Sleep maintenance insomnia happens when you can’t stay asleep. It may be caused by health conditions, such as illness, some medications, or stress.
Not being able to sleep through the night can be infuriating.
You wake up — who knows why — and immediately stress about how cruddy you’re going to feel the next day if you can’t fall back asleep fast enough.
Having just one episode is bad enough, but if it keeps happening, you’ll probably want to figure out why and what to do about your insomnia. Yes, not being able to stay asleep is actually a type of insomnia, and various factors, from your lifestyle to an underlying condition, could be to blame.
Insomnia is commonly thought of as simply staying up all night and not being able to get to sleep, but that’s just one type of insomnia.
Being unable to stay asleep is a type of insomnia, too.
It’s referred to as maintenance insomnia, sleep maintenance insomnia, and, sometimes, middle-of-the-night insomnia.
If you can’t stay asleep at least three nights per week for three months or longer, your insomnia is considered chronic.
There are many reasons you may struggle to stay asleep. Here are some of the most common causes.
Stress
Stress is one of the most common reasons for insomnia. The cause of stress can be all kinds of things, from lifestyle to medical conditions.
However,
The real kicker with maintenance insomnia is that stress from not being able to stay asleep can keep the cycle going, making your insomnia worse and leaving you feeling pretty lousy.
Sleep apnea, asthma, or other breathing problems
Respiratory disturbances at night are common if you have asthma, sleep apnea, or any other breathing problem, like allergies or even a cold.
If anything disrupts your breathing, even just for a second, it can wake you up and make it hard to fall back asleep.
Pain
With some conditions, like fibromyalgia and arthritis, pain can flare up at night and wake you up.
If you have an injury or pain that’s worse with movement, turning over can hurt and wake you up, too.
Illness
There are several illnesses associated with sleep issues. While not an exhaustive list by any stretch, some common ones include:
- neurological conditions, like Parkinson’s and Alzheimer’s
- cardiovascular conditions
- diabetes
- other sleep disorders, like restless leg syndrome
Mental health disorders like depression or schizophrenia
Trouble falling asleep or staying asleep is a common side effect of mental health conditions, like anxiety, depression, and schizophrenia. On the flip side, poor sleep can also worsen symptoms of these conditions.
Certain medications
Some over-the-counter (OTC) and prescription medications can cause side effects that wake you up at night, like excitability, frequent urination, and vivid dreams.
These are some possible culprits:
- diuretics
- cold and allergy medications
- corticosteroids
- anticonvulsants
- antidepressants
- beta agonists
External issues, like worries about work or your social life
Got stuff on your mind?
Worries about things like work or relationships can impact a full night’s sleep. You can even experience nocturnal panic attacks if you’re under a lot of stress or feeling anxious.
Hot flashes or hormone fluctuations
While anyone can experience hormone fluctuations that can mess with sleep, women are more prone to hormone-induced sleep issues because they may experience fluctuations during periods, pregnancy, perimenopause, and menopause.
Hormone fluctuations can trigger sleep-disrupting symptoms like anxiety, hot flashes, and night sweats.
Acid reflux
There’s nothing quite like stomach acid and other contents making their way up into your esophagus and mouth to wake you up.
Lying flat can make acid reflux worse and even lead to choking.
Jet lag
Jet lag happens when there’s a mismatch between your circadian rhythm and the time of day.
While your body’s clock is still anchored to another time zone, you can have trouble falling asleep and staying asleep.
Poor sleep environment
Yep, your environment could be to blame for your inability to sleep through the night.
As comfy and cozy as your bed may be, environmental factors, like bright lights outside your bedroom window, street noise, or the incessant humming of an air conditioner, can wake you up throughout the night.
Blue light
Like to scroll your social feeds in bed? Your screen time and exposure to blue light could be the reason why you can’t stay asleep.
Blue light suppresses melatonin secretion, affecting sleep. It can also increase alertness, which is the last thing you need when it’s time for sleep.
Age
As we age, our sleep patterns change. Nighttime arousal, shorter periods of deep sleep, and fragmented sleep become very common for older adults.
The risk for chronic conditions also increases with age, adding to the stress that makes it even harder to stay asleep.
Here are some common suggestions for making sure your sleep is restful.
Relax
No duh, right? Relaxation may be hard to come by when you’ve got a lot on your mind and are stressed about your sleep issues to boot.
Here are some relaxation techniques that can help:
Talk with your doctor about your medication
If you’re taking meds, ask your doctor if insomnia is a known side effect.
They may recommend taking your medication at a different time or swapping it out for another one that won’t interfere with sleep.
Give yourself a bedtime
Strict bedtimes work for toddlers and can work for you, too. Aim to go to bed around the same time every night so you can get your body used to sleeping at that time. This bedtime consistency is all part of practicing good sleep hygiene.
Avoid caffeine later in the day
Caffeine later in the day could sabotage a good night’s sleep. In fact, research suggests stopping your coffee intake 8-9 hours before your bedtime.
Here are some common caffeinated beverages to avoid:
- coffee
- black tea
- energy drinks
- soda
Avoid alcohol
You might find that alcohol helps you unwind and can make you drowsy enough to fall asleep. But it won’t help you stay asleep.
According to
Avoid smoking
A
Exercise, just not before bedtime
Exercise can improve your sleep and reduce stress and anxiety that can be messing with your slumber.
Just don’t do it too close to bedtime, or you’ll risk perking yourself up when you should be winding down.
Don’t eat or drink before bedtime
Limit eating or drinking
Going to bed on a full stomach can interfere with sleep and cause nocturnal heartburn and reflux. Drinking too much or drinking too close to bedtime will make you more likely to have to get up to pee.
Limit blue light exposure
This means no screen time 2 to 3 hours before bedtime. Swapping out a nightlight for a red bulb and investing in some room-darkening curtains can also help.
Improve your sleep environment
Keeping your room at a comfortable temperature or investing in earplugs, a good mattress, and bedding can all contribute to a full night’s sleep.
Don’t nap during the day
Napping can feel oh-so-good on a lazy afternoon, but even a short nap can prevent you from staying asleep all night.
If you really want to lie down during the day, make it earlier in the day and keep it under 20 minutes.
Change your sheets weekly
Dirty sheets can trigger or worsen symptoms if you have allergies or asthma. Change your sheets weekly to prevent a stuffy nose and other sleep-busting symptoms.
There are many reasons why you might not be able to stay asleep. There are many lifestyle changes and sleep hygiene practices you can implement to improve your sleep quality.
If you are still having trouble staying asleep, consider talking with a healthcare professional to understand the underlying cause of your sleep challenges and explore treatment options.
Adrienne Santos-Longhurst is a Canada-based freelance writer and author who has written extensively on all things health and lifestyle for more than a decade. When she’s not holed-up in her writing shed researching an article or off interviewing health professionals, she can be found frolicking around her beach town with husband and dogs in tow or splashing about the lake trying to master the stand-up paddle board.