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I don’t struggle drifting off. Typically, my head hits the pillow, and that’s all I remember.

Yet a few nights each week, I find myself wide awake at 2am – stressing about a work deadline, concerned for my kid’s adaptation to her new school or listing errands like washing the vehicle. Frequently, I fall asleep again within sixty minutes, although at 8am, I feel groggy, desiring more rest.

Struggling to remain asleep is called maintenance insomnia, says Dr Julia Kogan, an insomnia researcher. Although nighttime awakenings are normal, some people have trouble getting back into slumber. Worrying often plays a role. “People wake and cannot shut their mind off, making it difficult to return to sleep,” she explains.

Such insomnia might affect daytime activities, though help is available. Here’s what you need to know on nighttime awakenings.

Defining Maintenance Insomnia

Even though most associate insomnia with struggling to drift off, it comes in multiple forms, says Dr Jamie Zeitzer. Certain individuals can’t fall asleep (sleep onset insomnia), others awaken too soon (premature waking) and a portion wake overnight (maintenance insomnia, due to trouble staying asleep).

Many people suffer from a combination of sleep issues, and Zeitzer says maintenance insomnia on its own or experienced with other forms occurs regularly. Roughly 20% of people with sleep issues according to research experienced extended middle-of-the-night wakings.

It’s normal to wake up at night, the expert states. For example, using the restroom could be necessary or awakening when sleep is lightest. Most individuals forget short awakenings without next-day effects. But others aren’t so lucky.

“It’s not necessarily what wakes people up, but what happens after with their mind that causes prolonged wakefulness,” the expert explains. Some people wake up at night and their thoughts accelerate, making it hard to rest. Anxiety over sleep loss can build, and this worry prolongs wakefulness, leading to a repetitive pattern.

This condition varies widely from person to person, Kogan adds. Many have lengthy episodes of wakefulness a night, while another wakes up and falls back asleep many times.

Maintenance insomnia can cause various health problems, like reduced daily functioning, anxiety, physical symptoms, says Dr Olabimpe Fashanu. Sleep loss can also increase the risk of further health problems, including obesity, diabetes and heart conditions.

Factors Behind Sleep Maintenance Issues

Multiple factors can contribute, although various reasons exist to the inability to stay asleep, according to the specialist.

Anxiety and Stress: The top factor for this sleep issue is high stress and anxiety, the specialist notes. When individuals stir, their mind activates – maybe regarding tasks, daily stressors or anxiety over poor sleep.

“Bad dreams from stress, trauma or psychological issues can also make it hard to return to sleep,” Kogan says.

Low Sleep Urge: Not feeling sleepy enough may cause nighttime wakefulness, the specialist explains. Common causes for low sleep drive are afternoon rests and extra time in bed. “Those with this condition believe that spending more time in bed will help them get more sleep, but typically reduces total sleep,” she states.

Aches and Unease: Pain is often associated with insomnia. This can stir an individual and prevent returning to sleep, Zeitzer says. Long-term pain issues can cause lasting insomnia, but even temporary issues like a backache or sunburn might disrupt sleep.

Additional troubling health conditions relate to sleep problems, the expert states. These encompass nerve conditions (such as headaches and inflammation), circulatory problems and lung ailments. Treatments for such issues can themselves cause nighttime awakenings, the doctor notes.

Age and Sex: Senior citizens tend to wake more often because of neurological changes, restroom needs and heartburn, as per the expert. “Even in the absence of these stimuli, older adults generally experience lighter sleep, resulting in increased stirring,” the expert explains.

Ladies, especially pre-menopausal, face higher risk of nighttime awakenings due to hormonal changes, based on analysis.

Those with this condition believe that additional bed rest will improve rest, but it usually leads to less sleep overall

Suboptimal Bedrooms: Noise, light, heat, cold, an uncomfortable bed, a loud bedmate and additional factors can contribute to maintenance insomnia, the expert notes.

Individual responses to disturbances vary among individuals. For instance, many stir at quiet steps in the hallway, although many rest despite noise. “Some people do better with sleep disruption in general, the doctor notes.

Managing Night Wakings

Treatment for maintenance insomnia often targets the source, says Fashanu. When discomfort or bedroom issues cause repeated stirring, addressing these can help. Counseling or prescription drugs can prevent stress-induced wakefulness.

If these factors are ruled out, additional options exist.

CBT for Sleep: A proven psychological approach is a form of therapy that “changes your attitude toward wakefulness, which enables you to go back to sleep much faster”, says Zeitzer. It’s the preferred approach for this condition. Usually, six to eight visits to rewire how a person thinks about sleep and develop improved routines.

Medication: Certain sleep medications may assist temporarily, but Kogan doesn’t recommend sleep medication before other options have been explored. “Sleep issues often stem from thoughts and habits, so sleep meds are often a band-aid without addressing root causes,” she explains, noting that prolonged usage of OTC products {is not recommended|is discouraged|isn’