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6 possible reasons why you keep waking up at night

Medically reviewed by Neka Miller, PhD on July 10, 2020. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.


The typical adult needs 7 to 9 hours of sleep per night. But unfortunately, many of us don’t get that amount of sleep. What’s more, even if you technically stay in bed for 7+ hours each night, you might frequently wake up at night—reducing the amount of deep sleep you get.

Here, you’ll find possible answers to the question, “Why can’t I stay asleep?” So read on to discover possible reasons why you keep waking up at night, tips for avoiding an interrupted sleep cycle and daytime sleepiness, and how you can learn more about your cycle with a cortisol test from Everlywell.

Keep waking up at night? Here are 6 possible reasons why

1. Restless legs syndrome

Restless legs syndrome (RLS), or Willis-Ekbom Disease, causes sensations in the legs that give you an urge to move them. These symptoms often appear in the late afternoon or at night, which can make it difficult to fall asleep or stay asleep. For some, getting up and moving around can alleviate the symptoms, but they show up again as soon as you lie back down. Because RLS causes daytime sleepiness, people with the disorder might have trouble concentrating, working, or completing daily tasks.

Roughly 7-10% of the population in the United States suffers from RLS, and women are more likely than men to be diagnosed with it. Treatment can include non-drug therapies, as well as medication—so if you find that you experience “throbbing, pulling, crawling, or creeping” sensations in your legs at night, reach out to your healthcare professional to discuss your symptoms. Although ongoing research is attempting to pin down the possible causes of RLS, it’s believed that it may be caused by a malfunction in the part of the brain that controls body movement. It can also be due to nerve damage, pregnancy, iron deficiency, certain medications, and more.

2. Having a full bladder

If you drink water or tea right before bed and fall asleep without first using the restroom, then a full bladder might be the answer to your question, “Why can’t I stay asleep?” To get more restful sleep, it’s important to find a balance with your fluid intake. You don’t want to wake up in the middle of the night thirsty, but you don’t want to have to go to the bathroom either. It may help to use the restroom before going to bed and have a bottle of water at your bedside in case you wake up thirsty.

3. Thyroid issues

Thyroid conditions can impact your sleep. With hyperthyroidism (overactive thyroid), different functions in the body speed up—such as your metabolism. This can lead you to feel jittery and anxious—and find it difficult to get to sleep. With hypothyroidism, on the other hand, the thyroid gland is underactive, which can cause you to feel sluggish. Daytime tiredness due to hypothyroidism can disrupt your normal sleep cycle (if you’re frequently napping throughout the day, for example), making it harder to stay asleep at night.

If you suspect there may be an issue with your thyroid function, consider taking a thyroid test at home to see if key thyroid hormones are balanced.

4. Caffeine or alcohol consumption

Caffeine, especially when you’re tired from lack of sleep, can be tempting. And alcohol, with its drowsy side effects, might seem like a harmless choice in the evening. But alcohol and caffeine can both interfere with sleep—so if you’re waking up at night, consider avoiding them altogether or indulging earlier in the day.

If you’re going to have caffeine, try avoiding it in the afternoon, and if you’re having a drink at night, limit it to just one drink. Caffeine is a stimulant, which can not only make it hard to fall asleep, but can also reduce your overall sleep time. Alcohol, although it can help you fall asleep faster, is known to disrupt sleep later on in the night. As a practice for good sleep hygiene, avoid drinking within three hours of your bedtime if you want to get restful sleep.

5. Daytime napping

Finding the balance between napping and sleep schedules can be challenging, but striking the right balance can be vital to restful sleep.

Afternoon napping, especially naps after 5 PM, can decrease sleep drive and keep you awake at night. If you have to nap, try a short one earlier in the afternoon. Set your alarm if you have to and keep your nap to 20 minutes or so. When you’re tired and don’t have an alarm set, you run the risk of oversleeping and throwing off your sleep cycle for that evening.

