In each edition of Ask Dr. Lisa, our medical sleep expert, Dr. Lisa Shives, answers your questions about why you can’t get the sleep you need. In this installment, Dr. Lisa answers a question from a woman who can’t seem to sleep all night.
Marta Fernandez asks: If you wake up at 4am what should you do?
Dr. Lisa says: I’m going to assume that this is a regular problem with you, and that you have trouble falling back asleep once you wake up. It sounds like you’re experiencing an interruption in your sleep cycle, but there are a number of issues that could create that disruption.
One thing that could be causing it is alcohol. If you drink alcohol before bed, it can make you drowsy, but when the main ingredient in alcohol wears off, you may wake up. If you tend to have a drink in the evening, try skipping it for a few nights and see if it makes a difference.
Another problem could be your sleep environment. Are there noises that happen outside your home at that time? Is your bedding comfortable and supportive? Does it tend to get too hot or too cold in your room in the middle of the night?
Still another reason could be low blood sugar. If your body is hungry, it secretes hormones that can cause you to wake up. Try eating something light and healthy right before bed, such as something high in protein, to keep your blood sugar regulated all night.
In the end, there are literally dozens of reasons for nighttime wakings. If none of the above apply to you, visit your family doctor or a sleep specialist to rule out health problems that could be causing your nighttime wakings. It should be noted that earlier in human history it was not at all unusual for people to wake in the middle of the night, stay up for a little while, and then go back to sleep. If it’s found that there is no underlying health problem causing your wakings, then you proabably have what we call maintenance insomnia. You can try listening to something calm (audiobooks or music) for 15-20 minutes when you wake up. You may find that it lulls you back to sleep. It is important that you do not engage in any activity that requires much light because light enters the brain via the eyes and tells your brain that it’s time to get up and feed the chickens. So no “screens” and if you must get up or read, use a flashlight so that the light shines away from your eyes.
Dr. Shives works with SleepBetter.org to provide a medical view of sleep issues. She is one of only a few practitioners with a fellowship in Sleep Medicine in addition to board certification by both the American Board of Internal Medicine and the American Board of Sleep Medicine.