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I don’t struggle falling asleep. Typically, once I get into bed, and that’s all I remember.

However, regularly, I find myself wide awake at the middle of the night – anxious about upcoming tasks, concerned for my kid’s adaptation to her new school or making a note on my phone like washing the vehicle. Usually, I get back to sleep in an hour, although at 8am, I feel groggy, wishing I’d had that extra shut-eye.

Waking and not returning to sleep is called night-waking insomnia, according to a sleep specialist, a health psychologist and insomnia specialist. Although nighttime awakenings are normal, some people have trouble getting back into slumber. Anxious thoughts are a common cause. “Individuals awaken with racing thoughts, making it difficult to get back to rest,” the doctor states.

Such insomnia might affect everyday performance, but there is treatment. Read on for important details about maintenance insomnia.

What is maintenance insomnia?

Although insomnia is often seen as struggling to drift off, various types exist, says Dr Jamie Zeitzer. Certain individuals can’t fall asleep (initial insomnia), others awaken too soon (early waking insomnia) plus many experience nighttime awakenings (middle-of-the-night insomnia, because sleep isn’t sustained).

Many people suffer from a combination of these insomnia forms, and the expert notes this type on its own or experienced with other forms is fairly common. Roughly 20% of people with sleep issues in one 2014 study had prolonged nighttime awakenings.

Nighttime awakenings are natural, says Zeitzer. For example, a bathroom trip might be needed or awakening when sleep is lightest. The majority don’t recall momentary stirs without next-day effects. However, many aren’t immune.

“The cause of waking isn’t always the issue, instead, it’s the thoughts after that keeps them up,” Kogan says. When people awaken and their thoughts accelerate, making it hard to rest. They may even worry about losing sleep, and that stress also keeps them awake, forming a vicious cycle.

Maintenance insomnia can look different for each sufferer, Kogan adds. Some face one or two extended periods each night, and some stir frequently.

Maintenance insomnia can cause multiple concerns, like reduced daily functioning, worry, pains and discomfort, notes an expert. Sleep loss can also increase the risk of other conditions, like weight gain, diabetes and circulatory ailments.

Factors Behind Sleep Maintenance Issues

Multiple factors can contribute, although various reasons exist for nighttime awakenings, says Kogan.

Anxiety and Stress: The most common reason for nighttime awakenings is anxiety, says Kogan. When some people wake, their mind activates – possibly over responsibilities, routine worries or anxiety over poor sleep.

“Bad dreams from stress, PTSD or other mental health conditions can hinder falling back asleep,” the expert states.

Insufficient Sleep Pressure: Inadequate tiredness can lead to prolonged awakenings, the specialist explains. Factors behind low sleep pressure are afternoon rests and extra time in bed. “Sufferers often assume that additional bed rest will improve rest, but it usually leads to less sleep overall,” says Kogan.

Aches and Unease: Discomfort frequently links to sleep issues. This can stir an individual and prevent returning to sleep, Zeitzer says. Persistent ailments can spark long-term sleep issues, but even temporary issues including minor injuries can lead to awakenings.

Further worrisome ailments connect to insomnia, says Kogan. These include neurological disorders (including chronic pain), circulatory problems and breathing disorders. Treatments for such issues can result in stirring, the specialist explains.

Age and gender: Older adults tend to wake more often because of neurological changes, urinary problems and digestive issues, according to Zeitzer. “Even in the absence of these stimuli, seniors usually have lighter slumber, resulting in increased stirring,” the expert explains.

Women, especially those approaching menopause, face higher risk of nighttime awakenings because of hormone fluctuations, as per research.

People with maintenance insomnia think that additional bed rest will help them get more sleep, however, it often decreases rest

Poor Sleep Settings: Disturbances, illumination, climate, unsupportive bedding, a loud bedmate and outside influences can lead to sleep disruptions, says Fashanu.

Sensitivity to noise differs for each person. As an illustration, some might wake up to the soft sound of footsteps in the hallway, while others can sleep even with the TV blaring. “Many cope better with interruptions, Fashanu says.

Managing Night Wakings

Addressing nighttime awakenings usually relates to the root issue, says Fashanu. When discomfort or bedroom issues lead to regular awakenings, remedying those factors is often enough. Therapy or psychiatric medications may reduce anxiety-related awakenings.

Once these are eliminated, additional options exist.

Cognitive Behavioral Therapy for Insomnia: Cognitive behavioral therapy for insomnia (CBT-I) is a form of therapy that “essentially teaches you not to care about your insomnia, which enables you to go back to sleep much faster”, says Zeitzer. It is considered the go-to treatment for this condition. It typically takes six to eight sessions to alter perceptions of rest and create new sleep behavior.

Prescriptions: Prescription aids can help for short-term use, although medication isn’t first choice until trying other methods. “Sleep issues often stem from thoughts and habits, so sleep meds are often a band-aid if underlying issues remain,” the specialist notes, noting that prolonged usage of non-prescription drugs {is not recommended|is discouraged|isn’