Middle of the Night Wake Up Calls

Photo by  Alexandra Gorn  on  Unsplash

by Candace Liccione

I have a lot of people come into my store who have sleep issues. There are so many reasons for insomnia that it can be difficult to find what works for each person’s issues with sleep. So many don’t want to discuss why they don’t sleep - they don’t want to delve deep into reasons for their sleeplessness. Some people can’t shut off their brains, some people worry, some people eat improperly and take medications with side effects that hamper good sleep. The reasons go on and on. Most people just take a pill so they don’t have to figure out what is wrong in their lives that can be fixed and help them to sleep better.

Sleep deprivation, which is less than 6 or 7 hours of sleep, can be harmful. Not getting enough sleep can lead to health issues, impaired driving and work performance. Excessive sleep can also be a sign of health issues or depression issues.

Do any of these ring true for you?

Waking up at 3 - 4 am: your liver goes to sleep at night and wakes up at 3-4 am and starts its detox phase and continues detoxing until you ingest food that causes your liver to have to start producing bile.

Pee: if you wake up 4 or more times a night, your balance of water and electrolytes may be off. 30 minutes before bed, drink a small glass of water with a pinch of unprocessed sea salt.

Hot room: 60-65 degrees is best for most people to sleep comfortably. A warm bath also raises your temperature but when you exit the tub you have a slight drop in temp that signals your brain to go into sleep mode.

Menopause: can cause hormonal changes that contribute to depression and disrupts sleep.

Social media: exposing your eyes to light during the evening stops the body from making melatonin. Dim the lights and no social media one hour before bed.

Age: as we age, many people shift their sleep patterns. Your body clock shifts with age and you can take longer to fall asleep, wake up more often and then to linger in the deepest phases of sleep for less time.  And at age 60 you could be waking up 2 hours earlier than you did in your 30’s. Going to bed earlier is a good solution.

Alcohol: alcohol produces a form of sleep that can prevent the healthy REM (rapid eye movement) that you need for good sleep. Quit drinking a few hours before bedtime.

Breathing issues: stuffy nose, allergies, cold – cause sleep disruption

Sleep apnea: causes sleep issues  - in sleep apnea the airway become so narrow during sleep that is completely closes off. Your brain then wakes you up and in severe cases of sleep apnea you can wake up 60 times in an hour.

Thyroid issues: overactive or underactive thyroid hormonal imbalances. Overactive can cause heart racing, adrenaline surges, insomnia, anxiety and underactive which is common after age 50 can cause some people (35%) to be more likely to have sleep apnea.

Stress: activates parts of your brain associated with attention and arousal and can cause stress related insomnia

Acid reflux: wakes you up - try smaller meals, no late-night eating, lose weight, try aloe vera juice.

Excess belly fat: triggers higher levels of inflammation that disrupts neurological pathways that control sleep and it is also harder for you to breathe when you lie down.

Being a caregiver: tough on your mental health. Try a soothing cup of chamomile tea to calm and soothe.

Vitamin D deficiency: estimated 40% of people have a vitamin D deficiency. 12% of people with low levels of vitamin D sleep less than 5 hours and 57% were awake for 90 minutes or more in the middle of the night.

Positive attitude: a less than positive attitude interferes with sleep. Sleep isn’t a luxury but a necessity.

Sleep medications: More than 1 in 3 American adults according to the CDC don’t get enough sleep. When you can’t sleep most people try sleep medications but there are drawbacks with all of them whether prescription pills, over the counter products or herbal supplements.  There are 2 ways to treat insomnia – cognitive behavior therapy (CBT) or medication. It is believed that CBT works better than medication for most people. Remember that there are many reasons why people don’t sleep well and depression, sleep apnea and emotional issues can also contribute to sleeplessness.

In a study in 2014 benzodiazepine (tranquilizers) prescription rates and long-term use was highest in people over age 65 and older people are at higher risk for falling and cognitive impairment. There is some evidence associating benzodiazepine use with dementia.

It is estimated that 30.6 million American adults use benzodiazepines. 25.3 million use them as prescribed (in addition to insomnia, the drugs are used for anxiety, seizures and panic attacks. And 5.3 million are misusing the medication – i.e. getting the pills from someone else.

Z drugs – Ambien, Lunesta, Sonata don’t contain benzodiazepines but have the same effect. These drugs are considered safer but can have side effects.

Over the counter drugs like Unisom, ZZZQuil and Tylenol PM contain an antihistamine called diphenhydramine, but little research has been done on this antihistamine for helping insomnia and it does have side effects like morning grogginess and dry mouth. Diphenhydramine is deemed inappropriate for over 65 as it can trigger cognitive impairments, dizziness and falls and is not good for your liver or kidneys.

The frightening thing is that some people even grab for meds that aren’t designed specifically for aiding in sleep. For instance, people who take an antihistamine such as Benadryl (for cold or allergies), drowsiness is often a welcome side effect. But a Baylor College of Medicine sleep expert cautions against turning to this type of medication as a sleep aid. Antihistamines have side effects that include altered mental state, urinary retention and dry mouth. While these side effects are generally mild and well tolerated in young patients without other medical problems, they can pose a risk, especially for the elderly.

Tylenol PM contains two medications—the pain reliever acetaminophen and an antihistamine (diphenhydramine) to help with insomnia. High doses of acetaminophen can cause liver damage and the risk increases if you consume alcohol.

Herbal supplements: supplements like melatonin or valerian are helpful for some people but you must be careful of the quality and quantity as they vary. Herbal sleep herbs work for some people depending on what the cause of their insomnia is.

Essential oils: Lavender is definitely the essential oil of choice when it comes to relaxation and rest. Place a few drops into a nice warm bath or use a diffuser in your room.