6. Sleep apnea

If you can’t stay asleep at night, sleep apnea might be the culprit. Sleep apnea is a sleep disorder that disrupts your breathing and interrupts your sleep cycle.

Obstructive sleep apnea refers to a breathing pause that lasts ten seconds or longer when you’re asleep. It occurs when muscles in the back of the throat can’t keep the airway open even as the body attempts to breathe. Obstructive sleep apnea can cause disrupted sleep and low blood oxygen levels, which can potentially lead to heart disease, mood problems, and memory issues.

There’s also central sleep apnea, a less common disorder in which the brain can’t control breathing during sleep.

If you’re a chronic snorer who experiences disturbed sleep or excessive sleepiness, reach out to your healthcare provider. Fortunately, there are several treatments available for sleep apnea, as well as lifestyle changes that can help.

Tips for a restful night’s sleep

Here are some tips to help you avoid an interrupted sleep cycle and get some shut-eye all night long.

Don’t exercise too late

Regular exercise is good and can leave you feeling ready for a full night’s sleep ahead. Exercising too close to bedtime, however, can interfere with sleep. If you’re going to go to your nighttime yoga class or an evening run, make sure you give yourself enough time to get home, unwind, and settle into your bedtime routine.

Put away your phone and other electronic devices

If you’re having trouble falling asleep at night, it’s best not to turn to your phone or other electronic devices as you try to wind down. The blue light from these devices can disrupt levels of melatonin—the “sleep hormone”—making it less likely that you’ll get quality sleep.

Create a peaceful sleep environment

Peaceful sleep environments are different for every sleeper. For some, this is a bright white comforter with soft pillows and mellow music. Others prefer earplugs, blackout curtains, and an eye mask. If you find yourself waking up often during the night, consider setting a more peaceful, tranquil sleep environment. For example, make sure the temperature in your bedroom is right for you and that you’re dressed comfortably. Spritzing soothing aromas into the air of your bedroom (or lighting incense) is another step you can take to create a calming sleep environment.

Write it out

If you’re dealing with stressful or emotional issues before bedtime, your body might be producing high cortisol levels. Cortisol is known as the “stress hormone,” which also increases alertness. Instead of mulling on problems or anxiety-inducing situations before bed, write it out. Make a list of the things that are troubling you, then place it outside the bedroom door and return to it in the morning (if you want to). This can help short-circuit an overactive mind’s tendency to obsess over a list of worries.

Learn about your sleep cycle hormones with home testing

If you want to learn more about your sleep cycle, try the Everlywell at-home Sleep & Stress Test kit. The stress level test lets you check in on 3 key hormones that are involved in the sleep-wake cycle (including your melatonin and cortisol levels). The test results may help you determine why you’ve been experiencing sleep issues—so you can then share these insights with your healthcare provider and understand the best course of action to take toward better sleep and less fatigue throughout the day.


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References

1. Restless Legs Syndrome Fact Sheet. National Institute of Neurological Disorders and Stroke. URL. Accessed July 10, 2020.

2. Urinating more at night. Medline Plus. URL. Accessed July 10, 2020.

3. Hyperthyroidism (Overactive Thyroid). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/endocrine-diseases/hyperthyroidism. Accessed July 10, 2020.

4. VanDyck P, Chadband R, Chaudhary B, Stachura ME. Sleep apnea, sleep disorders, and hypothyroidism. Am J Med Sci. 1989;298(2):119-122. doi:10.1097/00000441-198908000-00008

5. O'Callaghan F, Muurlink O, Reid N. Effects of caffeine on sleep quality and daytime functioning. Risk Manag Healthc Policy. 2018;11:263-271. Published 2018 Dec 7. doi:10.2147/RMHP.S156404

6. Sleep tips: 6 steps to better sleep. Mayo Clinic. URL. Accessed July 10, 2020.

7. Sleep apnea. Mayo Clinic. URL. Accessed July 10, 2020.