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The Power of Sleep

Most people do not sleep nearly as well as they should. They toss n’ turn throughout the night. They wake up and can’t get back to sleep. They lay there for hours trying to get to sleep or get back to sleep. Even getting up to urinate is not normal. And if you take one of the many sleeping pills to knock yourself out then you’re really depriving yourself of some quality zzzzz…..

If you sleep well you most likely take it for granted, while many people out there would do anything to fall asleep in a short matter of time and stay asleep until morning. A restful night in the sack will do wonders for your health and mental and physical performance. Sleep and health are directly related to one another – the better your sleep, the more healthy you will be, and the more healthy you are the better you will sleep. Are you really sleeping as well as you should be? Look at the recent death of pop star Michael Jackson. He took Propofol to knock him out every night. And I say “knock him out” because he surely was not getting restful sleep taking that drug. And when that wasn’t available he took up to 10 Xanax pills a day. (Some reports claim as high as 40!) Xanax works by increasing GABA in the body – the most powerful inhibitory (calming) neurotransmitter in the human body. Actually, most all sleeping pills such as Ambien, Lunesta, and the many others work via GABA. Taking one of these pills to help you sleep is obviously not addressing the problem. Wake up and read on…

Quality Sleep

Many individuals do not get enough quality sleep. I say quality, because quantity is not always a good predictor to justify if you are getting the benefit of sleep. Some people sleep six hours a night and feel great while others may feel the need to sleep ten hours only to wake up tired. What is normal? Basically it comes down to this: You should fall asleep in a relative short period of time (such as less than 15 minutes). You should not wake up, even to go to the bathroom once. It doesn’t matter how much water you had to drink. (I hear this one all the time: “I drink a lot before I go to bed so I have to get up and pee at 3am every night.” Very rarely are these related.) You should not be tossing and turning thru the night. You should wake up rested and feeling good, (that also means pain free). Now – here’s the disclaimer on what is normal to wake up to: Barking dogs, the pet(s) on your bed, your significant other snoring (not normal for them though), or possibly crushing you in a small bed, that street light shining in your eye, your neighbor shooting off fireworks at 2am, your kids waking you up, hurricanes and other forces of nature, and any act of war….well, you get the point.

Stress & Your Adrenal Glands Affect Sleep

The quality of sleep has a lot to do with the adrenal glands. For my regular readers, you know how important the adrenal glands are and why they are the overworked and underpaid hormonal glands. I’ve talked extensively about the major stress hormone secreted by the adrenal gland, cortisol, in other articles. (You can search adrenal glands using the search bar on this site.) Cortisol is normally highest in the morning (6-8am) and then slowly lowers itself throughout the day until it is at its lowest around 11pm – midnight, ensuring a restful sleep. Fluctuations in this cycle can wreak havoc on sleep cycles, particularly if cortisol levels are high in the late evening. Individuals under high stress and athletes training too hard have a tendency to output high cortisol levels throughout the entire day. Even going long periods throughout the day without eating will increase cortisol levels, as will a diet too high in carbohydrates. Many times these individuals feel as though they do not “need” more sleep because they have so much energy. They may feel hyped-up and always on the go. Often we call this “tired and wired” as they need coffee to get them going in the morning and then they are more productive in the evening (night owls). Many people resort to alcohol to calm them down at night. (You can say it winds you down if that makes you sleep better; yes the pun is intended.)

Some individuals, often from prolonged unresolved stress, have low cortisol levels throughout the entire day. They go to bed exhausted and wake up still tired. Exercise usually gives them a jump-start to get them through the day, as does coffee or maybe some pharmaceutical drug. This is also an adrenal gland dysfunction problem.

