6 Common Reasons You're Waking Up In the Middle of the Night

It's 3 a.m. You just woke upagain. A second ago you were deep in dreamland, and now you're staring at your bedroom ceiling wondering, "What gives?"

According to an 8,937-person study in Sleep Medicine, about one-third of American adults wake up at night at least three times a week. Three times! The study also found that 43 percent of those sleepless folks have a hard time falling back asleep.

The disorder also has a name: sleep-maintenance insomnia. Often it's referred to as middle insomnia or middle-of-the-night insomnia, but regardless of your name of choice, one thing is for sure: It's downright frustrating.

Now, the occasional nighttime awakening is nothing to be concerned about, says Terry Cralle, R.N., a certified clinical sleep educator and co-author of "Sleeping Your Way to the Top." It can happen when we're stressed, jet lagged or recovering from a nasty cold. But if you find yourself waking up at night on the regular, it might be time to evaluate your sleeping habits.

After all, sleep is crucial for our overall health and wellness, and when we don't get consistent, quality rest, our bodies can take quite the hit.

"Sleep deprivation [negatively] affects nearly every aspect of our health," explains Dr. Jennifer Chen Hopkins, M.D., a sleep disorders specialist at the Sleep Health Clinic of The Woodlands in Texas. "[This includes] blood pressure, blood sugar, metabolism, pain perception, mood, memory and the ability to focus and concentrate." It can even impact your physical appearance and sexual function, too. Simply put, we need to sleep survive and thrive.

But what happens when staying asleep feels like an impossible feat? Before chalking it up to your inner night owl, educate yourself on the common reasons people rise from their slumber. Some factors, such as habits and behaviors can be changed with practice and time. But other reasons—including medical conditions—may call for professional help.

Consider these six common reasons a starting point, and be honest with yourself (and your doctor!) about your struggles, behaviors and experiences with sleep. By recognizing different factors of a good night's rest, you'll be one step closer to catching those essential zzz's.

1. You're Too Stressed

It's no secret that stress makes it difficult to fall asleep. What's worse, however, is that it can also cause problems even after you doze off.

Stress puts your body in a state of hyperarousal. And according to a 2018 article in Nature, hyperarousal plays a major role in all types of insomnia, including sleep-maintenance insomnia. Plus, stress-induced insomnia can lead to more stress, creating an endless (and sleepless) cycle.

While it's not realistic to eliminate all stress, it's crucial to make time for stress relief. To do so, focus on simple, mindful habits that help you find moments of respite in the face of stress.

Take a tip from Cralle and try list-making. "[In the early] evening, write down a 'to-do' list and a 'worry list.' Then, put it away until the next morning," she recommends. The act of getting it out of your system and onto paper can do wonders for clearing your head.

Another method is to make a habit of keeping a gratitude journal. "[Before going to sleep], write down two or three things you are grateful for," encourages Cralle. It's a small yet powerful way to honor the little things, no matter how stressful life gets.<pagebreak>

2. Your Surroundings Are Noisy

Noise pollution can also disrupt your slumber, according to the National Sleep Foundation. Your brain, after all, still processes sounds as you snooze. Since you're most sensitive to noise during the lighter stages of sleep, you're more likely to be jolted awake in the wee hours of the morning if your bedroom is situated in a loud area. The issue can be especially difficult if you live in a noisy neighborhood or busy apartment building. Trains, planes and honking cars can add to the commotion, too.

While we can't stop the outside world from doing its thing, there are certainly ways to limit unwanted sounds. One method is to use a white noise machine. As a constant and soothing sound, white noise can mask sounds that might otherwise interrupt your beauty sleep. You can also use a sound machine that plays calming sounds, like crashing waves. 

But you don't necessarily need a fancy noise machine to get some shut eye. A fan, humidifier, air conditioner or air purifier can also get the job done. Ear plugs can also be an option, depending on whether they fit comfortably in your ears.

3. You're Not Comfortable Enough

Do you wake up at night with aches, pains and everything in between? Your sleep surface might be to blame. When mattresses and pillows have had their run, they're more likely to spark pain and stiffness in the back, shoulders and neck. As a result, hitting the sack can feel like a nightmare before you're able to drift off to dreamland.

