How to fall back asleep when awakened in the night

Q:  I seem to have fallen into the unfortunate habit of awakening every night at about the same time.  Once that happens I cannot fall back asleep, and then I feel more tired and irritable during the day.  Any ideas?

A:  The inability to fall back asleep after being awakened in the night (sometimes called the really dreadful-sounding “terminal insomnia”) is something many of us face.  It’s fairly common among insomniacs.

One possible factor has to do with the alignment of your homeostatic sleep drive and your circadian rhythm, two key physiologic components that control sleep.

In normal sleepers, the homeostatic sleep drive sends a signal to the brain that it’s time for sleep after about 16 hours of nonstop wakefulness.  So we fall asleep.  But after several hours of slumber, the effect of sleep drive is reduced, and it’s not unusual to awaken.

In fact, normal sleepers awaken at least a dozen or so times per night on average.  The difference is normal sleepers fall right back asleep and typically forget about it by morning.

Here’s where your circadian rhythm comes into play.  As sleep drive is reduced, the circadian rhythm then helps reinforce slumber, enabling us to more easily fall back asleep when awakened.  Our circadian rhythm does this by sustaining a physiologic state conducive to sleep.  This circadian-driven resting state includes such biologic markers as a lower core body temperature, reduced heart and respiration rate, and lower blood pressure.

The two processes mutually support and complement each other, and when synchronized, sleep is naturally improved. In fact, when the circadian cycle and sleep drive are working well together sleep can become practically irresistible.

Consistency with your sleep-wake schedule is key to aligning and synchronizing your sleep drive and circadian rhythm.  For most  people, this means a consistent bed time, and especially important is a consistent wake-up time 7 days a week as much as possible.

Beyond that, when awakened in the night many people find that using in-bed relaxation methods — such as deep diaphragmatic breathing and progressive muscle relaxation — can help promote sleep.

To be sure, there can be many other factors involved with terminal insomnia, including diet.  In particular, people who drink alcohol in a misguided attempt to fall asleep often experience a stimulating rebound effect a few hours later that awakens them.

If you’d like more information, a comprehensive source of natural sleep improvement methods is contained in cognitive behavioral therapy (CBT) specifically designed for sleep.  CBT methods have been shown to be very effective, helping most people who try them.  Many become normal sleepers again.

There is every reason to believe these methods will help you too.

Explore posts in the same categories: Health, Insomnia, sleep

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2 Comments on “How to fall back asleep when awakened in the night”

  1. […] Enabling good sleep can take many forms, and is usually most effective when methods are combined simultaneously.  Using in-bed relaxation methods is just one part of a comprehensive solution for insomnia that does not require drugs to work. […]

  2. […] second idea you’ve described is in-bed relaxation, also one of the core CBT sleep training […]

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