Herbie Murray
Sleep is essential for our well-being, but many people struggle with sleep disturbances, including difficulty falling asleep or waking up too early. This phenomenon, known as sleep-maintenance insomnia, is a common issue that can be frustrating and exhausting. Various factors, such as genetics, age, hormones, and stress, contribute to these sleep disruptions. Understanding the reasons behind them is crucial for finding effective solutions and improving sleep quality.
| Characteristics | Values |
|---|---|
| Anxiety | Anxiety about waking up early can keep you awake at night. |
| Genetics | Genetic differences can influence whether someone is an early riser or a late riser. |
| Age | Older people need fewer hours of sleep at night. |
| Sleep cycle | As we grow older, our sleep cycle becomes shorter, and we spend less time in deep sleep. |
| Sleep anxiety | Worrying about sleep and the impact of a lack of sleep can cause insomnia. |
| Sleep-maintenance insomnia | This is the inability to remain asleep during the night. |
| Sleep-onset insomnia | This is the kind of insomnia that prevents you from falling asleep when you want to. |
| Hormones | Hormonal changes during menopause can disrupt sleep. |
| Temperature | A hot bedroom can cause sleep disturbances. |
| Light | Exposure to blue and green light can make you feel more alert. |
| Pain | Chronic pain can cause sleep disturbances. |
| Relaxation | Practising relaxation techniques may lead to a better night's sleep. |
| Sleep deprivation | Sleep deprivation can cause exhaustion. |
| Sleep schedule | Watching videos or playing video games late at night can disrupt your sleep schedule. |
| Relaxation | Accepting that you may not sleep can take the pressure off and help you fall asleep. |
| Preparation | Preparing for your morning in advance may reduce stress and help you sleep. |
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What You'll Learn
Anxiety about waking up early can keep you awake
Waking up early can be a stressful experience, especially if you have a lot to do or somewhere important to be. It is common to experience anxiety about waking up early, and this anxiety can sometimes keep you from getting a good night's sleep. This can lead to a vicious cycle of stress and insomnia, where the anxiety about not getting enough sleep becomes the main cause of your insomnia.
There are several reasons why you might wake up earlier than you intended. As you get older, changes in your circadian rhythm cause you to need fewer hours of sleep at night, which can disrupt your sleep patterns and cause you to wake up earlier than planned. Women experiencing menopause may also find that hormonal shifts disrupt their sleep.
If you are experiencing anxiety about waking up early, there are a few things you can try. Firstly, it may be helpful to prepare for your morning the night before. For example, you could lay out your clothes, prepare breakfast, or group your work things together. This may reduce your stress levels and make it easier to fall asleep.
Another strategy is to adjust your bedtime. Try going to bed later, even if this feels counterintuitive. By building up your sleep drive, you may find it easier to sleep through the night. Only go to bed when you feel truly tired, and if you can't sleep, get up and do something relaxing for 20-30 minutes before trying again.
It is also important to make your bedroom sleep-friendly. Ensure your room is cool, dark, and that your bedding is comfortable. Exposure to blue and green light from electronic devices can make you feel more alert, so it's best to avoid looking at your phone, tablet, or computer if you wake up during the night. Instead of checking the time, try practising progressive muscle relaxation techniques to help you fall back asleep.
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It may be genetic—some people are 'morning larks'
It may be genetic—some people are predisposed to be morning larks, naturally waking up early and preferring early mornings to staying up late at night. A genetic study of nearly 700,000 people revealed new insights about the genetics of chronotype, our preference to rise early or sleep late, and how it influences our mental and physical health.
Our chronotype is influenced by our environment, including season, latitude, and whether we live in an urban area. Men are more likely than women to be owls (late sleepers), and we become more lark-like as we age. However, studies have shown that anywhere between a fifth and a half of our chronotype is fixed at birth by our genes. Some genetic variants have been identified in or near genes responsible for the correct functioning of the body clock, suggesting that some differences between larks and owls can be ascribed to slight differences in the clock itself.
The body clock can operate without external interference, but in humans, it tends to run for slightly longer than a 24-hour day. To stay in sync with the day-night cycle, it receives cues from the environment via the body, from sensed levels of temperature and light. These cues allow the clock to be "entrained" (corrected) each day. Some of the genetic variants found were in genes important to the retina, which converts light focused by the eyeball to signals for communication to the brain. In an experiment investigating the effect of night-time artificial light on humans, researchers showed that the body clocks of owls were delayed more than larks.
Being a morning person has certain advantages over being a night owl. Morning people have a lower risk of certain mental disorders, and studies have found that they are less likely to develop depression than night owls. On the other hand, being predisposed to being a night owl may put you at a higher risk for developing type 2 diabetes and heart disease than being a morning person.
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Age can cause changes in sleep cycles and shorter sleep
Age can significantly influence sleep patterns, with older people experiencing changes in their sleep cycles and shorter sleep durations. This phenomenon is supported by research, which reveals that over a typical lifespan, the amount of time spent sleeping each day decreases. Newborns, for instance, sleep for 16 to 20 hours daily, while adults have sleep cycles lasting about 90 minutes.
As people advance in age, they tend to experience a shift in their sleep patterns, finding it harder to fall asleep and stay asleep throughout the night. Older adults typically experience shorter periods of slow-wave sleep (N3 sleep) and fewer of them. N3 sleep refers to the non-dreaming, restorative type of sleep, also known as deep sleep. Consequently, sleep becomes lighter and more fragmented, with older individuals waking up more frequently during the night and in the early morning.
