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YOUR BACK-TO-SLEEP-GUIDE FOR 3AM WAKE-UPS

Medical & health articles 14 Jun 2022

Ever find yourself wide awake in the early hours, unable to re-enter the land of
nod? Many women struggle with 3am wake-ups. Here’s what might be causing them
and how to take action.



For Lucy Clark, it’s thoughts of work that often keep her from slumber.

“I may mull over things I'm stressed about and on some occasions I won't go back
to sleep at all,” says the 33-year-old publicist, who has “struggled” with sleep
on and off since her early 20s.

“[I] will go through stints of the classic 3 or 4am wake up,” she says.



SOUND FAMILIAR?

The state of women’s shut-eye isn't great, with results of our 2021 national
sleep survey showing 41% of women rated their sleep quality as poor, compared to
32% of men.

Psychologist and CEO of the Sleep Health Foundation Moira Junge says that waking
in the very early morning hours is not only common, “it can be considered
normal”.

“Sleep studies show us that people can wake during the night often [and for
healthy sleepers, it’s a non-event].” These people, she explains, generally go
back to sleep effortlessly with no memory of the wakening. They don’t check the
time or consider themselves a poor sleeper.

According to Dr Junge, the problem occurs when there is a difficulty returning
to sleep, in other words, insomnia.


WHY CAN’T I GET BACK TO SLEEP?

There are plenty of reasons for early morning insomnia, such as chronic pain and
other underlying health concerns. However, in Dr Junge’s experience, “anxiety is
the most common [reason]”.

TOO STRESSED TO SLEEP?

When we are overly stressed, we are too “wired” and “alert” for sleep, says Dr
Junge. If the heightened stress and disrupted sleep persist, she says “what
generally happens is the primary problem becomes the worry of not sleeping”.

As difficult as it may be, “it’s important not to stress about not sleeping or
associate sleeping with stress”, she adds.

THE ALCOHOL EFFECT

With its power to send us to sleep quickly, alcohol appears the perfect sleep
aid. But according to Steve Allsop, professor at Curtin University’s National
Drug Research Institute, “we do not get quality sleep under alcohol’s
influence”.

Alcohol can “increase the speed of falling asleep, [but] it suppresses or
reduces rapid eye movement (REM) sleep, which is essential to sleep health and
waking refreshed”, he says. The drink also increases urine production, meaning
night-time trips to the loo, plus large amounts can affect the respiratory
system, promoting snoring and poor sleep, adds Prof Allsop.

As for how many drinks it takes to disrupt sleep, Prof Allsop says “even modest
amounts of alcohol can have an impact”. Ultimately, he recommends factoring your
alcohol consumption into your sleep plan, having a few alcohol-free days each
week and observing the drinking guidelines.




WHEN MENOPAUSE MUSCLES IN

Research shows that around 56% of women report ongoing insomnia in the lead-up
to their final menstrual period (perimenopause).

Disrupted sleep around the time of menopause makes sense. Many women experience
hot flushes, night sweats, migraines, mood changes and other symptoms that can
affect their daily lives.

Studies also show that cases of obstructive sleep apnoea increase around this
time, with weight gain and hormonal changes at menopause a possible reason.
Obstructive sleep apnoea occurs when the muscles in the throat relax during
sleep, stopping the person from breathing. Snoring is one of the signs of the
condition.

In addition, Dr Junge says this stage of life can be demanding, with many women
juggling ageing parents, dependent children and work. She recommends keeping
active and being mindful that once menopause symptoms settle, sleep problems and
any sleep-related anxiety can linger if we’re not careful.

Listen to a podcast on menopause and sleep, featuring Jean Hailes
endocrinologist Dr Sonia Davison.

BODY CLOCK CHAOS

In some cases, early morning sleep troubles are driven by a bedtime schedule
that is out of sync with the body’s circadian rhythm, or internal ‘clock’. Dr
Junge points to shift workers who may experience this problem.

To promote a healthy circadian rhythm, she says we should ideally expose
ourselves to light during the waking period and darkness as the sun sets. To do
the latter, she recommends using dim lighting and avoiding screen time before
bed.




THE TOLL

Unsurprisingly, poor sleep can affect almost every aspect of our lives. “When
sleep-deprived, the part of the brain that ties emotions to memories, the
amygdala, doesn’t function properly, which means reactions will be more intense
in some situations,” says Alisha Guyett, PhD candidate in Flinders University’s
sleep health division.

She says that insufficient shut-eye affects memory, mood regulation and
judgment. “From a physical perspective, sleep allows the body to restore its
immune system. If we reduce the amount of sleep, our bodies can be more
susceptible to illness.”

So how do you address those 3am wake-ups?


BACK-TO-SLEEP TIPS

It’s important to identify the cause of the insomnia, of which there are many.
If your sleep issues are persistent or concerning, seek medical advice.

If medication or a medical condition isn’t driving the problem, these tips from
Dr Junge might help:

 1. Don’t panic – Avoid checking your clock and try not to worry about being
    awake.
 2. Enjoy the moment – Give yourself 20 to 30 minutes of lying peacefully in
    bed.
 3. Try to reset – If you’re frustrated, get up and do a non-stimulating
    activity in dim lighting, such as reading. Then return to bed.
 4. Know when to call it quits – If it’s nearing your scheduled wake-up time,
    cut your losses and consider having an early start.
 5. Consider your circadian rhythm – Can you adjust aspects of your schedule to
    suit your natural sleep tendencies?
 6. Try to reduce stress – If stress is keeping you awake, find healthy ways to
    relax, such as mindfulness meditation.


LISTEN TO A PODCAST

To learn more about sleep disorders and why we shouldn’t panic when we can’t
doze off, check out our 'Rest easy' podcast featuring Dr Junge.

Rest easy
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