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Sleep Maintenance Insomnia: Definition, Causes & Solutions | Sleep Reset

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January 9, 2023

Falling Back Asleep: Overcoming Sleep Maintenance Insomnia

Medically reviewed by: 

Falling asleep was easy. But now it's 3 a.m., and your partner just jostled the bed as they went to grab a glass of water. Or the cat started meowing outside the door. You're now wide awake, and worse, you can't fall back asleep.

If this sounds familiar, you may be experiencing sleep maintenance insomnia, a disorder that makes it difficult to sleep through the night. Sleep maintenance insomnia affects millions of people, leaving them tired and exhausted the next day.

Waking up before you're ready isn't strange. It's estimated that most people wake up about two times per night on average. However, when you cannot fall asleep, these interruptions become extremely frustrating.

Fortunately, there are ways to overcome sleep maintenance insomnia and get your natural sleep rhythm back on track.

What is sleep maintenance insomnia?

Sleep maintenance insomnia is a type of insomnia where you have difficulty falling back asleep after waking up during the night. Sleep maintenance insomnia sometimes gets called middle insomnia because it often strikes in the middle of the night.

Research shows that sleep maintenance insomnia is prevalent, especially as we age. Unlike other types of sleep disorders, such as delayed sleep-phase syndrome or jet lag disorder, you don't need to stress your body clock for it to affect you. Sleep maintenance insomnia can hit anyone anytime, and it's often set off by anxiety or lifestyle choices.

When waking up in the middle of the night is concerning

Waking up to go to the bathroom and drifting back to sleep five minutes later isn't a sign that something's wrong. Even tossing and turning for a night or two may not indicate anything to worry about.

Most people will experience an occasional night of restlessness, so it’s not concerning unless it happens frequently and negatively affects your life. If you're having difficulty falling back asleep throughout the week or month, it might be time to consider sleep maintenance insomnia. 

What causes sleep maintenance insomnia?

The exact cause of sleep maintenance insomnia is unknown. Sleep disturbance is a complex issue, and the causes can range from medical issues to lifestyle changes. Sleep maintenance insomnia may be caused by:

  • Stress or anxiety
  • Poor sleep hygiene (such as using electronics or caffeine before bed)
  • Sleep apnea
  • Sleep schedule changes
  • Sleep deprivation
  • Medical conditions (such as chronic pain or depression)
  • Medications or substance use

Your sleep cycle gets split into four stages. Each stage affects different body parts, from your muscles to your heart rate. Sleep maintenance insomnia prevents you from progressing through the stages properly, which can lead to feeling unrested.

Signs of sleep maintenance insomnia

If you're unsure if you have sleep maintenance insomnia, there are a few common signs that can help you figure out what's happening. Sleep maintenance insomnia often presents itself with the same symptoms.

  • Waking up multiple times throughout the night: Are you waking up more than two or three times per night? If you’re tired but can’t sleep, it’s a strong sign that something's wrong with your sleep.
  • Difficulty falling back asleep after waking up: When you wake up, is it a struggle to fall back into a deep sleep?
  • Waking up too early: When you're dealing with sleep maintenance insomnia, you may find yourself waking up hours before your alarm clock.

If you're exhibiting any of these symptoms, it's worth looking into what's happening.

Preventing and treating sleep maintenance insomnia

There are many ways to prevent and treat sleep maintenance insomnia.

Prevention starts with good sleep hygiene. Treat getting a good night's rest like a skill you can improve.

This psychological shift means following a healthy lifestyle and avoiding heavy snacks and caffeine before bed. Sleep hygiene also includes going to sleep and waking up at the same time each day and trying to avoid naps.

Stress-reduction techniques, such as yoga or meditation, can help as well.

If you're already experiencing sleep maintenance insomnia, getting active with your treatment is a good idea. When you're lying in bed trying to sleep, staring anxiously at the clock isn't going to help.

Instead, work on relaxation techniques such as deep breathing, progressive muscle relaxation, and guided imagery. Focusing on something calming can help you drift off to sleep in no time. It's also helpful to limit your activities when you're awake and not to eat or drink anything late at night—these things can impact how quickly you fall asleep.

Don’t battle sleep concerns alone

Sleep Reset uses personalized coaching and cognitive behavioral therapy for insomnia (CBT-I) techniques to help you overcome sleep anxiety. With Sleep Reset, you can figure out what's causing your middle insomnia so that you can get a better night's rest. You'll be able to wake feeling refreshed and energized each morning.

Sleep Reset gets you back on track and helps you sleep each night soundly. Don’t spend another night watching the clock tick. If you’re ready to conquer your middle insomnia, take the sleep quiz.