Then, there are the individuals whose cortisol levels are out of rhythm with their internal body clock. This is very common, especially in overtrained athletes, heavy stress, long hour job, or people eating poorly throughout the day (going more than 5-6 hours without eating or too many refined foods). Their cortisol levels may be fine all day long until the night, when it spikes instead of drops. This could result in just laying there in bed counting sheep while others may fall right asleep yet they wake up in the middle of the night, say around 2-3am. They might lie there for 10 minutes or 2 hours, until they are finally able to fall back asleep. Something is tripping the sleep-wake cycle that needs to be corrected. The most common reason for this is due to a spike in cortisol, (think of it almost like adrenalin, but not as powerful), as well as epinephrine (adrenalin), due to a drop in blood sugar. Your body increases epinephrine levels when your blood sugar drops too low so it can pull glucose (sugar) from glycogen (stored sugar) from your liver. Your body will increase cortisol to break down valuable anabolic (tissue building) amino acids from protein to convert into glucose to elevate your blood sugar. That surge in either stress hormone will wake you up. And you may wake up hungry, or not.

I find it rather funny that there is a diagnosis out there called Night Eating Syndrome. There is actually a study going on at Duke right now to learn more about this. What a waste of time; what a waste of money – not to belittle anyone with a true disease. Guess what – if you’re eating at night it’s because either you’re not eating enough during the day, or you’re not eating enough of the right foods during the day to take care of your nutritional needs. So at night you’re trying to play catch-up because you depleted yourself all day long. And you’ll pay for it during sleep too. Instead of being anabolic (rebuilding tissue and healing organs), you’ll be catabolic (breaking down sugars and muscle to give you energy). Next thing you know you’re up buying a ShamWow at 4am. (I heard they’re actually pretty good though.)

Waking Up at Night to Go to the Bathroom

Another common sleep problem many people experience is waking up in the middle of the night to urinate. Normal? Rarely. I always use that as a sign to tell me that something is just not as quite right as it should be with the patient. Something is up, (other than yourself at 3am), and again, it is most often due to some physical, chemical/nutritional, or emotional stress stirring up your adrenal glands. Vitamin B1, (thiamine), is the most common nutritional deficiency that can cause this, or help resolve the problem. But this article isn’t necessarily telling you to take it.

Aldosterone, another adrenal hormone, is responsible for mineral balance in the body (sodium-potassium). It is higher at night, opposite that of cortisol. High aldosterone means that sodium is retained, which also means that fluid is retained. This means that you sleep better since the dreaded walk to the bathroom isn’t needed. A low aldosterone at night means you are going to have to get up and go, literally. But at first you have to lie there and wish it to go away; that is some unwritten law that I can’t explain to you.

Another reason for frequent nighttime urination is from lactic acid, usually from a hard (anaerobic) workout, irritating the wall of the bladder. This irritation will cause you to wake up and urinate, but often results in low urine volume. That is when you think to yourself, “I got up for this?”…only to return with a similar outcome a couple hours later. For you men out there it is important to note that frequent urination and especially that of low volume can be due to a prostate problem. That is not something you want to ignore. You can read more about this in my prostate article.

Snoring & Sleep Apnea

Snoring – definitely not normal – and if you’re to the point of sleep apnea and a CPAP machine, well, you’ve got some work to do. Snoring can result from many problems – hormonal issues (as mentioned above), inflammation, irritation to the digestive tract (from a food sensitivity, medication, or gut fungus/yeast) – to name a few. I tend to look at snoring as a sign that something is not right and needs to be corrected. When someone’s health improves, so does the snoring.

Waking Up at the Same Time Every Night

Another common sleep problem that people have is waking up at the exact same time every night. They will say, “I wake up at 2:55am every night”, or “I can’t get to sleep before 1:00am.” When specific times are involved this has to do with the acupuncture meridian system and its relationship to certain organs at those times. 11pm to 1am is the time when the gallbladder is at its highest energy. So if a person has a problem with their gallbladder, (too many bad fats, smoking, caffeine, etc.), then they often can’t get to sleep between those times, or if they are asleep before 11pm then they may wake up during that 2-hour cycle. Between 1am and 3am is liver. This is the most common time a person wakes up and is due to many reasons. As noted above, when cortisol or epinephrine levels elevate to pull sugar from the liver, this will wake the person up, as it taxes the liver as well. Also the liver has to deal with detoxification of hormones, such as cortisol and estrogen, leading to more work for the organ at that time. Medications will result in a similar problem, maybe even the same medication you’re taking to get you to sleep! 3am to 5am is lung – so think breathing difficulty, and sometimes sinus problems (allergies) can show up here too. And 5-7am is large intestine. Though many people wake up during this time I’ve often heard someone say, “I can’t sleep past 5am no matter what,” or “It’s like I’m just wide awake at 6am even though I don’t need to get up until 7am.” Their large intestine (colon) is irritated – most likely from a food sensitivity/allergy or some dysbiosis (bad gut bacteria), or gut fungus/yeast.

