As a holistic sleep coach for adults, I often hear from clients that they wake up in the middle of the night for various health reasons. Waking up during the night can disrupt your sleep and leave you feeling tired and groggy the next day. In this article, we will discuss common health reasons why adults wake up at night and how you can address them for a more restful sleep.
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“I do my best to present the best and most accurate information here, but here’s what I am – a pharmacist and holistic sleep coach. I’m not a doctor or psychologist so use your best judgement when implementing my information.”
Table of Contents
Waking up to pee at night
If you wake up in the middle of the night to pee, it may be due to drinking too much fluid before bedtime or an underlying health condition such as an overactive bladder.
To address this, try to limit your fluid intake a few hours before bedtime and empty your bladder before going to bed. I would also recommend to have at least 2 glasses of water ready to drink the moment you wake up. If the issue persists, speak with your healthcare provider.
Waking up drenched in sweat (Menopause)
If you wake up drenched in sweat, it may be due to an underlying health condition such as menopause or hyperthyroidism. It could also be due to sleeping in a warm environment or using too many blankets. If you think hormones that cause menopause then we are mainly looking at low progesterone and estrogen. You can go through menopause anywhere from 35 to 55 years old.
To address this, keep your bedroom cool and consider using breathable sheets and lighter blankets. In addition, you may want to check your thermostat. Research has shown that most people sleep best around 61 to 67 F. If you are wanting to address hormones, this will always be an individualized approach, or at least it should be. Your doctor will have different doses of hormones that fit your labs AND how you are feeling. For people that have not gone through menopause you may suggested to take your hormones from day 14 to 25 of your menstrual cycle. Where women in menopause may take it every day or with a hormone holiday after day 25 to 28.
If the issue persists, speak with a functional medicine doctor that has done a fellowship in hormone replacement. There could be common labs they can check if you are a woman over the age of 30 years old. Here is an example of test:
You are probably wondering about laboratory test when it comes to your hormones. Here is a brief explanation of the methods out there:
Different Labs to Check
Saliva testing is known as the most accurate testing with sex hormones like estrogen and progesterone. Testing the saliva is the best way to show the actual amount from your hormone dosing and how much of the hormone is active in the blood stream. The active amount in the blood stream is called bioavailable. This is about 1-3% of the total amount in the body, but the bioavailable is the type that actually reaches the tissue to do its job. In addition, saliva testing helps to accurately measure hormone dosing that is usually given topically on the skin or sublingual (under the tongue). These are typically common ways to deliver hormones.
Blood or serum
This is when you prick your finger, and squeeze the blood onto a filter card. Once the blood is dried, it has been shown to be very stable for shipping. This ideal for testing hormones and has been shown to give more accurate results than serum when using topical hormone treatment. In addition to hormones, you can test things like insulin blood levels, Vitamin D, thyroid levels, and elements like Magnesium.
Serum from blood
This is the testing that is performed when the phlebotomist or nurse stick a needle in the vein to draw blood. Which is know as the old fashion way. Serum testing will measure the total amount of hormones, especially the inactive hormone that is usually bound to protein in the blood stream.
- This can lead to inaccurate results if you are using topical hormonal therapy.
- In general, it can also be easier to overdose if you use topical hormonal therapy and your doctor is measuring with serum.
You are probably thinking! Seriously, this is a scam. What can a doctor possibly get from urine. Well, to a trained functional medicine practioner, A LOT! Hormones in your body just like everything else must be broken down and eliminated. So, when we test urine, we are looking to test the metabolites in the urine. Urinary hormones tell your doctor the hormone levels produced by your hormone system and how they convert throughout your body.
We can also look at how the body is breaking down or building up. So, if you are in good health, you can tell if your body is spending more time in an anabolic (building) state versus catabolic (breakdown) state.
- These are never covered by insurance plans and can be pricey.
Dr. Zeke Medina
Co-Founder, Live Love Sleep®
Adult Sleep Consultant
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Waking up to Poop
If you wake up to poop, it may be due to a change in your bowel habits, diet, or an underlying health condition such as irritable bowel syndrome. Sometimes when you travel east to west, your body can get on an earlier schedule making you have the urge to poop.
To address this, maintain a consistent sleep schedule and eat a balanced diet with plenty of fiber. In addition, set your meal times at the same time and don’t forget to adopt the eating schedule of your time zone. Read more on how to strengthen your Circadian Rhythm here.
Waking up hungry
If you wake up hungry, it may be due to eating too little before bedtime or an underlying health condition such as diabetes. Also, eating sweet and highly processed foods that quickly turn into sugar once they are absorbed into the bloodstream. This leads to a massive influx of insulin and therefore dropping your blood sugar. This drop can happen in the middle of the night causing you to wake up.
To address this, try to eat a small snack before bedtime. Make sure your snack is filled with protein and complex carbohydrates. Avoid crackers and bread that contain the word “flour” in the ingredients. This will have the same negative effects as consuming a dessert or soda.
Waking up with Jaw Pain
If you wake up with jaw pain, it may be due to teeth grinding or temporomandibular joint disorder (TMJ). Also, a functional medicine doctor may refer something like a parasite panel to check for little creatures that be causing some extra stress.
To address this, try to reduce stress, avoid caffeine and alcohol, and use a mouthguard at night. If the issue persists, speak with your dentist or a functional medicine doctor to have a parasite evaluation.
