Experts Explain Why You Are Waking Up In The Middle Of The Night

During a 2010 study, 31% of people reported that they wake up at night at least three times a week. Although it is common, many people do not question why they wake up. Some reasons are mundane, such as drinking caffeine or eating at night. But in other instances, people awaken because of an underlying health issue. Thyroid troubles, arthritis, and even asthma can disrupt your night’s rest. Have you ever wondered what is disrupting your nighttime sleep? Read all the possible reasons that experts have discussed.

Why You Wake Up With Anxiety

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Michael Williamson/The Washington Post via Getty Images

If you wake up feeling anxious, you’re not alone. Grant Blashki, the lead clinical advisor at Beyond Blue, says that it’s a combination of biology and psychology. When people wake, the body releases adrenaline and cortisol, two stress hormones that make people alert. But people who are prone to anxiety might feel anxious instead.

“Often what happens is people wake up with their mind in overdrive,” Blashki said. People with anxiety disorders are susceptible to “morning dread,” as some call it. But you don’t have to have a disorder; long-term stress can also cause it.

Two Thyroid Problems Could Be To Blame

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Smith Collection/Gado/Getty Images

Two thyroid problems could upset sleep: hypothyroidism, when the thyroid does not secrete enough hormones, and hyperthyroidism when it creates too many. When hormone levels become imbalanced, the body feels restless, and it wakes up.

Sound Sleep Medical says that thyroid problems could cause a vast host of symptoms, including jitters, rapid breathing, and night sweats. These symptoms could wake people up in the middle of the night and make you feel fatigued during the day. If you experience these symptoms, consult a health professional.

Is Your Bladder Waking You Up?

A woman lies awake in bed at two in the morning.
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Wodicka/ullstein bild via Getty Images

According to Harvard Health Publishing, nearly two-thirds of adults wake up to urinate a few times a week. During a mild case, you might wake up two or three times, in which case you should drink less water before bed. But extreme cases wake people five to six nights per night.

This condition, called nocturia, becomes more common the older you get. It could also have underlying health issues, such as diabetes, a urinary tract infection, or medication side effects. If you’re losing a ton of sleep due to urination, consult a doctor.

Most Arthritis Patients Don’t Sleep Well

A woman with arthritis clutches her aching wrist.
BSIP/UIG Via Getty Images
BSIP/UIG Via Getty Images

Believe it or not, 80% of arthritis patients have difficulty sleeping. When joints feel swollen, tense, or aching, people have trouble remaining comfortable for the entire night. Some rheumatoid arthritis medications also contribute to restlessness.

Rheumatologist Jeffrey Fong says that, even if arthritis patients have their pain under control, they can still wake up at night. Stress and inflammation contribute to poor sleep, even if you can’t feel it. If you have arthritis, working with a rheumatologist might help you sleep through the entire night.

Your Issue Might Depend On The Time You Wake Up

A diagram shows which times correlate with which parts of the body, according to Chinese medicine.
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Kristen Chinn/Pinterest

Traditional Chinese medicine connects health issues to sleep. According to the “body clock,” the time you wake up at night dictates your body’s ailment. For instance, people with lung ailments wake up between 3:00 am and 5:00 am, while the large intestine wakes people between 5:00 am and 7:00 am.

Research has not backed up this aspect of Chinese medicine. However, it is true that the body has a natural “body clock” called the circadian rhythm. Peoples’ sleep schedules rely on the circadian rhythm, and there are many reasons why you might wake up at night.

Are You Sleeping With Chronic Stress?

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Stress and sleep have a tense relationship, says the American Institute of Stress. When we feel stressed, the body releases hormones such as cortisol, adrenaline, and noradrenaline. These initiate the “fight or flight” response, which makes it difficult to relax and sleep.

Stress raises your blood pressure, tightens muscles, and speeds up your heart rate. All of these symptoms could make you wake up in the middle of the night. Even worse, the less sleep you get, the more stress you feel. It becomes a vicious cycle that’s hard to rectify if you don’t tackle your stress.

Why You Shouldn’t Eat Too Close To Bedtime

A refrigerator opens at night.
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Getty Images

If you eat too close to bed, you might not sleep as well. Gastroenterologist Scott Gabbard says that late-night eating can cause heartburn or indigestion overnight. These could wake you up with an unpleasant burning sensation in your throat or nausea.

According to researchers at the Universidade Federal de São Paulo, foods with high calories and fat are more likely to wake you up at night. However, a light snack before bed will not harm you. As a general rule, wait for at least three hours between eating a meal and going to bed.