So what can you do about all this? Well, like all things I talk about, sleep problems can be resolved with proper treatment, lifestyle, diet, and exercise modifications. Hormones such as cortisol and estrogen can be measured though inexpensive yet highly accurate saliva tests. Here is a short case history as a common example.

Ryan was a 25-year-old runner who came to my office for knee pain on the inside of his right knee. During the history, he told me that he frequently wakes up four to five nights a week and stays awake for about an hour before he can fall back to sleep. He also got dizzy when he stood up. (Both dizziness upon standing and knee problems are also common adrenal gland related problems.) His adrenal glands were treated through various therapies and his diet was adjusted accordingly. He was training too anaerobic, and he often worked out late in the evening when most anaerobic workouts should not be done, which was raising his cortisol level too high for him to stay asleep. He began training aerobically and earlier in the day. He returned the following week noting that the dizziness was gone and he was sleeping through the night, all but one night that week. His knee was significantly better, and took just two more weeks to return to full function.

A Healthy Sleep Environment

Lack of quality sleep really takes its toll on a person over time. Here I briefly described a few very common and very treatable reasons for not getting a good night’s rest. There are many other sleep issues that can be discussed – from the use of melatonin and pineal gland function to brain waves, as those done during sleep studies, (which I often find to be unnecessary unless other issues discussed here have been investigated fully, or to get a person on a machine for an apnea crisis). But a few last important notes on sleep:

  • Your environment. Make sure it is dark. The pineal gland which secretes melatonin so you can sleep is turned off by light sources. So the darker the room the better. Many also recommend removing major electronic sources from your room – particularly the TV. (I have a small battery clock by my bed – that’s it.) Many people have resolved their sleep problems by removing their TV or their giant LED clock on their nightstand.
  • Next, shoot for going to bed around 10pm, or 11pm a the latest. It’s true that you’ll sleep much better if you sleep more in line with the sun. Sleeping eight hours from 10pm to 6am is much healthier than 12am to 8am, and so much better for you than 2am to 10am. The later you get to sleep past 1opm, the worst off you’ll be.
  • Your mattress: I’ve never seen a particular mattress work better than another. As long as you are comfortable then it should be fine. The only mattresses you should stay away from are the ones that contain magnets – either in the mattress or under. These are major endocrine system disruptors and although many say they sleep great on them it’s because they’re suppressing their entire hormonal system and sedating them heavily. That’s not a good thing.

More sleep problems, such as bruxism (grinding teeth), growing pains in kids, and RLS here!
New article (Feb 2013) specifically related to bruxism here.

Dr. Gangemi

177 Comments

Leave a comment
  1. Brianne permalink

    I wake up anywhere from 2-5 times per night.
    I wake up not really feeling like I need to pee but I cant fall back to sleep unless I get up and go. I return to bed and fall asleep almost immediately.
    If I dont get up and go then I lay there feeling like my body is waking more and more until I finally get up to go.
    I dont even feel the need in my bladder to go!!!!
    Makes me crazy!!!
    Im can not remember the last time I slept through an entire night.
    I am only 25 years old.

    • That’s no fun Brianne. Best on-line advice I can suggest is that look to where your stress is coming from. That could be emotional stress (work/family), nutritional (diet – carbs/caffeine/food sensitivity), or physical (pain/past injuries). These are things I have ways of figuring out in the office but w/o seeing you it’s pretty much impossible to pinpoint or even be more specific. Hope that helps though.

