Why am I waking up in the middle of the night?  …and what can I do about it?

Answer:
Thank you to the long-time patient who sent me the first question in the Q&A series of In-Between Visit podcast.  I love that it is about sleep because anyone who knows me knows that this is always where I start.  Possibly because it has been one of my biggest health challenges and let’s face it research is me-search but more likely because without quality sleep it is very difficult to achieve optimal health.  

This is a fantastic question and probably what I see most in practice as it relates to sleep issues. I will ask patients if they struggle with Insomnia and they tell me, NO, but I wake up every night around the same time.  Friends, that is insomnia, it’s called sleep disrupted insomnia.   It’s the dreaded middle of the night wake up.  Many people will struggle and even normalize this pattern for months and years.  I am here to tell you that it is a symptom of a deeper imbalance and something that can be addressed with basic lifestyle changes. 

So let’s get going with answering this important question, this is happening for a possible few reasons and I am going to discuss the ones you have influence over through lifestyle choices.

1). You are not actually getting into restorative sleep in the first part of your sleep cycle 
In essence, you are “passing out” but not actually moving into the full parasympathetic relaxation response required for deep sleep.   Sound like this could be you?  You are so exhausted that you fall asleep on the couch, with your kid in their bed or before you even read the first paragraph of your book, you are “crashing”  The problem here is that in order to achieve deep sleep you need to move from the fight or flight to the relaxation response and for most of us unless you provide some external cues for this transition, then it will not happen.


Solution: Listen to a progressive or whole-body relaxation meditation as you are falling asleep, take a lavender bath before you sleep or take to your ND about possible supplements to support the transition of your nervous system. 

2) Your blood sugar has dropped due to high sugar snacks, alcohol or prolonged fasting 
Your blood sugar may be dropping in the middle of your sleep cycles and that causes an increase in cortisol, the hormone that triggers the body to get up and go.   So it may be the cookies before bed that causes your blood sugar to drop to the point where it is actually waking you up.  The opposite is true if you eat a big plate of nachos before bed.  Your body will be working all night trying to digestion the food instead of being in the restorative, recovery state that is so important for quality sleep 


Solution: Eat a high protein snack like Greek yogurt, almond butter or bone broth before bed to stabilize blood sugar.  The added bonus to this is many protein sources contain the amino acid tryptophan which is a precursor to melatonin, the hormone that helps us stay asleep.  

3) You have a maladaptive stress response due to your busy life. 
Imbalanced cortisol levels throughout the day will show up at night, if our cortisol curve is up and down throughout during waking hours then the same will happen at night.  Waking up at 3:00 am is a classic example of maladaptive stress response with the body surging this hormone at the wrong time.  The reality is that once you are finished listening to this podcast or reading this blog you will still have a very busy professional life, a dog, 2 children, a long commute, dinners to make, groceries to buy etc… that’s not changing nor does it necessarily need to.  What you are looking for is a way to support yourself (and your body) to manage the requirements of your busy life.  If you decrease your physical stress response during the day it will have a huge impact on the quality of sleep you have at night. 

Solution: Breathe through the day, take 3-5 belly breaths during each transition between the activities of your day.  Also, stay mindful of external stimulants like coffee and sugar that cause spikes in cortisol levels.