How to get help for middle-of-the-night insomnia
You might not struggle with getting to sleep at night, but with the way things are going, you’re starting to wonder how to get help for middle-of-the-night insomnia.
Everything seems like it’s going okay, you’re sleeping well, snoring even. And then it happens, you roll over, your eyes flutter open, and a half an hour later, you find yourself counting the hours, maybe even minutes, that you have left until the alarm goes off.
The next day, you’re plagued by exhaustion and hoping it doesn’t happen again.
You aren’t alone. Sleep maintenance insomnia is common and impacts many people.
What is Middle-of-the-night insomnia or sleep maintenance insomnia?
We’ve all heard of insomnia. We know that it is basically having a hard time sleeping. There are two types of insomnia. The first is sleep onset insomnia or trouble falling asleep. The second is sleep maintenance insomnia, which is trouble falling asleep.
Some people struggle with both types of insomnia, while others struggle with only one.
Chronic insomnia, or insomnia that occurs for over a month and happens regularly, affects about 10% of the population. That includes the numbers for both types of insomnia.
Normal sleep patterns include waking up briefly throughout the night, the problem is when the person can’t get back to sleep.
Having trouble getting back to sleep is more likely to happen during midlife. This is due to hormonal changes, life stress, and other physical changes (medical conditions) that occur during this time period. But it can also happen at any age.
Now that we know what’s happening, how do we stop it from happening?
What to do- Easy habits to implement to help you sleep better
Here are some good sleep habits that you can start to implement that will increase the likelihood that you’ll be able to fall asleep and stay asleep.
You can start them right away, and they’ll help you sleep better tonight. Also, the more regularly you use them, the better sleep quality you will get.
So if you need help for middle-of-the-night insomnia, start here:
Create an optimal sleep environment
Your sleep environment is the foundation of your sleep. If your bedroom or bed is uncomfortable, it will impact your ability to get better sleep. Start by making sure that your room is quiet and dark. Make sure your bed is comfortable, and even though the room should be cool, you can get warm enough to be comfortable. It’s also important for your body to know that your bed is for sleep, so make sure that you don’t do anything other than sleep in bed, even during the day.Establish a consistent rise time
When you wake up at the same time every day, this helps your body understand what time it’s supposed to be sleeping and what time it’s supposed to be waking up. So really, you aren’t just establishing a wake-up time but also a consistent sleep schedule. Be sure to keep the same wake-up time, even if you slept horribly the night before. When your body knows it’s time for sleep, it will be easier to fall asleep and stay that way through the night.Exercise regularly
Getting regular physical activity helps you to reset your body's regular circadian rhythm. It also helps your body to settle into sleep more easily and stay asleep longer. Insomnia can be a nervous system activation issue, and regular exercise helps to lower this activation and maintain the decrease.
Maintain a consistent bedtime routine
When it comes to maintaining a consistent sleep routine, we’re talking about creating a routine of things that you do before bed. This helps your body know that sleep is coming. These activities can be typical bedtime routines, or they can be activities that will help you to relax so that you are more likely to sleep. Some activities that might help you relax are taking a shower, mindfulness, meditation, and other relaxation techniques. The important thing is that you do the same things each night before bed so that your brain knows that it’s bedtime.
These ideas are quick and easy to implement. The hard part is the consistency, but often, once you start sleeping a little better, it helps you stay motivated to keep going.
What not to do: Common mistakes that interfere with sleeping through the night
Now you know some easy strategies to put in place, it’s time to look at the bad habits you might need to quit or lower so you can sleep better.
Cutting down or eliminating these from your day makes a big difference in your ability to sleep through the night.
Here are three things not to do if you want to sleep through the night:
Don’t drink alcohol
Many people believe that alcohol helps them sleep better. But in reality, this isn’t true. For some, alcohol might help you fall asleep quickly, but in a couple of hours, the alcohol interrupts your sleep cycle and makes it harder for you to stay asleep.