      • Brianne permalink

        Thanks for your response. :)
        The only interesting thing that comes of this is that I experience vivid Wake Initiated Lucid Dreams. I have only just realized this though… its been happening for years with no conscious effort and I didn’t even know what was going on. Only just this week I looked into what was happening and found lots of information. Im pretty fascinated that people put effort and imply various techniques into experiencing this state when it happens to me naturally on a regular basis with no conscious effort or awareness.

      • SANDY permalink

        HELLO, IM HAVEING TROUBLE SLEEPING, I FALL ASLEEP EASY BUT ONLY SLEEP A SOILD 4 HRS WAKE UP NOT GO BACK TO SLEEP TOSS AND TURN UNTILL TIME TO GET UP. IM EARY TO BED AND EARLY ARISE.IM IN BED BY 8:30 TO 9:00 PM UP BY 5:00 OR 6:00AM MY NORMAL DAY. IM HEALTHY PERSON EXCEPT FOR THIS. I WALK EVERY DAY, EAT RIGHT, DRINK NO SUGARS. MY BODY/MIND NEED REST. WHAT CAN I DO TO GET A GOOD NITES REST? SANDY

        • That is common (not normal). Read through all the comments. I really can’t offer any more specific advice other than what I have given in the comments & article.

      • Hi,
        I have major health issue.
        I have herniated lumbar disc and snore during sleep, have AIR MASK. Waking up at around 2:30am and have trouble going back to sleep while have air mask on. I’ve been going to yoga but still I wake up at 2:30am.
        By the time, time to wake up began to sleepy.
        I was wondering if air mask doesn’t help and still waking up at night, can’t fall back to sleep, I must have some type of hormonal imbalance.
        I am in late 40s and I heard many women have sleep issues.
        Need your good advise and would greatly appreciated Which type of doctor could help my problem? Greatly appreciate your help. Thank you

  2. My best friend… who is only 14 is going to bed at a decent time.. but wakes up at 3am and can’t go back to sleep till around 6am and has to wake up at 7am for school… her and I are both wondering.. is that Bad?? or even normall for a teen to go through this???

    • That is not normal and not healthy. Waking up at 3am is usually from something stressing out the liver (think sugar, maybe caffeine, or a medication for a 14 year old).

  3. Hi Ron. I can’t give specific advice here, sorry. Other than the general recommendations I have in the article you have to try to figure out what is causing your stress and keeping you from not sleeping well. Obviously make sure your room is pitch black; that can only help. Unfortunately most doctors don’t know how to treat sleep problems other than with meds.

  4. Marisa permalink

    Hello,

    I have had sleep disruptions in the past, lately they have started up again. I am waking up at 1 am every night…and tossing and turning for at least an hour and a half until I resort to xanax to help me relax and get back to sleep. I work 6am until 3pm so I get up around 4:45am. At night I start to feel tired around 7:30/8:00pm…so exhausted that I go to bed and fall into a deep sleep until 1 am on the nose! For the past few days I have taken melatonin before bed, again I fall asleep fast, but can’t stay asleep. I thought it was psychological that I’m worried about feeling tired the next day so I start to get anxious. I reeeeallly don’t want to take xanax every night…what can I do???

    • Hi Marisa, problems like this really need to be sorted out either via treatment or perhaps a phone consult, to see what may be triggering your sleep problem. 1am often means something is taxing your liver, (which could be the very same medication that is initially helping you get to sleep).

  5. Sean permalink

    Dr. Gangemi – this is the BEST article I have ever read on sleep!! I suffered from insomnia starting in my late 20s and am always looking for ways to cure it. So thanks for educating people on sleep hygiene and explaining to people how the body actually works to promote sleep. I have the night-time urination issue and sleep onset took too long. Then I discovered it was becuase I was going out for my jog too late in the evening (8-9 pm). So now I don’t do anything close to bed except for washing dishes or going for a light walk and it seems to be working. You rock!

  6. Isaac permalink

    Hey, I have been on Lunesta, it works slower than ambien but with less side effects to me..
    I work out everyday, would not call my self an athletic, I do have a lot bread for breakfast and lunch -is that too much carbs_
    I am so hyper at night, I feel as if I could run a marathon. I tried going to gym at lunch time instead of night, but its actually best for my sleep to do work out nigh.

