Why Do I Keep Waking Up at 3 am?
Why Do I Keep Waking Up at 3 am?
This week, in the Daily Wellness Text Community, we dug into a few common sleep questions.
Why is it so hard to get out of bed? Why am i so tired in the morning? We used a validated sleep questionnaire to answer these questions and more to figure out what’s keeping us from getting peaceful sleep. Because, as we’ve discussed all month, getting quality sleep not only makes us feel better, but it’s anti-inflammatory effects protect our metabolic health.
We’ve all been there before. Right before a big day, you have a sleepless night. All night, you’re tossing and turning, which leads to daytime fatigue. And we just want to know why! Why am I waking up at 3 am (or maybe even waking up at 4 am)? Then I’m stuck wondering, how can I get back to sleep? Once I’ve been up all night with no sleep, of course, I find myself struggling to get out of bed in the morning. And sometimes, here’s the kicker, even when I think I’ve slept for the right amount of time, I wake up tired! Why am I waking up tired after 8 hours of sleep?
If you deal with these sleep questions on a regular basis, it’s hard not to feel like a failure. We’re not failures for not getting high-quality sleep. The world interferes with our sleep in so many ways that it’s a miracle we ever find time to sleep. But, if we’re waking up tired, then we HAVE failed to meet our bodies’ needs. And that’s worth examining. For that, we go back to the drawing board i.e our discussion question for this week:
Discussion Question for This Week:
For whom are you modeling attitudes and habits around sleep and rest? Which child, mentee, colleague, friend or loved one is watching how you respond to being tired?
What are they learning from you?
Do they learn that rest is something to be negotiated? (I can take a couple moments to myself if I finish more of my work first…I’m always tired, but I have too much on my plate to justify sleeping for a full 8 hours.)
Or do they see you prioritizing rest as much as possible. (I’ll ask my partner to put the kids to bed so I can get to bed early or take some non-sleep rest time for myself. I’ll work more efficiently and set a hard stop time for my work so I can have enough time to wind down for bed)
We had lots of chatter about this question on the thread, just like last week’s question (who modeled rest and sleep for us).
Wanted to share a response to last week’s question from our long-time member Michelle (who gave me permission to share her quote).
We asked “Who modeled rest and sleep for us when we were children, and what did we learn from them?”
Michelle answered that question with:
“My grandmother modeled rest by laying down on the couch, reclining in her chair, doing crossword puzzles, listening to sermons, etc.”
I don’t know about you, but I LOVE hearing about Black women creating spaces of rest and time for leisure in their everyday circumstances. Rest is what you make it.
Waking Up Tired…
If you’re plagued by sleep issues and you’re not the only one! Sleep complaints seem to have increased during the pandemic as our home duties and caregiving duties merge with work that has shifted from the office to home and, in some cases, back again. Now, more than ever, we need understand that waking up tired means it’s time to troubleshoot inadequate sleep
In the Daily Wellness Text Thread this past week, we reviewed the Pittsburgh Sleep Quality Index (PSQI). The PSQI (http://www.opapc.com/uploads/documents/PSQI.pdf)is a commonly used tool in research settings and clinical settings (like your doctor’s office).
You can take the survey and score your answers here. Scoring gets a little complicated, so I recorded an hour-long video walking our Daily Wellness Text Community through the whole process- scoring interpretations and all. Click here to join the Daily Wellness Text Community and get access to that video if you need help with scoring.
Otherwise, if you’re already Community Member, scroll to your Thursday text message for the video link.
How to Wake Up Feeling Well-Rested
Figuring out how to wake up feeling well-rested depends on you figuring out what is keeping you from getting enough high-quality sleep. That’s where the PSQI comes in. In scoring the PSQI, Component 5 asks about the events that could disrupt our sleep:
Pain
Having trouble breathing
Getting up to go to the bathroom
Experiencing restless legs
more…
We’ll talk more about these next week, but you should know that all of these are reasons to talk to your healthcare provider.
Pain While Sleeping
Pain that is severe enough to keep you up at night could come from muscle or bone injury (like back pain) or from damaged nerves (like neuropathy in type 2 diabetes), or from blocked arteries (arterial insufficiency) among other issues).
-Diagnosing each of these involves a physical exam from your healthcare provider, possible imaging like XRay/ MRI, artery testing or nerve testing (EMG) and physical therapy.
Trouble Breathing While Sleeping
Trouble breathing at night could herald any number of severe conditions including:
- Uncontrolled asthma (which often takes the form of coughing or shortness of breath that is worse at night than during the day).
-Obstructive sleep apnea (which is correlated with increased weight gain and added mass in the oropharynx, also known as the mouth and upper throat)
Your doctor can conduct a physical exam and send you for lung function testing (pulmonary function test) to rule out asthma. Your doctor can examine your mouth, tongue and throat then send you to get a sleep study to diagnose sleep apnea (obstructive type or central type).
Needing to Go To The Bathroom While Sleeping
If you’re getting up once or many times per night to use the bathroom, that is a conversation to have with your doctor!
If we’re talking about an increased urge to urinate (not have a bowel movement), try making a couple changes to your pre-bedtime routine. Cut out liquid for 1-2 hours before bed, especially diuretics like coffee and alcohol, that will increase your urine volume. while you sleep.
If you cut back on pre-bedtime drinks and still wake up with the urge to urinate, talk with your doctor.
-Your doctor can help you rule out two common causes of urinary urge: Overactive bladder in women and Benign Prostatic Hyperplasia (BPH)
-For people born without a prostate (born biologically female) your primary care doctor can refer you to a urogynecologist for dynamic bladder testing to rule out overactive bladder. Treatment includes medications and potentially pelvic floor physical therapy.
-For people born with a prostate (born biologically male), your doctor can conduct a physical exam to identify an enlarged prostate and can ask the right questions to check other urinary symptoms (dribbling and low flow) that are common with BPH.
-Whether you have a prostate or not, a urinary tract infection is another cause of frequent urination that your doctor can help you diagnose and treat.
Restless Legs While Sleeping
-If you experience the sensation of needing to move your legs, and it’s disrupting your sleep, that’s a reason to talk to your healthcare provider!
-A discussion and physical exam can help your provider diagnose the cause of your restlessness.
-Possible treatments for restless leg syndrome include prescription medications, improved blood flow (from exercise, stretching), improved sleep quality (fatigue worsens symptoms), and nutritional supplements like vitamin D. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5886433/).
With that, I’ll leave you to enjoy your Saturday. Hope it’s a restful one!
Happy Healthy Living,
Dr. Wuse