Insomnia: Why can't 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?

- No name / No state given

Answer

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, but depression could 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 stress-reduction strategies. Make sure to get some exercise into your day, and then set up a quiet, relaxing bedtime routine, such as a warm shower or soft music. Gentle upper body stretches or gentle yoga may help tight muscles unwind. When you wake up in the middle of the night, staying in bed and listening to some soft music or a book on tape with the lights out may help you transition back to sleep. But if you've been struggling to fall asleep for more than 20 minutes, go to another room and do something quiet and relaxing until the urge to sleep returns. It's best to avoid long periods of distress in your bed.

You might also want to avoid foods, drinks or activities that might affect your sleep patterns. Caffeine, alcohol and sugary foods can affect the quality of your sleep. Avoid caffeine after noon, limit alcohol to one drink several hours before bedtime, and pass on late night sweet snacks.

If the problem persists, talk to your doctor. In order to determine the cause and best treatment for such insomnia, you might need a referral to a sleep specialist for further evaluation. Over-the-counter sleep aids rarely offer significant help for this problem. Your doctor may prescribe medication specially designed to help you get back to sleep, combined with specific behavior changes.

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