I wake up in the middle of the night and can't get back to sleep. What can I do?

Answer From Eric J. Olson, M.D.

Waking up in the middle of the night is called insomnia, and it's a common problem. Mid-sleep awakenings often happen during periods of stress. Sleep aids that you can buy without a prescription rarely offer effective or long-term help for this problem.

To help stay asleep through the night and prevent insomnia, try these tips:

  • Create a quiet, relaxing bedtime routine. For example, drink a cup of caffeine-free tea, take a warm shower or listen to soft music. Don't use electronic devices with a screen, such as laptops, smartphones and ebooks, for an extended time just before bed. The light from these screens can disrupt your sleep.
  • Relax your body. Gentle yoga or progressive muscle relaxation can ease tension and help tight muscles to relax.
  • Make your bedroom favorable to sleep. Keep light, noise and the temperature at levels that are comfortable and won't disturb your rest. Don't do activities other than sleeping or sex in your bedroom. This will help your body know this room is for sleeping.
  • Put clocks in your bedroom out of sight. Clock-watching causes stress and makes it harder to go back to sleep if you wake up during the night.
  • Don't have caffeine after noon, and limit alcohol to one drink at least four hours before bedtime. Both caffeine and alcohol can disturb sleep.
  • Don't smoke. Besides being a major health risk, nicotine use can disrupt sleep.
  • Get regular physical activity and exercise. But keep in mind, exercising too close to bedtime may disturb sleep.
  • Go to bed only when you're sleepy. If you aren't sleepy at bedtime, do something relaxing that will help you wind down.
  • Wake up at the same time every day. Even if you 're awake for long periods during the night, resist the urge to sleep in.
  • Avoid daytime napping. Napping can throw off your sleep cycle.
  • If you wake up and can't fall back to sleep within 20 minutes or so, get out of bed. Go to another room and read or do other quiet activities until you feel sleepy.

Sometimes insomnia is caused by a medical condition such as sleep apnea, restless legs syndrome or long-term pain. Insomnia also can be caused by a mental health condition such as depression. Treatment for one of these underlying conditions may be needed for insomnia to get better. Also, treating insomnia may help depression symptoms improve faster.

If you keep having sleep problems, talk to your healthcare professional. To find the cause and best treatment for insomnia, you may need to see a sleep specialist. Your doctor or other healthcare professional may prescribe medicine and have you try other ways to get your sleep pattern back on track. Depending on the cause of insomnia, a referral to a mental health professional may help some people.


Eric J. Olson, M.D.

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Feb. 13, 2024 See more Expert Answers

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