Are you waking up at different times of night?

I hear you, it is a real pain to go to bed every night hoping for restful sleep only to be woken up by some unknown reasons and often not once, but several times during the night! Insomnia problems and broken sleep affect more than 65% of the UK population, so it is unfortunately a very common problem.

In my previous blog I wrote about the two main causes of nighttime wakings - environmental and physiological. Today let’s have a look at the psychological causes of waking up at different times of night.

Have you ever heard the term ‘body noise’, what about ‘mind noise’?

These two refer to a range of psychological factors that influence the quality and quantity of our sleep. Andrew Weil, MD, clinical professor or medicine, Director for Integrative Medicine at the University of Arizona, defines 'body noise’ as a group of biological and psychological conditions that lead to or contribute to insomnia. It is the conditions arising ‘within’ your body that may prevent you from getting restorative sleep. Among these most common are restless leg syndrome, muscles and joints aches and pains, the adverse effects of caffeine, digestive problems such as IBS or acid reflux, or GERD, symptoms accompanying perimenopause and menopause, hay fever and airborne allergies and the side effects of various medications.

When it comes to digestive disorders, studies have long been trying to understand the relationship between digestive tract disorders and quality of sleep. In the opinions of many researchers the relationship is bidirectional. Poor sleep quality results in increased sensitivity to pain in the abdomen and also to increased likelihood for flare-ups. At the same time, the presence of painful gastrointestinal symptoms often disrupts sleep.

Many people with IBS report that their symptoms may wake them up at different times during the night, and it is the unpredictable character of the symptoms that appear to be difficult to foresee. In a recent study, researchers once again tested the directional relationship between IBS symptoms and quality of sleep and found that it was poor quality sleep at night that could predict abdominal pain and GI symptoms the following day, but not vice versa. The most likely explanation for this is perhaps the circadian aspect of the digestive system, which repairs itself as we sleep. Having had poor quality sleep, the GI is more sensitised giving you reactions to the foods and drinks that you would normally have in your diet without effects.

Having heartburn or acid reflux is another common reason why you may keep waking up at different times during the night. Our motility and peristalsis (the speed with which food moves along the digestive tract and the contractions of the muscles of the GI tract) both slow down in late evening. Heartburn is often the result of having a late evening meal. Having to move and digest the food when the GI tract has slowed down becomes a real burden for the body.

Acid secretion is believed to be on a circadian rhythm which influences acid gastric motor activity. Acid secretion increases in a circadian pattern between 10 pm and 2 am giving you the painful symptoms of heartburn. One hypothesis of this is that while food gets to sit in our gut for a longer period during the night, the higher acidity ensures that we don’t get poisoned by bacteria or parasites coming with that food.

Have a look at your diet, review what foods and drinks might be causing you GI upsets and work to eliminate those so that your sleep doesn’t suffer as a result.

Other types of body noise that may keep waking you up during the night include muscle tension and muscle and joint aches, including restless legs syndrome.
Restless leg syndrome affects as many as 1 in 10 people. Women are twice as likely to develop restless legs syndrome at some point in their lives than men. The overwhelming urge to move your legs is often worse in the late evening or night, making it difficult to drop of initially or having to wake up several times during the night giving poor quality of sleep not only to you but also to your partner.

There is another type of restlessness in the body that many people experience regularly during the night. These are hypnic jerks. Hypnic jerks or sleep starts, are typically normal physiological events that occur as we transition from wakefulness to sleep. These are uncontrolled sporadic twitching-like movements in the body, which can be spontaneous or due to a secondary stimulus. Some people report having a sensation of falling, tingling, or they might be a response to auditory or visual hallucinations. Hypnic jerks become a problem for the person if they start happening several times throughout the night, leaving the person ‘in the grip’ of constant startling sensation.

When it comes to reducing and managing ‘body noise’ it is worth mentioning that it is often not the problem in the sleep structure itself, but rather a problem of excessive overstimulation in the body that interferes with people’s innate ability to sleep well. Various body-mind techniques help calm the system and relieve buildup tension. These are yoga, stretching, breath work, progressive relaxation, self-hypnosis, neurofeedback and others. A lack of adequate physical activity is also a contributing factor for having regular ‘body noise’ and irregular sleep patterns.

What about ‘mind noise’?

These are thoughts and feelings that hinder your sleep quality. Not all thoughts and feelings, however stressful they might be, interfere with sleep quality. It is found that anxiety that is persistent and unmanaged for an extended period of time that is most likely to lead to disturbed sleep.

Having mood disorders, such as anxiety and depression, is shown in research to be associated with the worse self-reported sleep quality. At the same time having insufficient sleep over weeks and months can lead to the onset of anxiety and depression. Research into this bidirectional relationship is ongoing.

Anxiety can disrupt sleep, which creates a sleep debt that worsens anxiety symptoms.
In people I coached with sleep problems, often times there is what is called ‘sleep anxiety’ - these are thoughts and beliefs that are rooted in misguided beliefs. Having gone through a period of restless nights, often months and years rather than weeks, a person believes that their body is unable to have restorative sleep. Thus going to bed is accompanied by a feeling of dread, something that a person views as disturbing. The bed itself is no longer a welcoming soothing space, but is viewed as uncomfortable place of nightly existence. Sleep anxiety is born.

Insufficient or broken sleep is a serious concern for the population overall. Sleep debt accrues, and sleep deprived people get accustomed to being sleep deprived, considering it their norm. Based on numerous studies of average sleep time and quality and also their outcomes on health, millions of people unwittingly spend years of their life in a sub-optimal state of physiological and psychological functioning, where their low energy, poor concentration and impaired cognitive functions have now become a daily norm.

Psychological causes of nighttime wakings and sleep disturbances may seem more difficult to address and remove, especially if you don’t have support. But having worked with many people on restoring their quality sleep, I must admit these are often the ones that you need to start working from in order to have your good sleep back.

If you have sleep problems, don’t think of sleep as something intricate, a mystery your body doesn’t know now. Sleep is simply an act of ‘letting go’ of wakefulness. Your body knows how to do it. You may just need a bit of support. If you need help, I have now devised a Restore Sleep programme alongside my standard Health Coaching programmes. See the details here: https://boostmyenergy.co.uk/program4