Help! I Can’t Stay Asleep

Has this ever happened to you? It’s 3 AM and you are wide awake. Bedtime was normal, you fell asleep pretty quickly but now. Now you’re wide awake. A glance at the clock: now it’s 3:30 AM.  You start thinking about the meetings you have tomorrow – wait – later today, and then you wonder if you sent the email reminder to everyone about your meeting. Eventually, you doze again, but feel exhausted the entire next day. 

Most of us do wake up several times a night, but we just roll over and go back to sleep, as a normal part of our sleep cycle. Stages of a sleep cycle include a transition from being awake to being asleep; light sleep; deep sleep and REM (rapid-eye-movement) sleep. We repeat this cycle several times a night.

One theory about why we do this has to do with our history as a species. Dr. Jose Colon, author of ‘The Sleep Diet,’ says “Nobody sleeps through the night.” He says even four to six nocturnal awakenings are considered normal. “This goes back to our caveman days where one would wake up, scan the environment, make sure there are no tigers, and then go back to sleep,” he says. It’s only a problem if you cannot go back to sleep. 

Sleep problems can be temporary, or they can be serious. If you have trouble falling (or staying) asleep, or if you’re tired during the day, talk to your primary care provider. As many as 80 percent of sleep disorders go undiagnosed. Learn more about how INTEGRIS Health can help you get better sleep.

Here are some possible reasons for your middle-of-the-night insomnia

Acid reflux. This condition involves acid from your stomach burbling up into your esophagus. This can cause pain, in the form of heartburn, which will wake a person up. Even when heartburn pain does not occur, your esophagus will reflexively try to clear out the acid, which can also disrupt sleep. Make adjustments to ease your reflux: eat smaller meals, don’t eat late in the evening and keep your weight at a healthy level.

Distractions. Is your room too hot or too cold? Are you scrolling through your social media when you should be engaging in a relaxing bedtime routine? Is ambient light or sound creeping into your space? All of these can disrupt sleep. For most, a room temperature between 60-65 degrees F is perfect. As for your phone or laptop, put them down at least an hour before bed. Instead, sip some decaf chamomile tea and snuggle in with a good book. Try a white noise machine (or app) if distracting sounds are waking you up. Blackout blinds or drapes can keep light pollution to a minimum. 

Belly fat. Extra weight around your middle makes it harder to breathe when you lie down. Uneasy breathing is disruptive to sleep. Belly fat also tends to trigger inflammation in your body, which can diminish the function of the neurological pathways that control sleep. A vicious cycle ensues: not sleeping enough is linked to overeating; overeating is linked to poor sleep. Solve it by cutting calories, exercising more, and adding reasonable amounts of foods containing monosaturated fatty acids (helpful in abating weight gain, belly fat, heart disease and diabetes) to your diet. Avocados, olive oil and nuts are good sources of monosaturated fatty acids.

Alcohol and caffeine. Particularly late in the day or in excess, both alcohol and caffeine are fantastic sleep disruptors. Avoid caffeinated beverages late in the day and rethink drinking alcohol late at night.   

Depression. One of the most common signs of depression is insomnia or an inability to stay asleep. Other common metal illnesses that can cause insomnia in the middle of the night are schizophrenia, anxiety, attention deficit hyperactivity disorder (ADHD) and bipolar disorder. According to a recent Johns Hopkins article, some 75 percent of people with depression have trouble falling asleep or staying asleep. Here are tips to boost your mental health. Think you may be depressed? We can help. Talk to your primary care provider who can help provide a treatment plan. 

Stress. If you’re experiencing stress in your life, relaxing and sleeping through the night can be tricky. Stress activates the sympathetic nervous system, whose job is to prepare your body for mental and physical activity, making your heart beat stronger, constricting blood vessels, raising your temperature and blood pressure, causing pupil dilation and opening your airways. This activation is also known as the ‘fight or flight response,’ and it is not conducive to sleep. Consider stress relieving techniques like meditation or yoga to help you manage stress.

Next time you find yourself awake in the middle of the night, try Progressive Muscle Relaxation.

It’s a wonderful technique that teaches you to relax your muscles in two steps. First you tense up a muscle group and then you gradually (but totally) relax them. It’s a specific process, and you can target as many muscle groups as you’d like. First, identify a muscle group to work on. Now slowly inhale and squeeze the muscles of your left foot as hard as you can for a count of five seconds. Squeeze so hard it almost hurts but stop if you feel intense or shooting pain. Try tensing and relaxing muscle groups in this order:

Forehead. Tighten the muscles in your forehead. Draw your brows together and really squeeze. Feel the muscles continue to tighten and hold for a count of 15 seconds. Next, slowly let go of the tension you’ve built up. Allow your muscles to relax for a count of 30 seconds, until your forehead feels absolutely relaxed.  

Jaw. Clench your jaw and tense the muscles, holding for a count of 15 seconds. Slowly release while counting to 30. Notice your sense of relaxation beginning to deepen.

Neck and shoulders. Draw your shoulders up toward your ears and really tighten them. Hold for a count of 15 seconds. Slowly count to 30 as you gradually release the tension. Take a moment to notice the feeling of calm relaxation in your neck and shoulders.

Hands and arms. With your arms down by your sides, ball your hands into fists. As you tighten the muscles in your hands and arms, bring both hands into your chest. Hold there for 15 seconds, squeezing as tight as you can. Slowly relax your muscles and lower your hands and arms back down by your sides as you count to 30 seconds. Become aware of how heavy and relaxed your arms and hands feel.

Buttocks. While breathing slowly and evenly, tense your buttocks, increasing the tension for a count of 15 seconds. Slowly relax your buttocks over 30 seconds. As you do, feel the tension melting away. 

Legs. Focus on your calves and quadriceps, tightening them over a count of 15 seconds. Squeeze them as tight as you can. Next, slowly release the tension over a count of 30 seconds and savor the feeling of deep relaxation.

Feet. As you count off 15 seconds, gradually tighten the muscles in your feet and toes. Remember, tighten them only to a point of firm tension, not sharp pain. Then, for a count of 30 seconds, release the tension you’ve created. 

For more lifestyle and wellness content, visit the INTEGRIS Health For You blog.