When the alarm clock pulls you out of the depths of sleep, it’s not very happy, but “there is such a word“ necessary ”. But when you wake up 3 hours before the call, but it’s still early to get up and you want to sleep desperately — this is where it becomes insulting. Moreover, it is not always possible to fall asleep again for the remaining two or three hours. What leads to these frustrating early awakenings, despite evening fatigue and chronic sleep deprivation, MedAboutMe figured out.
Reason #1. Insomnia
By default, insomnia is considered to be when a person cannot fall asleep. But this sleep disorder can look different:
- sleep problems,
- heavy sleep with nightmares,
- restless, disturbed sleep,
- waking up too early.
A person can suffer from one of these symptoms, and from several at once. But most often, either difficulties with falling asleep and problems with getting up or easy falling asleep (“only the head touched the pillow”) and waking up a few hours before the scheduled time with the inability to continue the night’s rest are combined with each other.
An interesting point: young people often experience difficulties with falling asleep, but early awakening is more likely the lot of older citizens and middle-aged people.
What to do?
The same methods are suitable for combating insomnia of awakening as for treating insomnia in general:
- Avoid alcohol before bed, or at least reduce what you drink to a minimum, as well as a ban on any other stimulants (coffee and other sources of caffeine, smoking, etc.).
- Minimizing your intake of any liquid before bed will reduce the need for nightly trips to the toilet.
- Creating an environment protected from light and sound: thick dark curtains, sleeping without a snoring partner and animals in the same bed.
Reason number 2. sleep apnea
This is the name given to short pauses in breathing during sleep. The fact that a person has sleep apnea can be guessed by the combination of early awakening with chronic snoring, constant fatigue, high blood pressure in the morning and frequent headaches. In this case, an apnea attack can provoke an early awakening.
Often, sleep apnea manifests itself in the stage of REM sleep — paradoxical sleep or the stage of rapid eye movement. In this phase of sleep, muscle tone is lowered, the person is weakest of all, he is practically immobilized. The REM phase is for the most part just the second half of the night, so breathing stops most often occur during this period of sleep and, as a result, a person wakes up long before getting up.
What to do?
People who live alone don’t always know they have sleep apnea. Meanwhile, this is a serious problem that requires the help of a doctor. Sleep apnea has a devastating effect on the brain and heart muscle over the years, so if the symptoms suggest sleep apnea, you should go to the doctor and get recommendations for treatment.
Reason number 3. Stress
Experienced stress may not be noticeable from the outside. A person who is constantly under stress can look outwardly smiling and confident. However, living in a state of chronic deadlines or in an atmosphere of the risk of making a costly mistake in making fairly global decisions can gradually plunge a person into a state of constant stress.
Stress, both acute and chronic, increased anxiety can also cause early awakening. The fact that stress is the cause of jumping up in the middle of the night may be evidenced by a feeling of cheerfulness, a clear mind and a readiness to immediately get down to business. In fact, the body immediately after waking up turns on to the maximum and does not allow a person to sleep further. At the same time, awakening occurs at a time when the body has not yet had time to fully rest, which affects later, during the day, when unplanned fatigue leans on a person.
What to do?
The main way to deal with early awakening in this case is anti-stress therapy. It may include not only solving the problem that brings a person into a state of stress — it is much more important to learn how to cope with this state, regardless of external circumstances. The list of methods for dealing with stress includes: relaxation exercises that should be performed before going to bed, meditation, sleep hygiene, etc. The doctor may also recommend dietary supplements and other means with an anti-stress, sedative effect.
Reason number 4. Depression
Depression often causes disruption of the circadian rhythms that underlie the alternation of sleep and wake cycles. Often, people suffering from depression not only do not sleep well at the allotted time for this, they can also experience drowsiness in the midst of a period of activity and, on the contrary, suffer from bouts of vigor, waking up several hours before the alarm goes off.
In 2018, scientists from the University of Warwick found a link between depression and sleep disorders. The researchers explained this connection by the fact that in both cases the same areas of the brain are involved. Stimulation of these areas in people suffering from depression leads to the formation of difficult-to-control, obsessive emotional images, a person replays the same situation in his head over and over again, presenting different options for solving it, unable to stop this process — psychologists call this phenomenon rumination. Early awakening in these patients often leads to rumination and morning insomnia.
What to do?
It should be remembered that depression is a serious disease, the treatment of which is best entrusted to a doctor. If there is a suspicion of depression, you should consult a specialist to clarify the diagnosis. Do not trust publicly available tests for self-diagnosis of depression — only a doctor, based on the results of the test, interview and observation, can make an accurate diagnosis.
Reason number 5. Age-related changes in circadian rhythms
With age, the circadian rhythms we talked about above can change a bit. The amount of sleep a person needs also changes. This shift is especially pronounced in the elderly. It is not uncommon for a person to start going to bed earlier and earlier, waking up as a result at 3–4 am. In this case, he got a full sleep, his body rested, he does not experience daytime sleepiness — just his cycle of sleep and wakefulness has shifted by several hours.
Older people also have other characteristics. If among young people and middle-aged people insomnia occurs in 10–20% of cases, among the elderly the same figure reaches 40%. One of the reasons is the age-related change in sleep patterns. The period of falling asleep increases, the duration of the stages of deep sleep decreases, the efficiency of sleep also decreases, while early awakenings occur more and more often.
In addition, 70% of older people with insomnia are on medications that disrupt sleep, alcohol, suffer from various mental disorders or chronic diseases. In the case of the latter, the sleep apnea mentioned above, pains of various kinds that cause a person to wake up, etc., may develop.
For these reasons, and also due to the fact that more time a person is at the stage of superficial sleep, the sleep of the elderly becomes very sensitive. Any, even a slight noise, can interrupt it.
What to do?
Disturbances in melatonin production and altered circadian rhythms may be associated with a reduction in outdoor walks, where the patient is exposed to sunlight, which plays an important role in the regulation of circadian rhythms. Regular walks will help treat insomnia due to early awakening.
Problems of going to bed early and waking up early can be addressed with bright light therapy. With the help of bright light in the evenings, the production of melatonin is suppressed. This should move the moment of falling asleep to a later time. After the cessation of exposure to bright light, the production of the hormone increases, which leads to drowsiness, facilitates the process of falling asleep and shifts the time of awakening.
Older people who have experienced age-related sleep disorders are also recommended to take a course of cognitive behavioral therapy for insomnia.
Evidence-based recommendations for the assessment and management of sleep disorders in older persons. / Bloom HG, et al. // J Am Geriatr Soc. - May 2009 - 57(5)
Treatment of circadian rhythm sleep disorders with light. / Gooley JJ. // Ann Acad Med Singap. - 2008 Aug - 37(8)
Awake at 4 AM: treatment of insomnia with early morning awakenings among older adults. / Fiorentino L, Martin JL. // J Clin Psychol. - 2010 - 66(11)