Also, alcohol might help you get to sleep in the short term, but when you use it to fall asleep, you can end up dependent on it. Which means that you won’t be able to get to sleep without it. Even if it’s interfering with your ability to stay asleep all night. This makes it important to avoid alcohol for at least four hours before you go to bed if you want to sleep through the night.
Want to learn more? Check out our blog about alcohol-fueled insomnia here.Don’t nap
When you’ve been dealing with a lack of sleep, it’s tempting to lie down for a quick nap to help you feel more rested. Really, this ends up sabotaging sleep for your night ahead, and helps make insomnia even worse. It interferes with your ability to stay asleep at night. It does this by disrupting your normal sleep-wake cycle, so your brain doesn’t know how long you should be sleeping at night and when. If you struggle with any kind of insomnia, taking naps during the day will sabotage your efforts to get real restful sleep at night.
Don’t look at screens in bed
Many of us like to watch a show or look at social media while we’re winding down for bed at night or in the middle of the night when we can’t get back to sleep. Unfortunately, the light from your electronic devices, as well as the excitement that comes from bright moving images and the addictive nature of social media, makes it harder to fall asleep. The gold standard for sleep treatment to get better sleep is to put down your devices 2 hours before bed. But for many people, even half an hour before bed is enough to make the difference you need.
Giving up these habits will help you sleep better through the night and help you to wake up feeling better rested.
Other pitfalls
Some other habits can interfere with your ability to sleep. The first pitfall is trying to force yourself to sleep in the middle of the night, force and sleep don’t work well together. When you try to force yourself to sleep, it actually just makes it harder. This is especially true for babies.
Catastrophising about how much sleep you’re going to get or if you’re ever going to be able to sleep well again also makes it harder to sleep. These thoughts create stress and anxiety, both of which make it harder to sleep.
Last is trying to problem solve daytime issues or worry about things when you’re awake in the middle of the night. This puts your brain into a more active state, which makes it harder to sleep. If you find yourself worrying about something in the middle of the night, write it down so that you can come back to it in the morning.
What to do when you are awake in the middle of the night?
All of this might leave you wondering, if I’m awake in the middle of the night, what can I do to help myself get back to sleep?
Once you realize that you aren’t going to be able to get back to sleep, maybe after you’ve been lying there for 10-15 minutes, it’s time to get up and go into another room.
Once you’re in the other room, don’t turn all of the lights and TV on at full volume. Try to create a kind of intermediate quiet zone. Make the room mostly dark with a tiny bit of light, and do something that is calming that does not involve screens.
Don’t get back into bed until you’re sleepy and know that you will get back to sleep.
If these tips don’t help, what are the next steps?
For some people, the tips above aren’t quite enough.
If after trying these steps your sleep isn’t improving, it’s probably time to try Cognitive Behavioral Therapy for Insomnia, also called CBT-I.
The American Academy of Sleep Medicine considers CBT-I the gold standard treatment for all types of insomnia, including sleep maintenance insomnia.
CBT-I goes deeper than the sleep hygiene steps mentioned above in that it’s:
Personalized for each person and their sleep disorder
Assess for emotional problems that are interfering with your nightly rest
Relaxation techniques to help calm your nervous system for sleep
Addresses unhelpful thoughts around sleep with cognitive techniques
Utilizes stimulus control so you can reassociate bed and night with sleep
Teaches you to track your sleep so that you can see the progress you’re making
It uses sleep restriction therapy to increase the quality of sleep throughout the night
Most of our clients start to see improvements right away, and have significant improvement within 6 sessions.
Long-term CBT-I has been shown to be more effective than medication in helping someone who struggles with insomnia maintain improved sleep.
How to find a CBT-I therapist
If you’re feeling like it might be time to get some help for your middle-of-the-night insomnia, Rhythm Wellness can help. Our sleep specialists provide CBT-I to clients who are struggling with all kinds of chronic insomnia.
Schedule now to get your help for middle-of-the-night insomnia.