The total sleep time for older people may remain the same or slightly decrease, ranging from 6.5 to 7 hours per night. However, the transition between sleep and waking up can be abrupt, making them feel like lighter sleepers compared to their younger years. The reduction in deep sleep can lead to multiple awakenings during the night, with older adults waking up an average of 3 to 4 times. They are also more aware of being awake, which can contribute to the perception of lighter sleep.
Several factors contribute to age-related changes in sleep cycles and duration. One factor is the interaction between the sleep-wake homeostat and the internal clock. With age, the window during which the internal clock enables sleep narrows, making it more challenging to maintain sleep throughout the night. Additionally, older individuals may experience nocturia, the need to get up and urinate multiple times during the night, disrupting their sleep.
Furthermore, age-related illnesses and chronic pain conditions can cause discomfort and pain that interrupts sleep. Examples include arthritis, back problems, GERD, diabetes, and heart failure. These conditions can cause physical discomfort and affect the electrical signals in the brain and nervous system, impacting sleep quality.
To promote better sleep as we age, it is crucial to maintain good sleep habits and practice relaxation techniques. Establishing a consistent sleep schedule, creating a soothing bedtime routine, and avoiding stimulants like caffeine and alcohol close to bedtime can all contribute to improved sleep quality. Additionally, cognitive-behavioral therapy and, in some cases, antidepressant medications can be effective in addressing age-related sleep disturbances.
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Sleep-maintenance insomnia may be the cause
There are several factors that can increase the risk of sleep-maintenance insomnia. One of the factors is age. As people grow older, the amount of time spent in deep sleep decreases, affecting the sleep-wake cycle and causing nighttime awakenings. Additionally, women are more prone to all forms of insomnia, especially during menopause when changing hormones can disrupt sleep.
The original cause of sleep-maintenance insomnia may be difficult to identify, but it often leads to worry and anxiety about not getting enough sleep, creating a vicious cycle where this anxiety becomes the primary source of insomnia. This is known as sleep anxiety, which can maintain insomnia even after the initial trigger has passed.
To break the cycle of sleep-maintenance insomnia, it is recommended to practice good sleep hygiene and relaxation techniques. Cognitive-behavioural therapy (CBT) is a specialised form of psychotherapy that has proven effective in treating insomnia. CBT-i, or CBT for insomnia, addresses the thoughts, habits, and behaviours that impact sleep, helping to identify and change patterns that contribute to poor sleep. Additionally, maintaining a regular sleep schedule, avoiding caffeine, nicotine, and alcohol, and creating a sleep-friendly environment can also help improve sleep quality.
If you suspect you may be suffering from sleep-maintenance insomnia, it is important to seek professional help. A sleep specialist will assess your lifestyle, habits, and sleep patterns to determine the best course of treatment.
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Try cognitive and behavioural techniques to help you sleep
Sleep-maintenance insomnia, or the inability to remain asleep during the night, can be caused by health problems, depression, or stress. This can be addressed by maintaining good sleep habits and practising relaxation techniques.
Cognitive and behavioural techniques can be used to help you sleep. These include stimulus control, sleep restriction, and relaxation training. Cognitive behavioural therapy for insomnia (CBT-I) is a short, structured, and evidence-based approach to combating the symptoms of insomnia. CBT-I focuses on exploring the connection between thoughts, feelings, behaviours, and sleep. During treatment, a trained CBT-I provider helps to identify thoughts, feelings, and behaviours that are contributing to insomnia.
Therapy techniques involve cognitive restructuring, which attempts to change inaccurate or unhelpful thoughts about sleep. For example, if you are worried about not getting enough sleep, this worry itself can become the main source of insomnia. Behavioural interventions include stimulus control before bed, sleep restriction, and compression, and incorporating relaxation techniques to establish healthy pre-sleep habits. Sleep compression is a gentle approach, often used with older people, where time in bed is gradually reduced to match the time spent sleeping. Relaxation techniques can help reduce racing thoughts and tension. These include breathing exercises and progressive muscle relaxation, which involves tensing and releasing different muscle groups.
Other tips to help you sleep include avoiding caffeine, eating, and alcohol too close to bedtime, and ensuring your bedroom is cool, dark, and comfortable. If you wake up in the middle of the night, try not to stay in bed, as this can lead your brain to associate your bed with wakefulness. Instead, get up and do something relaxing until you feel sleepy.
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Frequently asked questions
This phenomenon could be caused by sleep anxiety, which is when you start to worry about your sleep and the impact that a lack of sleep will have on you. This anxiety can maintain insomnia even after the original trigger has disappeared.
There are several things you can do to fall asleep when you have to wake up early:
- Prepare for your morning the night before to reduce stress.
- Try to wake up at the same time every day to get your body used to the routine.
- Only go to bed when you feel tired.
- If you can't sleep, get up and do something relaxing until you feel sleepier.
- Avoid looking at the time, as counting the minutes of missed sleep increases stress and anxiety.
Insomnia can be caused by health problems, depression, or stress. It is also more common in women than in men.
Other reasons you might not be able to fall asleep include:
- Age-related changes in sleep patterns.
- Hormonal changes, such as those experienced during menopause or pregnancy.
- Anxiety about a situation or event, which can cause you to sleep fewer hours at a time.
