Why Do You Wake Up at Night?

There are two kinds of insomnia: difficulty falling asleep, and difficulty staying asleep.

If you’re reading this article, you probably already know most of the sleep hygiene recommendations. If not, here they are. These are the activities that tend to help you fall asleep, primarily. But what makes you wake up between midnight and 4 am, wide awake?

Blood Sugar Dropping

You might have hypoglycemia (low blood sugar) if you wake up in the middle of the night wide awake, though not necessarily worrying or thinking about anything. Hypoglycemia (in non-diabetics) can happen for a few reasons:

• You eat too much sugar/white carbs, especially not counterbalanced with protein or fat. This sets off of cycle of glucose instability. Repeat this cycle too long and too often, and you end up with insulin resistance, metabolic syndrome, and eventually diabetes.
• You’re in adrenal fatigue. Cortisol, the main hormone your adrenals produce, is responsible for keeping your blood sugar stable between meals. In adrenal fatigue, your adrenals aren’t producing as much cortisol as they should, and you tend to get hypoglycemic.
• You have candida. This kind of goes back to the first bullet point—you eat too much sugar/white carbs. Only in this case, you’re not doing it because you crave it, so much as because you’re feeding a little organism that craves it!

At night, you’re supposed to be hibernating, essentially: your heart rate slows, your body temperature drops, and you burn fat instead of glucose. But if your blood sugar is unstable during the daytime, and you find yourself craving carbs every few hours, the pattern will continue at night. When your body doesn’t get the glucose fix it’s come to expect, it triggers adrenaline and cortisol to stabilize you—but those are stress hormones. And now you’re wide awake.

Eating simple carbs at bedtime is about the worst thing you can do for this pattern. Instead, try eating a snack high in protein or in fat. And better yet—focus on stabilizing your blood sugar throughout the day, by eating a low simple carb, higher complex carb, protein, and fat diet. If you’re getting enough of the latter two macronutrients, you will likely find that your blood sugar stays stable enough to just eat three times per day. (But if you have candida, you probably will need to kill it too.)

Spinning Thoughts

If you wake up in the middle of the night trying to problem-solve, it’s less likely that your issue has to do with your blood sugar, and more likely to lie somewhere in the intersection between lifestyle and neurochemistry.

On the lifestyle side: very often, people who have this problem are really busy Type-A overachievers, and/or they spend most waking hours overstimulated. If this is you, you might have a variant of ADD/ADHD called ADT (Attention Deficit Trait). It’s more condition than diagnosis, and (the good news) reversible with a few key changes:

• Make a list of priorities for each day, and keep it short.  If everything is a priority, then nothing is.  A list, even one you have created yourself, keeps you from the moment-by-moment crisis of wondering which task to attend to first.  If the priorities aren’t immediately apparent to you, just pick something.  Write it down, and stick to it.  Cross off the tasks as you complete them, so that you can see that you’re making progress.
• One task at a time, and in bite-sized intervals. My favorite way to handle this is via a spreadsheet.  For big tasks or projects that will take more than one day to complete, I structure my time in hour increments, two at most, before I move on to the next project or task – whether I’m finished or not.  While attending to a task, though, it’s important to do your best to prevent distractions.  Close Facebook.  Close GoogleChat.  If it’s an option, turn off your phone.  Structure time at regular intervals to check email and voicemail, and only do it during those allotted times.
• Schedule time for yourself every day, and guard it. Treat this time like an appointment.  It’s not negotiable.  Try not to set too many expectations for this time, either, or it may become just another “task” – if you spend half an hour just staring at the wall at first, that’s fine!  The point is just to slow down.  Eventually, you will fill the time with activities that you look forward to every day.  Remember, it is your responsibility to take care of yourself – nobody is going to do it for you.
• Meditate. Seriously. Nothing else works to ground you in the present moment (exactly where you need to be for sleep!) like meditation. If the word scares you, I recommend you check out this article for more on what it is and how to do it.

On the neurochemistry side: the hormones and neurotransmitters frequently associated with anxiety and stress include epinephrine and norepinephrine (aka adrenaline: the fight-or-flight hormone, which will later spike cortisol—see the adrenal fatigue mention above), and imbalances such as too much dopamine, too little serotonin, or too little GABA. Of course, ADT and overthinking can lead to chemical imbalance, and vice versa… so recommendations above still apply. But these imbalances do have certain signatures to them. For instance:

• Too much adrenaline can cause sweating, a racing heart or palpitations.
• Too much dopamine or too little serotonin can cause overthinking, or worry.
• Too much glutamate and too little GABA or glycine can cause a generalized anxiety: the kind where you’re scared or anxious but don’t know what about.
• Too much cortisol (and therefore too little melatonin) usually just means you’re awake but not feeling anything in particular… you’re just awake.

To differentiate between these, I generally run a salivary cortisol test and/or a urinary neurotransmitter test, though sometimes I’ll diagnose clinically if it’s really obvious! These tests really help us to get on top of your particular cause of insomnia. From there, we correct with the appropriate amino acids, between meals, and the correct cofactors to help balance out neurotransmitter production. 

The Upshot:

• Balance your blood sugar. Eat meals low in simple carbs, and higher in protein and fat content–especially right before bed.
• Start meditating. If you’re not already, this is a fantastic idea for stress relief. Go to the app store if you have a smart phone: there are tons of free guided meditation apps to choose from.
• Start to prioritize and create a to-do list, and stick to it.
• Consider salivary cortisol testing. 
• Consider neurotransmitter testing.