The Longer You Have Asthma, The Less Sleep You Might Get

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Getty Images

The longer people have asthma, the more likely they are to develop sleep issues. Research in the European Respiratory Journal found that asthma patients are more likely to develop sleeping issues. If symptoms are not managed, both children and adults can wake up from breathing issues.

Unfortunately, the reverse is also true. In May 2020, the American College of Allergy, Asthma, and Immunology (ACAAI) discovered that poor sleep causes more asthma attacks. If you stay up from asthma, then you’ll get more asthma, and the cycle will continue. Get your symptoms under control.

Even Five Hours Before Bed, Caffeine Can Disrupt Sleep

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Joe Raedle/Getty Images

“Don’t drink caffeine before bed” seems obvious. But many people underestimate how long caffeine stays in your body. According to the National Institutes of Health, caffeine remains in the system for three to five hours. That means that if you go to bed around 10:00 pm, you should not drink coffee after 5:00 pm.

Even worse news: that’s only the half-life. Sleep researcher Olav Spigset says that some people might feel the effects of caffeine over eight hours before bed. “A cup of coffee at noon could cause problems falling asleep at 10 or 11 in the evening,” he said. Double-check how much caffeine you’re drinking.

Kidney Disease Patients Often Struggle To Sleep

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QAI Publishing/Universal Images Group via Getty Images

People with kidney disease are more likely to develop sleep problems, according to research in Nature of Science and Sleep. People with renal disease, especially end-stage renal disease, tend to have chronic pain. Physical pain and the stress of the condition can wake people up at night.

The opposite is true as well. When kidney patients struggle to sleep, their condition often becomes worse, says Dr. Ana Ricardo, a researcher at the University of Illinois. In her study, kidney disease patients slept for an average of 6.5 hours a night.

Too Much Weight Can Inhibit Your Breathing

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BSIP/Universal Images Group via Getty Images

Research has linked poor sleep to weight gain. In 2015, a study in Sleep Medicine concluded that obesity is a huge risk factor for sleep troubles. When fat develops near the airways, people struggle to breathe. This can cause snoring and waking up at night from sleep apnea.

An earlier study, this one in 2014, determined that overweight people are much more likely to develop obstructive sleep apnea. Poor sleep then leads to more weight gain, creating a vicious cycle. If you’ve gained weight recently, that could be why you’re waking up at night.

It Might Be Acid Reflux

While sitting in bed, a wife comforts her husband, who is suffering from heartburn.
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John Greim/LightRocket via Getty Images

Although some stomach aches feel better when you lie down, this isn’t the case with acid reflux. Reflux, which occurs when stomach acid leaps up to the esophagus, can interrupt your sleep. Lying down allows stomach acid to creep into the esophagus, says the American Sleep Apnea Association.

People with chronic acid reflux, called gastroesophageal reflux disease (GERD), especially struggle to sleep. In 2010, a survey found that 60% of people with GERD also have obstructive sleep apnea. Fortunately, heartburn patients can sleep better if they prop themselves up while sleeping.

The Harmful Effects Of Using Your Phone At Night

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If you scroll through your phone or laptop before bed, it could be harming your sleep. A review of several studies in Chronobiology International found that blue light messes up your natural sleep-wake cycle, called the circadian rhythm. Our eyes are sensitive to blue light, and we can’t sleep as well after seeing it.

Blue light emanates from phones, tablets, computers, TVs, gaming systems, and LED light bulbs. The National Sleep Foundation advises people to eliminate blue light sources at least 30 minutes before bed. If you need to leave your devices in the living room, so be it.

Unbalanced Hormones Impact Sleep, Especially In Women

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BSIP/UIG Via Getty Images
BSIP/UIG Via Getty Images

Insomnia appears more in women than in men, and part of that is due to hormone upsets. According to Yale University, rising and falling estrogen levels have a significant impact on sleep. So does progesterone, a hormone that relaxes people while also maintaining pregnancy.

Menstruation, pregnancy, and menopause all upset these hormones, which then disrupts sleep. Endocrinologist Lubn a Pal says that the correlation is complicated; both rising and falling hormones can make you wake up at night. If this sounds like you, talk to a doctor about your hormone levels.

How High Blood Sugar Disrupts Sleep

A woman checks her blood sugar levels next to a donut, milk, and lollipop.
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Jens Kalaene/picture alliance via Getty Images

When people wake up, certain hormones increase to raise blood sugar levels. This is called the dawn phenomenon, and it is normal. However, people with high blood pressure might awake earlier because of the dawn phenomenon.

