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Navigating Night Waking: Tips To Fall Back Asleep

Sleep Deep Summit

<h6>Audrey Wells, MD</h6>
In this video, I'm going to go over three simple skills that will help you get back to sleep. And I want to say straight away that getting back to sleep in the middle of the night is one of the most challenging problems that I'm confronted with by many, many people. In part, this is difficult because once you've satisfied some of your sleep needs in the first part of the night, you don't have that same drive to return to sleep. Now there's another idea that you need to consider, and that is, is there really a problem here? Now, a lot of people think I should sleep through the night, but that is not necessarily true. And before you go, shedding all over yourself, I want to tell you why. Adults with normal sleep can wake up five to 20 times each night. Now, you're not going to remember all of those brief awakenings. In fact, it takes approximately five minutes of continuous wakefulness to form a memory for that awakening. And when you look at the number of normally remembered awakenings per night, it's generally somewhere between zero and six. The average is one to three times per night for adults. The number of awakenings is going to increase with age, and it's not a big deal if you can get back to sleep. 

So what I do encourage you to actually start looking at is the amount of time you spend awake that may be the actual problem. And so if you wake up to conscious awareness and tell yourself that the awakening is the problem, this has a tendency to interfere with getting back to sleep and then you're awake longer. So with this new information, I hope that you may be able to reassure yourself, at least to some degree, that nothing has gone wrong. It's normal to have some remembered awakenings during the night. Instead, a good measurement is to aim for being asleep more than 85 to 90% of the time that you're in bed. If nighttime awakenings are a problem because you're spending way too much time awake. Realize that there are things you can do but this is going to require some attention and effort. And I would like to personally invite you to loosen your grip on getting back to sleep. The ironic thing about sleep is that trying harder will definitely get you further away from the result you want. So instead you can do a bit of a mindset shift and look at nighttime awakenings as an opportunity. Here is a chance to spend some dedicated time learning to regulate the thoughts in your mind, regulate your emotions, and the feelings in your body. And I'm going to tell you how to make it more likely that you'll be able to get back to sleep. 

You might have a busy brain. That's something I hear a lot of thoughts bouncing all around in your head that are making it impossible to fall asleep. Sometimes this is called monkey mind and it can easily prevent you from returning to sleep. Now, many people have just a handful of themes that the brain wants to chew on in the middle of the night. And remember, you do have a negativity bias, which is more active at night, much more than during the day. So thoughts tend to be under the broad categories of not enough, not safe, or not congruent. Now, with not enough, this is often a feeling of times scarcity or sometimes money scarcity. And it may also be feeling inadequate or having some degree of imposter syndrome. A common thought is, I have so much to do and there's not enough time. Now, the feeling of being safe or not safe tends to look like fear, catastrophizing, or feeling threatened. Your thoughts are anxious if you're having some kind of threat to your health, your wealth, or your relationships. For example, I had some chest pain today and I'm worried about a heart attack that will keep you up. Not congruent means something is out of alignment or you're doing something out of integrity with yourself. And this is kind of like going against your values or your goals. Something like, my job is awful, but I can't leave. There's often a conflicted feeling with this. 

Thoughts are heavy. They can be burdensome as they weigh on your mind. And at night your brain tends to go to the future or to the past with its negativity bias. And it has the amazing ability to scan for trouble again. Usually, only a handful of things bother us in the middle of the night. And if your brain is thinking in the past or in the future, that's a good clue that you're all up in your head. The first thing you want to do is capture your nighttime thoughts on paper. You're going to capture your thoughts at night and then look at those themes during the day when your logical brain is functioning better. Then you want to look for the antidote. And I'm going to tell you about what that looks like in a second. You're going to keep your antidote by your bedside if you need to remind yourself of it. And remember, all change will start with your internal dialog. For example, if you feel not enough then find your story of abundance. That is your antidote. What do you have? How is it? Enough. How are you? Enough. Write this out during the day so you can remind yourself that you have done all you can. And it's time for recovery and sleep at night. If you feel not safe, look for safety or certainty. How can you create reassurance with your rational brain during the day so you can tap into that at night and soothe your irrational brain? Finally, if you feel out of alignment, look for ways where you can be authentic. How can you live more fully into your values and goals? What choices are you not considering or giving airtime to in your head? What changes could you make? How could you better empower yourself? 

