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

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

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

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)


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