According to the Alaska Sleep Clinic, waking hormones release between 3:00 and 4:00 am. If you’re sensitive to insulin, you might wake up during this time. High blood pressure also causes excessive urination as the kidney tries to get rid of the sugar. This could also wake you up in the middle of the night.

People With Liver Disease Struggle To Sleep

A diagram shows both sides of the liver.
Encyclopaedia Britannica/UIG Via Getty Images
Encyclopaedia Britannica/UIG Via Getty Images

Many people with liver complications struggle to sleep through the night. In Clinical Gastroenterology and Hepatology, a study determined that 81% of cirrhosis patients have “disturbed sleep.” Fatty liver disease and Hepatitis C can also make people wake up at night.

Why does this happen? There are many causes. One reason could be the symptoms of liver disease, such as nausea and abdominal pain. Certain medications can also interrupt sleep. On top of that, people with liver disease can feel anxious or stressed, which makes them sleep lightly.

A Poor Diet Equals Poor Sleep

Multiple fast food containers are stacked on each other.
Matthew Horwood
Matthew Horwood

If your diet suffers, your sleep will suffer, too. In 2016, a study in the Journal of Clinical Sleep Medicine examined a diet of low fiber, high saturated fat, and high sugar. Participants on this diet had less restorative sleep and often woke up throughout the night.

Fortunately, you can reverse this by eating well. Get plenty of fiber and healthy fats, and stay away from sugar. Low-fat protein sources, vegetables, fruits, and whole grains can improve sleep, according to the National Sleep Foundation. Losing weight might also help.

Depression Could Be A Cause

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Waking up at night and struggling to go back to sleep is a common symptom of depression. In fact, some doctors are hesitant to diagnose depression if the patient does not have sleep troubles. The symptom is called terminal insomnia.

According to the National Sleep Foundation, sleep and depression have a bidirectional relationship. Lack of sleep can worsen depression, and depression can cause a lack of sleep. In 2008, a study found that 75% of people with depression also have insomnia. If this sounds like you, you might want to check for other depression symptoms.

Overnight Breathing Problems Could Be A Lung Issue

An elderly woman coughs while sitting up in bed.
BSIP/UIG Via Getty Images
BSIP/UIG Via Getty Images

If there is a problem with your lungs, you might have trouble sleeping. People with pulmonary diseases tend to wake up at night. According to the scientific journal Lung India, lung disease constricts the chest wall. This places pressure on the airways, making breathing difficult.

When people can’t sleep because of breathing issues, it’s called obstructive sleep apnea. This condition has a long list of causes, not just lung issues. If you experience chest pain, hoarseness, or a persistent cough, then you may want to get your lungs checked.

Multiple Digestive Issues Might Wake You Up

A man sits up in his bed because of indigestion.
Tom Kelley/Getty Images
Tom Kelley/Getty Images

In 2004, a study in Mayo Clinic Proceedings discovered that many people with insomnia have digestive issues. When participants were examined, 10% had irritable bowel syndrome (IBS), 13% had frequent heartburn, and 15% awoke from undiagnosed stomach pain.

Stomach pain can wake people up in the middle of the night. Whether it’s indigestion, acid reflux, or a chronic condition, digestive ailments can disrupt sleep. If you’ve been struggling with these, then your insomnia could go away once the symptoms or condition are managed with diet and medications.

Don’t Sleep On Your Stomach

A man sleeps on his stomach in bed.
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There are many comfortable sleeping positions, but lying on your stomach isn’t one of them. This position causes much discomfort which could wake you up throughout the night. According to Sleep Advisor, lying on your stomach causes great pain in your neck.

It also puts pressure on your spine. Not only will this hurt your back, but it could also strain the nerves that connect to your spine. If you wake up with numbness or tingling, double-check your sleeping position. You might need to lie on your back or side.

Even Light From Outside Can Disrupt Sleep

Light shines through a bedroom window at night.

Never sleep with too much light in your room. In 2006, scientists from the Sleep Research Society discovered that too much light ruins rest. Even when participants had light from the outside, they experienced less REM sleep.

If you have light leaking in from another room or the outdoors, then you’re more likely to fall asleep later and wake up throughout the night. Light suppresses melatonin, the hormone that helps you sleep. You can fix this by buying darker curtains and turning out all the lights.

Lack Of Exercise Means Lack Of Sleep

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Are you exercising daily? Research proves that people who exercise have a more restful sleep. On the other hand, people who don’t exercise have “difficulty maintaining sleep,” according to a study in the scientific journal Sleep. In other words, you’re more likely to wake up during the night.