To avoid physical discomfort, the National Sleep Foundation recommends replacing your pillows once they become lumpy and lose their shape, approximately every two years. It's also a good idea to replace your mattress every 10 or so years. The Journal of Chiropractic Medicine found that new mattresses can improve both back pain and sleep quality.

If you have chronic pain due to an injury or other condition, talk to your doctor. They'll able to suggest specific products, methods or sleeping positions to increase your level of comfort.

4. You're Using Electronics Too Late

If your bedtime routine involves late-night infomercials with a side of social media, you might want to re-think your habits. The light from glowing screens can mess with your internal clock, and the effects can last long after you shut them off.

"The short-wave, artificial blue light emitted by televisions, computers, cell phones and tablets confuse our brains by mimicking sunlight exposure," explains Cralle. "This triggers our body to stop making melatonin, the hormone that makes us sleepy." In turn, you're more likely to be awake in the dead of the night.<pagebreak>

To limit the harmful effects of electronics, Cralle suggests setting a "media curfew" each night. Turn off all electronics one to two hours before bedtime each night. This way, your brain will have time to relax before hitting the hay.

And if you do wake up in the middle of the night? Avoid reaching for your phone or the remote control; it will only delay the trip back to dreamland.

5. You're Experiencing Hormonal Changes

For women, hormonal fluctuations may be the culprit behind sleep troubles. This includes changes that occur during the menstrual cycle, pregnancy and menopause. And while these phases affect each woman differently, sleep-related issues are not unusual symptoms.

A study featured in Missouri Medicine shares that progesterone and estrogen have a strong link with your internal clock. So, when these hormones fluctuate, your sleep is thrown for a loop.

For example, when progesterone significantly rises in the latter half of your menstrual cycle, you're more likely to experience fragmented sleep. The emotional and physical symptoms of premenstrual syndrome (PMS) can also contribute to stress-induced insomnia. In fact, compared to women who don't have PMS, women with PMS are two to three times more likely to have sleep issues.

Progesterone also increases during pregnancy, leading to frequent wake-ups at night. Other factors, like digestive discomfort, fetal movement and breathing issues during sleep, can make it hard to snooze, as well.

In menopause, progesterone switches gears and decreases, which can wreak havoc on your sleep by making it hard to breathe at night. Top it off with a drop in estrogen, and you're left with frustrating hot flashes and nighttime sweats.
If you think hormones are at play, talk to your gynecologist and ask for help in controlling your specific symptoms. Depending on your age and stage in life, this may involve a combination of lifestyle changes and medication.

6. You Have Sleep Apnea

When you wake up at night, are you gasping for air or catching your breath? You might have sleep apnea, a disorder that temporarily stops your breathing during sleep.

"The most common form is obstructive sleep apnea, or OSA," explains Cralle. "[It] occurs when throat muscles relax, [which] causes shallow breathing or breathing pauses." As a result, your blood oxygen level drops and you wake up with a jolt.

"With central sleep apnea, the brain doesn't send proper signals to the muscles that control your breathing. Complex sleep apnea is when a person has both obstructive and central sleep apnea," says Cralle of the other two types.
Sleep apnea is extremely common and potentially dangerous, so it's important to keep it on your radar. It affects roughly 22 million Americans and can develop at any age. Moreover, the American Sleep Apnea Association estimates that 80 percent of moderate to severe cases of OSA are undiagnosed.

Talk to your doctor if your nighttime awakenings are accompanied by choking, gasping and/or loud snoring. A sleep specialist can perform the necessary tests and help you finally get a good night's rest.

Sometimes, staying asleep at night means altering your habits and behaviors around bedtime. But if you make a change and sleep problems persist, it may be time to visit a sleep specialist, says Dr. Hopkins.

Meanwhile, she recommends creating a relaxing bedtime routine to prime your body for sleep. "Change into [your pajamas], brush your teeth and moisturize with that lovely lavender hand cream," she recommends. "[This] will allow you to gradually transition into a sleepy state."

Come what may, try not to give up on your mission for restful sleep. It's one of the best things you can do for your health—today, tomorrow and beyond.