Now, notice how personal all of this is. I think sleep is a deeply personal experience, and you must figure out what your tastes are, what works for your body, and what works for your brain. This is skill number one. Here's the second skill. If you're noticing that you have big feelings keeping you awake. Feelings like anger, worry, regret, anxiety, agitation, etc. These negative feelings, especially if they're strong, will block your sleep. When you're having these feelings. Your brain and your body are more vigilant. The first thing to do is become aware of your feelings and then name them. Literally, look for the best word to describe what it is you're experiencing. If you name it, you can tame it and then you can start to soften it or even let it go. You can actually decide what emotion or emotions you want to feel, and which ones are conducive to sleep. And here you want to target emotions that you like for sleep. And then when you're lying in bed, you're cultivating that emotion. These emotions that I've listed here are compatible with sleep, and you want to purposely move toward emotions that are low amplitude, neutral, or even slightly positive. And then you want to learn to lie in bed in that state with those neutral or positive emotions around you. And this is a skill that you can develop if you practice, but it isn't going to come quickly or naturally. If you cannot make it to a feeling that is compatible with sleep, then that's a signal that you need to get up out of bed and journal or meditate or take a deep breath. You need to change the scene at that point. 

So again, this takes some practice to get it down, and the goal is to be able to have a few emotions that you can call on in order to sleep. For example, to feel satisfied you want to look for ways to want what you already have to feel gratitude. Remember a time when you gave or received heartfelt appreciation to feel compassion. You want to cultivate a sense of empathy for someone in your life. All of these skills create resilience and activate closeness, trust, and safety within yourself. Another one is generosity, and this one is for those of you who are awake because of a relationship problem, like replaying a conversation over and over. You want to direct generosity toward yourself and toward the other person. Look for the best, most generous interpretation that their words or actions could have. And this helps you to reframe it and bring you some peace. Now, you don't have to do anything different in real life, but your thoughts are your own. And this exercise is just to help you get back to sleep. Now I'm going to talk about the third skill, which is giving your body what it needs. Is your body feeling tense or agitated or even in pain? I mentioned that your brain lives in the future or in the past, oftentimes in the middle of the night. But the body lives in the present, and sometimes it gets neglected. If you turn your attention to your body, you're automatically more mindful and more in the present. Here's what to do. Close your eyes and do a body scan from bottom to top. Notice what parts are active or need attention. What can you do to feel better? Now, sometimes it's hard to know what you need. So if this is happening to you, think of yourself advising your best friend or someone that you care about deeply. Then do that thing. You want to give your body what it needs. 

Here are some ideas for soothing your body. Try some of them out and see what works for you. To soothe your body, you can tense and then stretch your arms and legs and even your torso. You can do some pillow propping to get comfortable and be in a better position that's supportive. You can use a weighted blanket, which is a way to put gentle pressure on your body, which is kind of like simulating a hug. You can also engage your senses to become more relaxed. For example, you can use headphones to practice relaxing with guided imagery or calming music or a non-sleep deep rest meditation. You can Google that. You can put an ice pack over your eyes and your forehead or use a heating pad on your feet. Remember, you have to take action to get a different result. So do try some of these things out and find out what you like and what works for you. Then do more of that thing. If you're having trouble getting back to sleep. Now, those are some ideas for a nighttime plan to soothe your body and engage your senses. You also need to make an extra effort to care for your body during the day. And this includes healthy food choices by eating a rainbow of colored and fresh foods, minimizing sugar and highly processed foods, and making sure you're getting enough water. You'll know that you're hydrated because your urine will be pale yellow. 

And then you need to move. You need to make a move in a way that makes you feel good. And this may be with walking or stretching or working on your strength or your balance. Moving helps your body and helps your sleep quality, and it also empowers you to take back control of your physical being. As a bonus, here are three things that you should avoid during a nighttime awakening. First off, take care not to look at or get hypnotized by an electronic screen, especially between 11 p.m. and 4 a.m., when melatonin levels are oftentimes the highest. The blue light will signal a wake to your brain and make it harder to return to sleep. Don't do calculations with the clock or just lie there feeling terrible that you're awake. If you're falling into that groove, get up out of bed. You want to avoid making an association with the bed and negative feelings. The following day don't tell yourself or tell others the story of how poorly you slept. This will make you feel worse, not better. Instead, keep your usual bedtime and look forward to your next night of sleep because it will likely be better than the last. These are simple skills, but they are not necessarily easy. However, if you can use them to solve the problem of prolonged nighttime awakenings, which is entirely possible, you have a valuable and major accomplishment. This is so worthwhile and I help people with this. If you need help, reach out to me.

https://d1tnc8rqovg0h0.cloudfront.net/2024+Summits/Sleep+Deep+Summit/Transcripts/2024_SDS_Mini+Talk+Day+3+Transcript+File.pdf

Dr. Wells is a sleep medicine physician. She is on a mission to promote healthy sleep as a foundation for a healthy life. In particular, she helps people with sleep apnea get fully treated without sacrificing their comfort. Through Super Sleep MD, she offers a comprehensive library of self-directed courses, a group coaching program, and a private Facebook community. There are free educational resources and more on her website SuperSleepMD.com.

Audrey Wells, MD

Navigating Night Waking: Tips To Fall Back Asleep

Audrey Wells, MD

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Audrey Wells, MD