Shuteye and sleep hygiene: the truth about why you keep waking up at 3am
You eschew caffeine after lunch, have stopped drinking alcohol and eat healthily. But you’re still staring at the ceiling in the small hours. Here’s why
Mon 17 Feb 2020 07.00 EST Last modified on Mon 17 Feb 2020 07.13 EST
You land in your body with a start, or else it slowly comes into groggy focus: either way it’s night-time, but you are now awake. Why? Alice Gregory, a psychology professor at Goldsmiths, University of London and the author of Nodding Off, says it’s quite normal to wake up during the night.
After dropping off, we move through different stages of sleep, a cycle that takes the average adult about 90 minutes to complete and speeds up towards morning.
“The night is also punctuated by brief awakenings,” says Gregory. “Typically, people return to sleep without realising that they had ever been awake.” But sometimes we might at least be more aware of it, or pulled entirely awake. Reasons range from the fairly obvious (being too hot or cold, needing the loo, having a nightmare, a crying baby) to the medical (disordered breathing such as sleep apnoea, or nocturia: excessive night-time urination). Advertisement
Waking up during the night does not necessarily mean you have insomnia, which, says Gregory, is diagnosed alongside other criteria such as the frequency of this occurrence and how long it has been happening. “If you find yourself waking regularly during the night, certainly flag this with your GP so they can consider any possible underlying causes.”
Still, sleep deprivation takes its own toll, from irritability and reduced focus in the short term, to an increased risk of obesity, heart disease and diabetes. If you do find yourself regularly waking up without any apparent reason – what can you do about it?
“It’s a misconception that we sleep the night through – nobody ever does,” says the sleep coach Katie Fischer. Waking as much as five or seven times a night is not necessarily a cause for concern – the most important thing is how you feel when you get up. “In the morning, do you feel refreshed, or groggy and unable to function, 30 minutes after waking?”
If there is nothing to suggest an underlying medical issue, Fischer will look at the bigger picture with a patient. “It’s really important to know if they have children. Do they have a partner who snores, or works shifts?” she says. “They might not have their own sleep issues but they might be sleeping next to someone who does.”
Lifestyle changes can make a big difference, even for people suffering from sleep apnoea (although that should be treated by a specialist). It is hackneyed to point the finger at caffeine, but people tend to underestimate how long its effects can last – Fischer says to stop consuming it by 2pm or 3pm. Water intake during the day is also a factor: “Even going to bed mildly dehydrated can disrupt our sleep.”
Similarly, although people commonly turn to alcohol to help them fall asleep – Fischer says one in 10 use it as a sleep aid – it has a disruptive effect beyond the initial crash, causing spikes in blood sugar and cortisol levels. Diet can function in the same way, with “anti-sleep foods” that are high in sugar or cause flatulence or heartburn (such as broccoli and cabbage).
A diet that contains plenty of fruit has been shown to improve sleep apnoea. Photograph: Christian Horz/Getty Images/EyeEm
A “pro-sleep” bedtime snack is a small amount of complex carbohydrates and protein, such as wholegrain cereal with milk, or toast with peanut butter, says Fischer. An “anti-inflammatory” diet favouring fruits, vegetables, lean protein, nuts, seeds and healthy fats (and limiting processed foods, red meats and alcohol) has been shown to improve sleep apnoea.
As for exercise, although being active during the day aids sleep, anything strenuous is to be avoided before bedtime. A lot of advice for preventing night-time “awakenings” falls under the umbrella of what has come to be known as “good sleep hygiene”: restrict the bedroom to sleep and sex, ban screens emitting blue light, keep to regular bedtimes and so on.
Our bedrooms – even our beds – have come to double as home cinemas, offices, “a dining room, maybe,” says the sleep consultant Maryanne Taylor. “You would be amazed at how significant that is for sleep. You’re training to associate your bed with wakefulness.” For that reason, if you do struggle to fall back asleep on waking up during the night, the advice is to get up for a bit. “Don’t just lie there – it’s counterproductive.”
So, too, is looking at the clock, especially if it doubles as your phone. “As soon as your brain has registered that it’s 2am, you convince yourself that that’s your lot,” says Taylor. Such worry loops might be waking you up in the first place.
For many of us, bedtime might be our first opportunity of the day to be alone with our thoughts, she says. “It’s connected to waking in the night because, if we haven’t had any processing time during the day, it’s the first time we stop and just be.” Managing stress and anxiety during waking hours and learning how to relax body and mind are key to a good night’s sleep – but ironically, fixating on getting your full eight hours can make it harder to achieve. “You get this awful self-fulfilling prophecy that’s quite hard to break,” says Fischer.
A mindset change may be what’s needed. “People might have this belief that they are a ‘bad sleeper’ and there is nothing that they can do about it. Sometimes it’s about changing people’s perceptions of what good sleep looks like.” Taylor says she “really cannot bear” fitness trackers, which monitor sleep, for focusing people’s minds on often inaccurate data. It is wrong to assume that you must sleep through the night, every night, she says. “We all have blips in our sleep – it’s never going to be that you sleep brilliantly all the time.”
But accepting that – even as you lie awake, hours before dawn – might be the first step towards it.