It may not be falling asleep that’s the problem, but staying asleep. There are lots of reasons why we wake up in the night and the good news is there’s lots that we can do about it.
The first thing to note is that we don’t sleep in a consistent block, rather in sleep cycles of approximately 90 minutes. In between these, we are very lightly asleep, and sometimes even awake (which we may or may not remember), to allow us to scan our environment for dangers.
Figure: This is an image of my sleep tracker from one night that showed this particularly clearly. I only remembered one of these wake-ups.
If there is something in our environment which alerts us during our light sleep, such as noise or light or being too hot, this may rouse us from sleep. It’s therefore important to keep our environment quiet, dark and cool. (See Going to Sleep section for more information here).
Another awareness that we may develop during light phases of our sleep cycles is needing to pee. If this is an issue for you, make sure you are drinking enough water early enough in the day, and stop drinking within an hour or two of bed.*
Another common reason for waking up is the others in our lives, including partners, pets and children. Find suggestions below about how to manage these aspects, along with tips about how to get back to sleep again.
*Waking up multiple times in the night can be a sign of medical problems. If you are worried, seek advice from your doctor. Another condition which can interrupt your sleep include obstructive sleep apnoea. Here, you may feel very tired in the day, your sleep tracker may reveal you that your oxygen levels are dipping in the night, or your partner may comment that you stop breathing in the night. Again, for this or any other concerns that you have, go and see a doctor.
Things you can do
Managing fluid intake
If you need to wake up often in the night to pee, one issue may be that you are drinking too close to bedtime.
Try to drink the majority of your fluid in the first 2/3 of the day, and stop drinking in the hour or two before bed. It is very important that you drinking enough fluid. Adult fluid guidelines are here.
It’s also important to avoid diuretics before bed, which can include tablets from your doctor (e.g. for heart failure), but also certain food and drinks like hibiscus tea or alcohol.
If you have worries about why you need to wee in the night, or have other symptoms that you're concerned about, go and see your doctor.
Alcohol and sleep
Alcohol and sleep are uneasy bedfellows.
Although a sedative that many people use to fall asleep, alcohol affects sleep quality, particularly in the second half of the night, causing wakening and affecting REM or ‘dream’ sleep.
Alcohol can also act as a diuretic, causing us to wake more frequently to pee…
The adult alcohol recommendation is to consume less than 14 units a week. It is recommended not to drink alcohol within three hours of bedtime
There is a fascinating conversation between Andrew Huberman and Matt Walker, below, about the impact of alcohol on sleep, and you can also hear Dr Caitlin Chasser talk about it in our Conversation with Experts, at timestamp 45:28.
A third of nighttime wakings-up are due to disturbance from partners. They may be snoring, tossing and turning, getting up to pee, sleep-talking, going to bed later or getting up earlier than you.
For differences in temperature preference or need, consider separate temperature ecosystems. If you are sharing a bed, temperature control mattress covers or separate duvets can really help, or separate beds or rooms are also an option, if that is acceptable to you both.
For noise disturbance, earplugs can work or, again, you can consider separate rooms if that is acceptable to both of you. It may also be worth your partner seeking medical advice if snoring is a big issue, to make sure that there is nothing structural or functional that could be addressed.
If your partner is waking much earlier than you, consider vibrating wrist alarms so that they don’t disturb you when their alarm goes off.
Children can be very disruptive to sleep. Please see the Sleep Project for specific advice and training programmes, below.
So can pets! Putting pets in other rooms, using stairgates for example, and making sure that they are warm, comfortable and fed enough so that they don’t disturb you, can be very helpful. If separation anxiety is a problem, consider formal training programmes.
Menopausal symptoms can be very disruptive to sleep both for those experiencing them, and for their partners.
Having separate sleep environments (separate cooling systems, separate duvets or separate beds or rooms), wearing non-sweaty fabrics and bedclothes, using chillows (or equivalents) and fans can all really help.
So can seeking medical support with menopausal symptoms, from your GP or from a menopause specialist.
What about if you are awake and you want to get back to sleep?
First, try not to wake yourself up more than you have to, by keeping warm, keeping the lighting conditions dim (as long as you’re safe to move around), and the noise levels low. Where possible, avoid having clocks visible in the bedroom as that can make you fire up your brain as you calculate how long you have left in bed.
You can deploy wind down techniques, such as breathwork, meditation or mindfulness techniques such as a body scan (see link below). You could also read a paper book, craft, have a gentle stretch. These techniques are particularly useful if you do them regularly at bedtime, as they will act as positive sleep associations for you. For other ideas, see ‘No and low screen options’, above.
If you aren’t drifting off, and are worrying about sleep, leave your bedroom until you feel sleepy again.
If this is regular or chronic, you’re not alone, and interventions like CBT-I (Cognitive Behavioural Therapy for Insomnia) can help within weeks, so see a sleep professional or your GP.
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