Move up your workout

Exercise is a wonderful way to improve your sleep quality.
Research has shown it can help people fall and stay asleep because it increases production of the sleep-regulating hormone melatonin, reduces stress, improves mood, and regulates your body’s temperature, which can help you doze off.
But if you find yourself waking up multiple times a night, try not to exercise in the evening, preferably within two hours of bedtime, Mukkavilli says.
Research found that intense physical activity late at night can impact sleep quality, likely because it increases your heart rate and body temperature.

Don’t check your phone

Phones are stimulating, so checking them at night even just to see what time it is can keep you up longer.
If you find yourself tempted to look at your phone, Kapur recommends leaving it out of your bedroom.
The same goes for your TV, tablet, laptop, and other electronic devices.
Melatonin is produced in the absence of light, Mukkavilli says, so using these devices can inhibit your body’s production of it.

Get out of bed

Most experts recommend staying in bed after night wakings and trying to fall back asleep for 15 to 20 minutes.
If you’re still awake after that window, get out of bed and go to a calm, quiet place in your home to do something relaxing like reading, completing a puzzle, or listening to an audiobook, Schneeberg says. If
you find reading particularly soothing, she believes it’s OK to do this activity in bed for up to 30 minutes, as it often helps people fall back asleep.

Avoid naps when possible

Napping can be an effective way to recharge when you’re tired.
But if you’re struggling with night wakings, napping during the day especially for too long or too late in the day could impact your nighttime sleep quality.
“Generally, if someone is having trouble with getting back to sleep after awakening at night, it’s better not to nap,” Kapur says.
There are exceptions to this rule.
Kapur says naps can be beneficial for people with daytime sleepiness related to obstructive sleep apnea, at least until it’s properly treated.
Schneeberg also adds that many older adults tend to need less nighttime sleep as they age, with a nap added in.

Enhance your environment

Environmental issues are a common cause of night wakings.
These could include disruptive noises, like cars driving by; a bedroom that’s too warm (around 65°F is ideal); too much light coming through your window; or movement, such as little kids or pets in your bed.
Pay attention to whether any of these are waking you up at night, and make adjustments accordingly.
For example, if you always wake up because the sun peeks in at 5 a.m., hang up blackout curtains.
Or, if you wake up feeling warm, set your thermostat a few degrees cooler the next night.

Consider doing CBT-I for insomnia

There are three primary types of insomnia:
- sleep onset insomnia (difficulty falling asleep),
- sleep maintenance insomnia (difficulty staying asleep),
- and early waking, a subset of sleep maintenance insomnia.
If you’ve ruled out medical conditions and have tried to improve your sleep habits, and you’re still struggling with night wakings, consider cognitive behavioral therapy for insomnia, or CBT-I.
“It’s as effective as medication,” Mukkavilli says, and it typically lasts just eight weeks.
“Even though it’s a short duration, it can have a lasting effect for the rest of someone’s life.”
Unfortunately, there are only few sleep therapists who practice CBT-I.
If you can’t schedule an appointment right away, there are several online CBT-I tools that are very helpful, Mukkavilli says.