Do you wake around 3 or 4am?

Have you ever had a time in your life when you wake at 3 or 4am? And try as you might you can’t get back to sleep? Instead you toss and turn and think and then you think and think some more? This problem is more common than you realise.

There are two types of insomnia – trouble getting to sleep and trouble staying asleep. The second is called sleep-maintenance insomnia. This problem is more common in women than men. Around one in four women have insomnia.

Why is sleep-maintenance insomnia more common in women than men? Well, this is what the Women’s Health website tells me. Women have unique hormonal changes linked to insomnia symptoms. These include:

• The menstrual cycle, especially in the days leading up to their period when many women report problems going to sleep and staying asleep.
• Pregnancy, especially in the third trimester, when women may wake up often because of discomfort, leg cramps, etc…
• Perimenopause and menopause, when hot flushes and night sweats can disturb sleep. 

Also, some mental health problems that are more common in women than in men, and can result in depression. These include: depression and anxiety. People with insomnia are 10 times more likely to have depression, and 17 times more likely to have anxiety. Researchers do not know if mental health conditions lead to insomnia or if insomnia leads to poor mental health. 

Historical basis for waking up

Some historians believe that pre-industrial people often used to go to bed early, wake up in the night, do some work, cook, eat, talk and then go back to bed for a second session of eating.” Segmented, or biphasic, sleep was the natural pattern of human slumber in the Western world and perhaps elsewhere from time immemorial to the modern age,” explains historian and sleep expert Dr Roger Ekirch. He said people broke their slumber into two parts, called first sleep and second sleep. However this changed over in the nineteenth century, with the introduction of electric lights. Dr Ekirch said people began staying up later, whereas once they would have gone to bed soon after sunset but got up in the early hours of the morning and worked by cancel light. Dr Ekirch argues that pushing back our bedtime has interrupted our circadian rhythms.

Dr Ekirch said if you wake up around 3 or 4am you should not feel worried or think there is something wrong. Instead consider that you are just returning to a pre-industrial human sleeping pattern. You could go to bed earlier to compensate for your early waking.

Moving from heavy to light sleep

The first four to five hours of sleep at night are usually deep sleep. During the second half of the night we got into lighter sleep when we experience rapid eye moment. In the night most people wake about six times. Most of those times are brief and we don’t even remember them, especially if we wake during the deep sleep period. But when we enter the light sleep stage in the early hours of the morning, it is harder to get back to sleep as the brain is more active during light sleep. If we have worries in our life they may catch up with us in these early hours of the morning. If you are under stress you may begin to wake up in the early hours. Try doing some relaxation exercises in the day, or confront what is worrying you and aim to deal with it. 

You’re slept out

As we age we need less sleep. If you have been going to bed for years at 9.30pm but are waking up at 3.30am it may be because you now only need six to seven hours of sleep. If you simply go to bed later you may find that the problem remedies itself.  

If you are menopausal you may also find your sleep interrupted, particularly if you are prone to night sweats.These are caused when the hypothalamus, which regulates your body temperature. It can be thrown out by fluctuating estrogen levels. 

Remedies for sleeping troubles

1. Go to bed later

Change your sleeping pattern. If you are going to bed at 10pm and sleeping till 3am, instead try retiring at midnight and sleeping to 6am. You are resetting your body clock. Once that works for you, sneak your bedtime back to 11pm and see if you still sleep through to 6am otherwise stick with the midnight retirement for a while. I also suggest you let yourself sleep in on weekends.

2. Make your bedroom a sanctuary for sleep

Never work in your bedroom. I try not to have any screens in my bedroom. I think they overstimulate your body. If you are still not sleeping get rid of the radio, the podcasts, the phone, the tablet and the digital alarm clock. 

3. Don’t stay in bed tossing and turning

If you wake up at 3am or 4am, get out of bed. Do not stay in bed tossing and turning for a couple of hours.  When I’m awake at these hours I get up and watch an old movie on TV. This is very relaxing and much more fun than staying in bed and overthinking your life!

4. Ignore the time

People who can’t sleep often end up with ‘I can’t sleep’ anxiety. This anxiety only makes it harder to sleep. You really just have to accept that you can’t sleep. As I said earlier, accept that you’ve gone back to a preindustrial sleep pattern. Watch a black and white movie. Just forget what the clock says. There's nothing worse than seeing those hands move or numbers tick. Too stressful. Please, look away.

Sleeplessness is often caused by stress, and you may need to address the cause of your stress and deal with it. It may be a good time to see a counsellor. Also aim for good sleep hygiene. That means no tea or coffee after lunchtime, no alcohol or screen time before bed, exercise in the day, and eat well.

Happy snoozing!