Waking up at night and not being able to go back to sleep can be frustrating to say the least. Tossing and turning to try and fall asleep has affected most of us at some stage, with some experiencing this on an ongoing basis which can be stressful and can have a myriad of knock-on effects that disrupt daily lives.
I am not talking about a nightly ritual to go to the toilet which can be bothersome but, for the most part, after 10 minutes, we can get back to sleep. I am talking about those who wake up every night in the middle of the night and can't get back to sleep. This throws off our natural body clock, in addition to not feeling rested, which can accumulate into other concerns including brain detoxification through the glymphatic system, hormone imbalances and metabolism. Ultimately, this can affect overall health and wellbeing.
So, this begs the questions, why is this happening and what can we do about it? Lets explore different aspects of how we get to sleep from a functional perspective and some of the key players in the system.
Cortisol and Melatonin and its impact on the circadian rhythm
Cortisol is our bodies main stress hormone, and It should rise as we sleep through the early morning with its peak when we wake up. From an evolutionary perspective, this is what gave us the get up and go, before we began to demonically use caffeine. Throughout the day, we should then see a gradual decline in our cortisol levels, with it dropping to its lowest point in the evening when we prepare getting ready for bed. At a point in the evening, while cortisol is dropping off, our melatonin levels should be increasing, which should makes us sleep and keep us asleep when for the first few hours of falling asleep.
This is how it should work in theory. However, given our hectic lifestyles, our “always on” relationship with technology, coupled with other stressors we have to deal with and eating a standard western diet, can be a perfect storm for these hormones not to work in the way they were set up to, which can lead to difficult falling asleep, staying asleep and waking up not rested. This can lead to a vicious cycle of continuous poor sleep and increased stress.
Given all the issues that sleep deprivation has, our sleep hygiene is becoming even more paramount so we can function at optimal levels. The best way to approach this it be aware of our natural circadian rhythm and how this is evolved from an evolutionary perspective.
Try avoiding any screen time 60 minutes before bed. This will reduce any stimulation from the screens so that by the time you hit the pillow, you will be naturally relaxed,
Use blue blocking glasses. Research has shown that using blue blocking glasses from 7 to 8 pm onwards can reduce the impact that screens have on our melatonin levels.
Reduce bright light exposure within your home, so try using dimmers and naturally increase the darkness in each of the rooms you are spending time in.
Be consistent with bedtime and waking time (even on weekends
Keep your room as dark as possible and turn off all lights including screens.
Turn off your WIFI or have it on a timer so it automatically turns on and off at set times
It's important to point out that before bed, it is important to slow down and be aware of sleep hygiene techniques so that we can reduce our stress levels and reduce any excess cortisol production.
Blood sugar dysregulation
Another common cause of mid-sleep interruption is blood sugar regulation. This can be either blood sugar spikes or dips. While we sleep, we are in a fasting state. This is important because it leaves time and energy for the important processes to take place during this time. While in this state, our body releases glucose from our liver stores to maintain our blood sugar levels so that the cells that need the energy have it available. However, if we have poor glucose control, insulin doesn’t respond appropriately, and we can have elevated blood sugar levels. This might cause you to wake up to urinate, feel thirsty and feeling restless. On the flip side, low blood sugar levels can cause us to waken. If we experience a dip in blood sugar, cortisol will be released as a signal to our body to release sugar from our stores, so our levels do not dip too low. This spike in cortisol and blood sugar may wake us up. It is important to have a balanced dinner, not too close or far away from bed – aim to eat 3-4 hours before bedtime. If you are waking in the night, consider a protein/fat snack before bed (such as a handful of seeds) to help.
A Traditional Chinese Medicine (TCM) Perspective
We can look to TCM perspectives to explore a more mental and emotional link to these sleep interruptions. In TCM, various organs correlate with different functions, times, emotions and more (this is different than the western understanding of organs.) The TCM perspective gives us further insights into what may be going on for you as an individual, and gives us another treatment direction to consider.
Waking at 1-3am: In TCM, 1-3am is liver time. The liver is responsible for smooth movement of Qi (energy or life force). When Qi movement is disrupted or becomes stagnated, we may experience emotional tension, frustration, depression or repressed anger. Liver is also responsible for our capacity for planning and a sense of direction in our life. If you’re lying awake at this time, worrying about the future, or stressed about a project or work, this may be a sign of TCM liver dysfunction. To relate the liver back to women’s health, liver is responsible for storing blood for release during menstruation. Symptoms of mid period spotting or light periods could also indicate a liver problem.
Waking at 3-5am: In TCM, 3-5am is lung time. The lung houses our protective and immune Qi, and also supports movement of Qi throughout the body. It is responsible for carrying out and following through on the plans that we make in liver. The emotion of lung is grief and sadness. If you find you are lying awake grieving a loss or a change in our life, we may consider treating the TCM lung to help you.
Sleep is a vital component of health, wellness and achieving overall balance. This is why at the clinic; we will always dive into all the details of your sleep. It is important that we know if you are experiencing these awakenings, so we can address it with a variety of our treatment tools. Let’s get you snoozing through the night so that you can feel your best. References: