Sleep Cycles: Why Do I Keep Waking Up?

Sleep is a vital process that allows the body to rest, repair, and restore itself. A typical night of sleep involves four to six sleep cycles, each composed of four stages: three non-rapid eye movement (NREM) stages and one rapid eye movement (REM) stage. It is normal to wake up briefly at the end of each REM stage as the sleep stages reset. However, if you find yourself waking up after each sleep cycle and struggling to fall back asleep, there may be underlying factors at play. This could be due to natural body rhythms like your circadian rhythm or sleep cycle, or external factors such as noise, light, stress, sleep habits, or medical conditions. Aging also plays a significant role in sleep cycles, with older adults experiencing changes in sleep patterns and a decrease in sleep quality.

Circadian rhythm sleep disorders

There are several types of circadian rhythm sleep disorders, including advanced or delayed sleep-wake phase disorder, irregular sleep-wake rhythm disorder, non-24-hour sleep-wake rhythm disorder, shift work disorder, and jet lag disorder. Delayed sleep-wake phase disorder (DSWPD) is characterised by a preference for sleeping and waking up much later than normal, often interfering with daily responsibilities. Advanced sleep-wake phase disorder, on the other hand, makes it difficult for individuals to stay awake in the evenings, causing them to wake up too early in the morning. This disorder is more common in older adults, who tend to prefer early sleeping and waking times.

Irregular sleep-wake rhythm disorder, as the name suggests, involves a lack of a consistent sleep-wake cycle, resulting in sleep occurring irregularly throughout a 24-hour period. Individuals with this disorder may struggle to sleep through the night and experience daytime sleepiness. Non-24-hour sleep-wake rhythm disorder (N24SWD) is characterised by a circadian rhythm that extends beyond the typical 24-hour schedule, causing bedtimes and wake-up times to gradually shift later each day. This disorder is commonly seen in blind individuals whose circadian rhythms cannot be influenced by light exposure.

Shift work disorder affects those who work night shifts or rotating schedules, leading to disrupted sleep patterns and symptoms such as insomnia, extreme tiredness, and sleepiness during work hours. Jet lag disorder, as the name implies, is associated with air travel across multiple time zones, causing the sleep-wake cycle to fall out of sync with the local time at the destination. This disorder can result in sleepiness or alertness at inappropriate times of the day or night.

Stress

To manage stress-related sleep disturbances, consider the following:

• Therapy: Cognitive-behavioral therapy (CBT) is a well-known treatment for insomnia. It can help you address negative thought patterns and behaviors that may be contributing to your sleep difficulties.
• Lifestyle adjustments: Making lifestyle changes can effectively reduce stress and improve sleep. This includes engaging in regular physical activity, practicing relaxation techniques (such as deep breathing or meditation), and establishing a bedtime routine that promotes winding down before sleep.
• Addressing underlying stressors: Identify and address the sources of stress in your life. This may involve making changes to your work or personal life to reduce stress triggers and improve your overall well-being.
• Improving sleep hygiene: Sleep hygiene refers to practices that promote good sleep. This includes maintaining a consistent sleep schedule, creating a comfortable sleep environment, limiting caffeine intake, and avoiding stimulating activities close to bedtime.
• Medical evaluation: If you suspect that a medical condition or medication is contributing to your sleep disturbances, consult your doctor. They can help identify any underlying health issues and provide appropriate treatments or adjustments.

By addressing stress and improving your sleep habits, you can enhance your sleep quality and overall well-being. It is important to remember that everyone's experience with stress and sleep is unique, so tailoring these strategies to your specific needs is crucial.

Insomnia

Waking up after each sleep cycle can be influenced by a variety of factors, including the natural body rhythm known as the circadian rhythm, which regulates the sleep-wake cycle. This cycle, which is approximately 24 hours long, interacts with the homeostatic sleep drive to produce one waking period during the day and continuous sleep at night. When this cycle is disrupted, sleep becomes fragmented, and issues like insomnia can arise.