    The question would be: what diet would you recommend to keep those levels of cortisol to allow me to slrrp fast and deep feeling amazing durin the day!!
    Can you give a very specific diet to follow; thanks”

    Great article!!

  7. Ryan permalink

    I’m 26 and for the last week or so I have been waking up around 3:10am to 3:45am. Once I’m up I’ll toss and turn for about 15min which in turn wakes my girlfriend up. I then throw on a movie or music and fall asleep after 5 minutes. When I do wake up in the middle of the night I feel really cold and my chest feels heavy at times. My girlfriend has also informed me that I snore very loud. My typical day is driving 45min to work where I’ll have at least three cups of coffee. Five-O-Clock hits and I’m back in the car. When I get home I’m too tired to do anything and watch movies until around 8 when I have dinner. I try and stay up late so I can sleep through the night. What can I do to to prevent this?

  8. Lemon permalink

    Dr. Gangemi, 4 days ago I had a very high fever, caused me to wake up at night just to pee, almost every 10-15 minutes, I could never even get 30 minutes of sleep, now my fever is gone, but I still keep waking up to urinate at night, for around 8 times at most. The longest sleep I’ve had since my fever healed was an hour, and I think I keep peeing at night due to stress because I haven’t been sleeping almost at all for 4 days. Do you think that there could be another reason or is it really due to stress?

    • Could still be your body recovering, especially from the stress the infection puts on your liver. Certain nutrients sometimes can help with this but it would be impossible for me to know what might work for you. One nice little thing you can do without any harm is sip on some lemon juice. Take 1/2 of the juice of a fresh lemon and mix it with about 4-6 oz of water. Then you want to sip this (don’t gulp it down) say over the course of a half hour. Try it closer to the evening and see if it helps your sleep. If it does, you can do it more frequently throughout the next couple days until you’re sleeping well again.

      • Lemon permalink

        Thank you very much! I’ll try that immediately and I’ll update you on what happens, Thanks again!

  9. Cindi permalink

    hey, my question is..
    I wake up every morning around the same time, around 4ish before I start my day; my question is, after I wake up around 4ish I wake up due to my bladder because I really have to go pee! how do I stop waking up around that time every morning because I have to go pee? and I go pee before I go to bed but I still get up around that time; what kind of diet would you put someone on that weighs 4’11” and around 132ish but has trouble loosing weight? and doesn’t drink soda; trying to loose weight because since they were on depo shot they are having a hard time of loosing weight?

    oh and its a girl, that’s having trouble loosing that weight; she’s 20 years old.
    thanks.

    • These are hormonal issues. I cannot give you more specific advice other than that is here throughout this site. Since it started after the Depo shot, her thyroid could have been affected, as well as the adrenal glands.

  10. Bronwyn permalink

    Hi,
    Im a 20 year old girl and as far back as i can remember ive not had a full nights sleep. Ive always got up at least 6 times a night and often still wake up before my alarm. When i wake up it varies between 10 minutes and an hour and a half (occasionally 5 minutes of awake time) before i fall back to sleep. Theres not a set time i wake up each night. I never need the toilet when i do wake up. Every time I fall asleep I get one of 3 nightmares that “play” then right at the end it tails of and a dream starts. (i’m not sure if that has anything to do with it) But take last night for example i had 6 hours of “sleep”. I got up at 2 n couldnt fall asleep till 2 30 got up at 2 45 think it was about 3 i fell asleep got up at 3 30 till 4 30 then got up at 5 just for about 10 mins then got up at 5 30 till about 6 then i got up at 6 10 6 20 6 30 6 40 6 50 n then 7 and just gave up then.

    • When I hear someone complain of nightmares and waking up at 2am (even though you wake up more after that) I always think of something that’s making the liver toxic. Even though you’ve had this for years, now at age 20 think hormones (are you on the BCP?) – or any other medication you’re taking, including NSAIDs. Also diet plays a big part – bad fats, sugar, caffeine. That’s where I’d start looking. Heavy metal toxicity could be something to investigate too – more on that under the Health Topics.