Exercise relieves stress, regulates your body temperature, and realigns your circadian rhythm. In 2012, researchers found that insomnia patients could fall asleep 13 minutes faster when they worked out every day. Even ten minutes of exercise can help you sleep better, according to the National Sleep Foundation.

Restless Leg Syndrome Is A Real Thing

A woman clutches her leg while sitting in bed.
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Yoshie Kimura/Pinterest

Restless leg syndrome is an irresistible or involuntary urge to move one’s leg, especially while sitting or lying down. In extreme cases, this syndrome can cause people to lose sleep or even wake up in the middle of the night.

According to the National Institutes of Neurological Disorders and Stroke, restless leg syndrome is largely genetic. However, there are other potential causes. An iron deficiency, renal disease, pregnancy, or certain medications can result in the syndrome. If your shaking leg keeps waking you up, consult a doctor.

Even Mild Dehydration Interrupts Sleep

While lying in bed, a man drinks a glass of water.
Dr. Paul Wolff & Tritschler/Corbis via Getty Images
Dr. Paul Wolff & Tritschler/Corbis via Getty Images

Even mild, barely-noticeable dehydration can interrupt your sleep. In 2019, a study in the Journal of Sleep Research found that dehydration leads to “sleep disturbances.” When your mouth and nose become dry, it could manifest in snoring, hoarseness, or even trouble breathing.

Like many other sleep issues, the opposite is true as well. Scientists from Penn State University found that lack of sleep often leads to dehydration. Don’t guzzle water right before bed, or you’ll wake up to urinate. Instead, focus on remaining hydrated throughout the day.

It Could Simply Be Age

An elderly man who suffers from sleep disorders sits up in bed.
Fairfax Media via Getty Images
Fairfax Media via Getty Images

According to the Journal of Family Medicine and Primary Care, up to 30% of adults have insomnia. As people grow older, many encounter sleep problems. The Sleep Foundation found that, on average, middle-aged adults lose 27 minutes of rest every decade.

There are many reasons why age results in insomnia. Seniors are more susceptible to mental stress, breathing issues, and restless leg syndrome. Fortunately, adults can work through insomnia with sleep therapy, medication, and relaxation techniques. If these don’t work, there might be an underlying issue.

Some Medications Might Wake You Up

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Certain medications can cause fragmented sleep. According to the American Association of Retired Persons, the most common medications that interfere with sleep are for blood pressure, depression, rheumatoid arthritis, blood vessels, heart disease, high cholesterol, and dementia.

The National Sleep Foundation says that even insomnia meds can wake you up because of weird dreams and nightmares. If you can’t find a reason why you wake up at night, double-check your medication. You can always ask your doctor to switch meds if you frequently wake up at night.

Why Nerve Pain Gets Worse At Night

A woman clutches her shoulder in pain when she sits up in bed.
BSIP/Universal Images Group via Getty Images
BSIP/Universal Images Group via Getty Images

If you frequently wake up due to numbness, tingling, or jabbing pain, it could be nerve damage. Nerve conditions and diseases tend to result in sleeplessness. On top of that, nerve pain tends to become worse at night, says the United Physician Group.

There are many reasons why nerves feel worse at night. Cooler temperatures, hormone levels, and uncomfortable sleeping positions could increase the pain, waking you up. It could also be that patients pay more attention to their pain when they aren’t distracted. That said, if you have sleep issues, don’t immediately assume that nerve damage is the cause.

Why You Should Have A Nighttime Routine

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EyesWideOpen/Getty Images

If you don’t have a night routine, you might have a less restful sleep. The American Heart Association says that night routines tone down stress, resulting in fewer distractions that could keep you up at night. Setting aside 15 minutes to get ready for bed might help you sleep through the night.

Sleep specialist Dr. Robert S. Rosenberg recommends doing something relaxing before bed. Taking a bath, drinking tea, and reading could help you wind down. Turning off electronic devices can also soothe your thoughts, prolonging your sleep.

Stop Drinking At Night

A wine glass and wine bottle sit in the darkness.
Tom Kelley/Getty Images
Tom Kelley/Getty Images

Because alcohol has sedative properties, many people drink before bed. But it does not help them sleep through the night. During a review of 27 studies, scientists found that people who drink before bed have less REM sleep. Participants often woke up during the second half of the night.

Researcher Irshaad Ebrahim explains that alcohol inhibits your breathing. This leads to snoring and sleep apnea, which can wake people up. Ebrahim does not advise using alcohol as a sleep aid. Do not drink within four hours before bedtime.