There are several types of insomnia:

• Sleep-onset insomnia: Difficulty in falling asleep initially, often caused by stress.
• Middle insomnia or sleep-maintenance insomnia: Difficulty in staying asleep, characterised by frequent awakenings and trouble returning to sleep, which can be associated with anxiety.
• Terminal insomnia: Waking up too early, before the desired wake-up time, and being unable to fall back asleep, potentially indicating depression.

If you are experiencing insomnia, there are several treatment options available. Cognitive behavioural therapy is often recommended to help manage insomnia and improve sleep quality. Light therapy has also been found to be beneficial. Lifestyle modifications, adjustments to sleep-wake times, and addressing underlying health conditions can also help improve insomnia. Additionally, practicing good "sleep hygiene" and maintaining a consistent sleep schedule are important for promoting healthy sleep patterns.

If you are experiencing frequent and prolonged periods of insomnia, it is important to consult a doctor or a healthcare professional. They can help determine if there are any underlying sleep disorders, health issues, or mental health concerns contributing to your insomnia.

Ageing

The quality of sleep decreases with age, and older individuals may feel sleep-deprived even when their total sleep duration remains relatively unchanged. This can lead to confusion and other mental changes associated with sleep deprivation. Ageing can also increase the likelihood of developing sleep disorders, such as insomnia, restless leg syndrome, sleep apnea, and hypersomnia. Additionally, older people may take medications that interfere with their sleep patterns, further disrupting their sleep cycles.

To address age-related changes in sleep, it is recommended to consult a healthcare provider, especially if insomnia or unusual sleep schedules are persistent. Cognitive-behavioural therapy and light therapy have been found to improve sleep quality in older adults. Maintaining a consistent sleep schedule, including on weekends and vacations, can also help regulate sleep cycles. It is advisable for older individuals to avoid sleep medications and instead explore alternatives such as mild antihistamines or melatonin supplements, but only after consultation with a healthcare provider.

Additionally, older individuals may experience differences in their response to medications compared to younger adults. It is crucial to consult a healthcare provider before taking any sleep medications, as these can have side effects and may lead to dependence or addiction. Antidepressants and melatonin supplements, when recommended and used appropriately, can be effective in improving sleep quality in older adults.

Sleep hygiene

Sleep is a natural process that allows the body to rest, repair, and restore itself. The amount of sleep one needs varies by age and individual health circumstances. Sleep hygiene refers to the habits and environment that can be optimized to achieve better sleep. Here are some tips to improve your sleep hygiene:

Set a Strict Sleep Schedule

Try to go to sleep and wake up at the same time every day, including weekends. Maintaining a consistent sleep schedule helps regulate your body's internal clock, making it easier to fall asleep and wake up feeling rested.

Follow a Bedtime Routine

Establish a relaxing bedtime routine that prepares your mind and body for sleep. This could include activities such as reading, listening to soothing music, or practicing meditation or deep breathing exercises. Avoid stimulating activities and give yourself enough time to wind down before bedtime.

Optimize Your Bedroom

Create a comfortable and peaceful sleep environment. Minimize noise by using heavy curtains or rugs to absorb sound, or consider using a white noise machine or soothing nature sounds. Block out light with curtains or shades, and maintain a slightly cool temperature in your bedroom, as most people sleep better in a cooler environment. Ensure your mattress and pillows are comfortable and supportive.

Form Healthy Habits

Adopt healthy habits that promote better sleep. Reduce your caffeine intake, especially later in the day, as it can interfere with your sleep schedule. Avoid nicotine and alcohol consumption close to bedtime, as they can disrupt your sleep quality. Establish a regular exercise routine, but try to finish your workouts at least a few hours before bedtime to give your body time to relax.

Manage Stress

Stress and anxiety can interfere with your sleep. Practice stress management techniques such as yoga, meditation, or journaling. Find what works best for you to calm your mind and ease tension before bedtime.

Remember, sleep hygiene is a personalized process, and you may need to experiment with different adjustments to find what works best for you. If you continue to experience sleep difficulties, consider consulting a healthcare professional for further guidance and support.

Frequently asked questions