Waking up at night and can't get back to sleep: what helps

Is it normal to wake up at night?

Yes, up to a point. Sleep comes in cycles of about an hour and a half, and between them the brain comes close to waking. Everyone has small wake-ups during the night. They usually last a few seconds and you don't remember them.

It becomes a problem when you wake up fully, look at the clock, start thinking and can't fall asleep again. If it happens several times a week for a few months and you feel bad during the day, the NHS calls it insomnia and advises talking to your doctor.

Why do I wake up at the same time every night?

Many people wake up around 3 or 4 am. There's no single explanation, but a few reasons come up again and again:

• Alcohol in the evening. It helps you fall asleep, but a few hours later, as your body clears it, sleep becomes restless.
• Stress. Towards morning sleep becomes lighter, and worries catch you more easily.
• Sleep cycles. If you always go to bed at the same time, the switch between cycles also falls at roughly the same time.
• Your bladder. Lots of fluid in the evening wakes you up to go to the toilet.
• Heat. A warm room or a duvet that's too thick wakes you.
• A big or very late dinner, with heartburn or heavy digestion.

What do you do in the moment you wake up?

1. Don't look at the clock. Counting the hours left wakes you up even more.
2. Don't pick up your phone. The light and what you see switch your brain on.
3. Breathe slowly for a few minutes: in for a count of 4, out for a count of 6.
4. If about 20 minutes pass and you still can't sleep, get up, go to another room with dim light and do something calm: a paper book, quiet music.
5. Go back to bed when you feel sleepy.

This rule of getting out of bed is part of cognitive behavioural therapy for insomnia, which US sleep doctors recommend as the first choice of treatment.

What do you change during the day to sleep through the night?

What you do	Why it helps
No alcohol in the 3–4 hours before bed	the second half of the night becomes calmer
Last coffee before 1–2 pm	caffeine can spoil sleep even 6 hours later
Less fluid in the last hour	your bladder no longer wakes you
Dinner 2–3 hours before bed	digestion no longer carries on at night
Worries written down in the evening	you get them out of your head before bed
The same wake-up time, however much you slept	sleep becomes more solid within a few weeks

What do you note in the morning after a broken night?

Memories of the night fade fast, so write them down right after you get up, in two minutes:

• what time you went to bed and roughly when you fell asleep;
• how many times you woke up and roughly how long you were awake;
• what you did in the evening: coffee, alcohol, late dinner, screens, a tense conversation;
• how you feel now, from 1 to 5.

Don't check the clock during the night to note things exactly. Rough guesses are enough. After two weeks, compare the good nights with the bad ones. Something that repeats often comes to light: the Friday wine, the big dinner, the stressful Monday.

If you take your notes to your doctor, you show them more than "I sleep badly". You show them a pattern, which helps them decide whether further investigations are needed.

How does MentorSano help when you keep waking up at night?

• The daily journal keeps, in a minute or two, how you slept, your coffee, dinner time, movement and your day. Wake-ups and possible causes, all in one place.
• The short sleep and stress questionnaires take 2–3 minutes each and show you where to start.
• Patterns in your journal: after a few weeks you see on a chart what the broken nights have in common.
• With the subscription you can write straight to the expert when you have a question, and the answers stay in your account. You also get a plan with steps for your evenings.

The journal is free. Create your free MentorSano account and note how you sleep for two weeks. The patterns show up sooner than you think.

When is it more than restless sleep?

Sometimes waking at night has a medical cause: sleep apnoea, reflux, needing to pee often, pain, anxiety or depression. In women, perimenopause often brings night waking with sweats. If the wake-ups have lasted for months or come with other signs, your doctor can help you find out why.