Sleep Maintenance Insomnia

It can be normal to wake up in the middle of the night, sometimes as many as 5 times per night, but typically we don’t recall these arousals. Nighttime awakenings become problematic when they are occurring in excess or keeping you from being able to fall back to sleep.  These disruptions can sometimes be related to medical causes, such as reflux or heartburn, mental health causes like anxiety, or sleep causes like sleep apnea, restless leg syndrome, narcolepsy or sleep maintenance insomnia. The question is how do you know which one it is?

First, if this is a chronic problem, meaning that is occurring more than 2 times per week and for greater than 3 months duration make sure you partner with your doctor to discuss this concern. More infrequent symptoms of shorter duration may respond well to some of the tips below.

Try to identify what you feel is making you wake up, other symptoms you experience at that time and then what your response is to waking up. It is important to review any specific medical conditions you may have and whether they can have night time worsening that could interfere with sleep. For instance, do you have reflux, asthma, or epilepsy and with your wakings do you find that you are experiencing symptoms related to these.

Once you exclude medical causes then evaluate for the other potential causes of nocturnal awakenings. Take a look at the following guide to see if this can help you determine the cause of your disturbed night time sleep:

  • Obstructive Sleep Apnea: Do you experience snoring? Awake with a gasp, cough or feeling of choking? Do you wake with a dry mouth and need a drink? Have increased nighttime urination or bedwetting?
  • Restless Leg Syndrome: Do you experience an uncomfortable sensation in your arms or legs that wakes you and only improves with moving them around? Do you need to get out of bed and walk around or need to massage your legs?
  • Narcolepsy: Do you wake spontaneously, but sometimes find it is associated with feelings of being stuck, frozen or paralyzed (sleep paralysis)? Do you have associated vivid dreaming or nightmares? Do you see or feel like someone else is in the room with you and feel frightened? Are you experiencing severe excessive sleepiness in the day?
  • Bruxism:  Do you wake up with a feel of soreness or pain in your jaw or teeth? Has your dentist asked if you grind your teeth?
  • Insomnia (sleep maintenance): Do you wake spontaneously and feel frustrated by this? Do you immediately check the clock or your cell phone? Stay in bed and “try” to fall back to sleep? “Try” to become sleepy by watching TV, Netflix or social media apps? Feel anxious or worry about not being able to fall back to sleep or your mind start wandering on all the things you have to do tomorrow?

Don’t Keep Yourself Awake

If you have identified symptoms from above that are consistent with the reason you are having difficulty getting a restful night’s sleep, please make sure you discuss with your provider or possibly a sleep specialist. In the meantime, here are some tips to improve sleep maintenance insomnia symptoms, which include ensuring that you are engaging in all the best behaviors to help maximize your ability to stay asleep or easily return to sleep. You don’t have to spend all night staring at the ceiling hoping for sleep. This and many other habits can prevent you from falling back asleep and keep you stuck in the insomnia cycle. Avoiding these activities can help you get a healthy night’s sleep:

  • Eating Bedtime Snacks – Eating before bed may make you feel sleepy, but it can also negatively impact your quality of sleep. Many snacks have high levels of sugar, caffeine, and other unhealthy additives. By sticking to a healthy diet and avoiding late night snacking, you can enjoy a restful night’s sleep.
  • Homework or Screen Time Hobbies – While it may seem like a good way to get your mind off things, this can impact your sleep patterns. Avoid doing homework or using Snapchat, Tiktok, Facebook, or Instagram in bed or right before bedtime to keep your mind calm or distracted, it will more likely have the opposite effect
  • Staying in Bed – You can’t just force yourself into sleep (much like you can’t force yourself to be hungry). If you feel like you have been laying in bed for about 20 minutes (NOT because you were staring at the clock, its time to get up, try using similar relaxing strategies that helped you fall asleep in the first place (i.e reading a book, meditation, listening to relaxing music or white noise), and when you feel sleepy again return to bed to fall asleep.

Healthy Sleep Time Practices

There are also plenty of techniques and practices you can use to get yourself back to sleep at night! If you’re dealing with trouble staying asleep, here are some easy-to-use ways of encouraging sleep:

  • Read a Book – A pleasant (but not engrossing) book can be the perfect solution to insomnia. But you shouldn’t turn on your tablet or cell phone to read it, or read anything too intense. The idea is to select something you like but that you can still put down, and that doesn’t emit white light.
  • Use White Noise – If you’re a light sleeper, unexpected noise, like a barking dog or car starting, can wake you up. Even a bird singing at dawn can stir you from your sleep. We recommend amplifying background noise. The gentle hum of a fan or noise machine (or even ASMR videos) can help you tune out disruptions.
  • Try Stress Reduction Techniques – Relaxation exercises before bedtime or when you find yourself wide awake at night can help your mind wind down. Everything from yoga, deep breathing, and even writing in a journal can help you unwind and sleep easier!

Wake Up and Learn is committed to ensuring that every child and teen gets a full night’s rest every night. Be sure to check back for more healthy sleep tips and tricks!