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Friday, November 28, 2014
A friend of mine is having trouble staying asleep. He can get to sleep with no problem most nights but he keeps waking up at 3am and can`t go back to sleep for 2 hours. He does go to bed around the same time every night and it`s late, between 11:30pm-12:15pm. He can`t drink warm milk. What could be the problem?
Waking up in the middle of the night and experiencing difficulty getting back to sleep can be troublesome. This is a form of insomnia known as "sleep maintenance insomnia" and may result from a number of varied causes. Some of the more common conditions or problems that may result in sleep maintenance insomnia include
- Breathing disorders in sleep
- Leg jerks during sleep or wakefulness (known as periodic limb movement disorder or restless legs syndrome, respectively)
- Conditions associated with pain
- Side effects from medications or substances (such as caffeine, alcohol, or nicotine)
- Circadian rhythm disturbances
- A poor sleep environment
Sometimes, simply improving sleep hygiene and sleep-related behaviors can help. This may include simple measures such as:
- Keeping a regular sleep schedule
- Avoiding caffeine and alcohol within 4-6 hours of bedtime
- Avoiding exercise and/or hot showers near bedtime
- Making sure the bedroom is quite, dark and comfortable
In addition, how your friend behaves once they awaken can be a significant cause of trouble getting back to sleep. Behaviors such as lying in bed when you can't sleep, clock watching or getting up and doing something stimulating (such as smoking, watching TV, etc.) can all be counterproductive for returning to sleep.
If your friend has good sleep hygiene practices or tries these maneuvers without success, then they should probably be referred to a Sleep Specialist for additional evaluation. All of the above mentioned conditions can be treated to some degree of success and the key lies to sorting what factors in their specific case need to be addressed.
To learn more about insomnia or other sleep disorders, please visit the American Academy of Sleep Medicine website. In addition to information, the website contains a list of Sleep Centers across the country so that you may locate one near you.
Good luck and here's to better sleep!
Dennis Auckley, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University