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I have no trouble falling asleep. On many evenings, as soon as I lie down, and I’m out.

Yet a few nights each week, I find myself wide awake at the middle of the night – anxious about upcoming tasks, wondering if my daughter is adjusting to her new school or jotting down reminders like washing the vehicle. Usually, I get back to sleep in an hour, but when my 8am alarm goes off, I feel groggy, wishing I’d had that extra shut-eye.

Struggling to remain asleep is called maintenance insomnia, notes an expert, a health psychologist and insomnia specialist. Although nighttime awakenings are normal, many can’t fall back asleep easily. Worrying often plays a role. “Individuals awaken with racing thoughts, making it difficult to get back to rest,” the doctor states.

The sleep disorder can impair daytime activities, but there is treatment. Read on for important details on nighttime awakenings.

Understanding Sleep Maintenance Issues

Although insomnia is often seen as struggling to drift off, there are different forms, according to a sleep expert. Some people have difficulties falling asleep (sleep onset insomnia), many rise before desired (premature waking) and some find themselves up in the middle of the night (maintenance insomnia, because sleep isn’t sustained).

Many people suffer from a combination of these, and the expert notes this type whether solo or with others is fairly common. About one-fifth of insomnia sufferers according to research woke for long periods overnight.

It’s normal to wake up at night, the expert states. For example, using the restroom could be necessary or simply wake at the end of a sleep cycle. Most individuals forget short awakenings without next-day effects. Yet some aren’t as fortunate.

“The cause of waking isn’t always the issue, but rather their mental response that causes prolonged wakefulness,” the expert explains. When people awaken and their thoughts accelerate, preventing further sleep. They may even worry about losing sleep, and this worry prolongs wakefulness, creating a frustrating cycle of wakefulness.

Maintenance insomnia can look different from person to person, the specialist notes. One might experience one or two long windows of wakefulness a night, whereas others wake repeatedly.

Maintenance insomnia can cause multiple concerns, including impaired daytime performance, anxiety, physical symptoms, according to a sleep physician. Sleep loss can also increase the risk of other conditions, including obesity, blood sugar issues and cardiovascular disease.

Factors Behind Sleep Maintenance Issues

Multiple factors can contribute, but several factors can contribute for nighttime awakenings, says Kogan.

Stress and anxiety: The most common reason for nighttime awakenings is anxiety, says Kogan. When some people wake, thoughts begin – maybe regarding tasks, routine worries or the stress of not being able to get good sleep.

“Frightening dreams associated with worry, trauma or psychological issues can hinder falling back asleep,” the expert states.

Lack of sleep drive: A lack of sleep drive can also keep people up at night, the doctor notes. Common causes for low sleep drive involve daytime napping and extended periods lying down. “People with maintenance insomnia think that spending more time in bed will help them get more sleep, but it usually leads to less sleep overall,” says Kogan.

Physical pain and discomfort: Aches can cause nighttime awakenings. This can stir an individual and hinder further rest, Zeitzer says. Painful, chronic conditions can cause lasting insomnia, although brief concerns including minor injuries might disrupt sleep.

Other uncomfortable and anxiety-inducing medical disorders connect to insomnia, according to the specialist. These include neurological disorders (including chronic pain), circulatory problems and breathing disorders. Medications associated with many of these conditions may lead to sleep disruptions, the specialist explains.

Age and Sex: Older adults typically stir repeatedly due to nerve issues, restroom needs and digestive issues, as per the expert. “Without these factors, older adults generally experience lighter sleep, which can mean more wakings,” he says.

Ladies, especially pre-menopausal, face higher risk of nighttime awakenings because of hormone fluctuations, as per research.

Those with this condition believe that longer periods in bed will increase sleep, but it usually leads to less sleep overall

Imperfect sleeping environments: Sound, brightness, temperature extremes, a poor mattress, a loud bedmate and outside influences can contribute to maintenance insomnia, the expert notes.

People react differently to disruptions for each person. For instance, certain people awaken to faint noises down the hall, although many rest despite noise. “Certain individuals handle disturbances well, Fashanu says.

Managing Night Wakings

Addressing nighttime awakenings usually relates to the root issue, the expert notes. When discomfort or bedroom issues are causing frequent wakings, addressing these can help. Counseling or prescription drugs can stop sleep disruptions caused by anxiety.

If these factors are ruled out, other treatments are available.

CBT for Sleep: A proven psychological approach is a method that “essentially teaches you not to care about your insomnia, helping you return to sleep quicker,” the expert explains. It’s the preferred approach for nighttime awakenings. Usually, six to eight visits to alter perceptions of rest and establish better habits.

Prescriptions: Sleeping pills like Ambien or Lunesta may assist temporarily, although medication isn’t first choice until trying other methods. “Sleep issues often stem from thoughts and habits, so medications only mask the problem without addressing root causes,” she explains, adding that regular and longterm use of over-the-counter medications {is not recommended|is discouraged|isn’