- With Mayo Clinic sleep specialist
Timothy Morgenthaler, M.D.
Causes (1)
- Late-day exercise: Can it cause insomnia?
Treatments and drugs (2)
- Ambien: Is dependence a concern?
- Sleep aids: Can antihistamines help me sleep?
Lifestyle and home remedies (6)
- Sleep guidelines: How many hours of sleep are enough?
- Foods that help you sleep: Does warm milk really work?
- Insomnia: How do I stay asleep?
- see all in Lifestyle and home remedies
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Question
Insomnia: How do I stay asleep?
I have no trouble falling asleep, but I often wake up in the middle of the night and can't get back to sleep. What can I do?
Answer
from Timothy Morgenthaler, M.D.
Waking up in the middle of the night is called sleep maintenance insomnia, and it's a common problem. These midsleep awakenings often occur during periods of stress, and depression can be a factor. Sleep maintenance insomnia may also be due to sleep apnea or restless legs syndrome.
To help stay asleep through the night, try some of these strategies:
- Set up a quiet, relaxing bedtime routine, such as a warm shower or soft music.
- Do some upper body stretches or gentle yoga to help tight muscles unwind.
- When you wake up in the middle of the night, stay in bed and listen to some soft music or an audiobook with the lights out. This may help you transition back to sleep.
- Put all clocks in your bedroom out of sight. Clock-watching causes stress and makes it harder to fall asleep.
- If you can't fall back asleep within about 20 minutes, go to another room. Read or engage in other quiet activities until you feel sleepy.
- Avoid caffeine after noon, and limit alcohol to one drink several hours before bedtime.
- Make sure to get some exercise — but don't exercise too close to bedtime.
- Go to bed only when you're sleepy.
- Wake up at the same time every day, regardless of how long you sleep.
- Avoid daytime napping.
If the problem continues, talk to your doctor. In order to determine the cause and best treatment for such insomnia, you might need a referral to see a sleep specialist. Over-the-counter sleep aids rarely offer significant help for this problem. Your doctor may prescribe medication and have you try some other strategies to get your sleep pattern back on track.
Next questionShift work: How do I adjust to daytime sleeping?
- Mahowald MW. Disorders of sleep. In: Goldman L, et al. Cecil Medicine. 23rd ed. Philadelphia, Pa.: 2008; Saunders Elsevier. http://www.mdconsult.com/das/book/body/157163139-3/0/1492/1438.html?tocnode=54629981&fromURL=1438.html#4-u1.0-B978-1-4160-2805-5..50434-1_18181. Accessed Aug. 31, 2009.
- Nebauer DN. Insomnia. Primary Care: Clinics in Office Practice. 2006;32:375.
- Morgenthaler TM (expert opinion). Mayo Clinic, Rochester Minn. Sept. 10, 2009.