Waking up very thirsty or dry mouth
If you wake up very thirsty or with a dry mouth, it may be due to sleeping in a dry environment or an underlying health condition such as diabetes or sleep apnea. More commonly, you may be a mouth breather. You can lose over 1 L of water when breathing through your mouth the whole night.
To address this, keep your bedroom humid and consider using a humidifier. In addition, try sleeping in a position that keeps your mouth closed. I have recommended to my clients with the supervision of your doctor to try mouth tape. For starters, try mouth taping during the day to make sure you don’t have a nose breathing issue. If the issue persists, speak with your healthcare provider.
Can’t sleep with stuffy nose or congestion
If you can’t sleep with a stuffy nose or congestion, it may be due to allergies or a cold. When you are not able to breath through your nose, you are forced to breath through your mouth as a survival tactic. Mouth breathing can affect the amount of oxygen that is delivered to your organs and brain. This lack of oxygen can stress the body enough to wake you up or cause you to feel groggy when you wake up.
To address this, use a nasal spray or allergy medication like Flonase or its generic form fluticasone Propionate. You can start out with 1 spray in each nostril twice daily for a week and then move up to 2 sprays in each nostril. Read the instructions on how to use this. Avoid spraying in the middle of your nose and always shake the bottle. Steroids like Flonase and others work best when use them everyday and allow them to build up. A lot of my clients use 2nd generation antihistamines like Claritin, Zyrtec, or Allegra closer to bedtime in order to breath better.
Other non-medication options I use are the netty pot or Neil-Med device to help flush out allergens, dander, or pollen out of my nose before I go to bed. I will also use nose strips to open the top of my nostrils to allow more air when my mucosa swells so much, I am unable to breath. I would also recommend using a humidifier as this can reduce bloody noses from really dry air. If the issue persists, speak with your doctor or make an appointment with a holistic allergy doctor. You could benefit from a complete gut evaluation to see if there are foods that could be increasing your risk of histamine production.
Can’t sleep during period (hormones or cramps)
If you can’t sleep during your period, it may be due to hormonal changes or menstrual cramps. You could potentially have an imbalance of too much estrogen which could be causing very intense cramping along with many other issues. Causes of worsened PMS symptoms.
- Low Progesterone levels. There is typically no range to how low this has to go, but it is good to have a baseline progesterone level to confirm with. Typically, the most accurate way to test for free progesterone is saliva testing.
- Serotonin levels drop naturally. When estrogen levels drop before your period, serotonin and dopamine levels decline. Due to this shift, it can cause an increase in activity, increase in psychomotor activity, and depression.
- Oral contraceptive or birth control. Birth control has been a common culprit of PMS due the synthetic version progestin. Progestin is typically a stronger hormone that binds to the Progesterone receptor more powerful than the natural hormones in the body.
- Highly stressed individuals. Stress can make PMS symptoms worse, no surprise there.
To address this, use over-the-counter pain medication or a heating pad have been recommended, but pain medication like NSAIDs could worsen other things like leaky gut.
A more holistic approach is to:
- Practice relaxation techniques such as deep breathing, and maintain a consistent sleep schedule.
- Address nutritional deficiencies. Common deficiencies like low vitamin B6, calcium, and magnesium have been linked to worsening symptoms.
- Drinking alcohol and salty foods can also worsen PMS symptoms.
- Bioidentical hormones can help with these symptoms if they are needed.
There are several approaches hormonally that your doctor can take. Progesterone, estrogen, or thyroid could be the issue worsening your cramps It is important to find yourself a well-trained functional medicine doctor to accurately test your hormones and recommend appropriate treatment.
Waking up for no reason
If you wake up for no reason, it may be due to stress, anxiety, or an underlying health condition such as sleep apnea. As I mentioned above, there are many things related to our stress response that can trigger a surge of cortisol into our blood stream and cause us to wake up for no reason. In my detailed article about stress; I’m tired and I can’t sleep, I talk about the different ways our body senses stress and some actionable steps on how to mitigate them.
To address this, there are several things we can do for ourselves. The first is identifying the mental triggers that are causing us to feel stressed or feel anxious. Once we identify them, try to reduce the stimulus or avoid them as much as possible to give ourselves breaks to recharge. In your off-time, do your best to stay away from electronics and try to practice occupying your time with a long walk or listen to some music while catching up on chores. Lastly, I would recommend working out or trying to stay active. You may find it difficult to meditate or practice deep breathing exercises, but may do better with activity to get your mind off of certain things.
In conclusion, waking up in the middle of the night can be disruptive to your sleep and leave you feeling tired and fatigued the next day. However, addressing the underlying health reasons behind your waking up can help improve the quality of your sleep.
What if I have multiple issues that cause me to wake up?
As a holistic sleep consultant for adults, I find that we often have multiple reasons that cause wake up in the middle of the night. We can target a long game plan and a short game plan. Short game would be tweaking your wake up with small changes like minimizing water intake 2 hours before bed, practicing nasal breathing, and perhaps mouth taping. The long game would be to hire a coach that could help minimize other stressors that are causing these problems in the body.
Also, a well-trained functional medicine doctor can help you by taking an in-depth look to find nutritional deficiencies, hidden pathogens, and underlying physical stress issues. By implementing these strategies and addressing any underlying health conditions, you can enjoy a restful and rejuvenating night’s sleep. If you are wanting to work with someone to help walk you through the process of self-healing. Reach out! I offer a free 15-minute discovery call to see if working together suits us both.
To Healthy Sleep,
Dr. Zeke Medina