  11. arif mustafa permalink

    what are major side effects of taking xanax.5 including any deficiancy in sex

    • Rather than think about side effects of sleep meds, or any drugs for that matter I suggest you look at medications another way. With rare exception, (such as antibiotics when truly necessary and certain life-saving medications), healthy people will not see any benefit from taking such medications and will often see other health problems result from taking them. Call them “side effects” if you want – but it’s really individualized as to whether you’ll have a headache, fatigue, mood swings, or low libido and it doesn’t matter what the pharmacist, doctor, or drug insert say are the common side effects because if you’re healthy you’ll have some problem. And if you feel better taking the medication well then you’re not healthy.

  12. Shawna permalink

    Im 38 and in 2006 I had weight loss surgery I lost 139lbs and for the past 3 years I have been on sleeping pills to get to sleep. For the past month I fall asleep then every night between 3 and 315 in the morning I wake up. I take my ambien every night I dont understand why I am waking up every night at the same time. I just got married and my husband says I wake him up at 3am he says I jump awake. I am so drained at work during the day could this be my sleeping pills?

  13. DAWOOD permalink

    Hi I a 38 years old and have difficulty sleeping, i had a acute rhinitis sinus infection took lots of decongestants and was put on aumentin . During the ordeal of the infection i used to wake up at 11:30pm with hear racing and sweats , to go to the toilet. i have fininshed my course of antibiotics and week later still have the heart racing and problem falling off to sleep. I am takin tumeric milk with ginger and honey, and no help. With my heart racing i cannot fall of to sleep until its almost time for me to awake at 05:30am.

    Please doctor assist me cos it is starting to take a toll on my life.

    • That’s not uncommon and from the toxicity on your liver and gallbladder caused by the antibiotics. If you were a patient, I’d be able to figure out specific nutrients to give you to help this out and resolve it quickly – but you’re not – so try some lemon juice. Take 1/2 of a fresh squeezed lemon in 6oz of water and sip it for the one hour before you go to sleep. See if that helps over the next few nights. Also make sure you get out all the bad fats in your diet (discussed throughout this site) and refined carbs too. Caffeine and chocolate too. Hopefully you don’t drink alcohol or smoke – those will really do a number on the gallbladder and liver.

  14. Eve permalink

    Hi! This is a great article, although I am not sure how much should it be trusted. I’ve slept at 9.40pm the night before and I’m now wide awake at 2am. I’ve been jogging in the morning yesterday after a full 8 hours rest, and eaten 3 proper meals with snacks in between, yoghurt at night with honey and apple cidar vinegar. I wonder what’s happening?

  15. Evan Hobbs permalink

    Hi Dr. Gangemi,

    Was just reading your article about sleep and came across this. My problem (among others) for years is that I wake up at some point in the middle of the night or early morning with low blood sugar and there is just about no way I can get back to sleep. BUT if I go eat something sugary or carb-rich it’s like a sleeping pill that completely knocks me out. The catch is that then I sleep like crap, can oversleep, and wake up feeling drugged and groggy… I have experimented a fair bit with paleo diets and the problem I have is when I restrict my carbohydrates I can’t even fall asleep at night… I can lie in bed for 2-3 hours waiting to fall asleep on a low-carb diet and the go eat a couple pieces of bread and fall asleep quickly. Just curious how this squares with your article. I eat a lot and have even tried eating more at time to no effect… Even on the times when I am able to sleep through the night I will often wake up completely starving.. Anyway I don’t know if this is the cause or the symptom but it has progressed such that foggy, tired, and slow most of the time…

    Thanks for any thoughts you have!!

    • What’s knocking you out with the carbs is the insulin surge – and that’s why you feel groggy. It’s not that eating low carb makes it so you can’t fall asleep you have to look at it that high carb makes you pass out. There’s a difference. Low carb just reveals some problem that you’re not addressing. It’s like saying I only have energy with caffeine and if I don’t drink caffeine then I want to nap all day.

  16. Adela Buzescu permalink

    Hi dr. Gangemi,
    I was diagnosed with adrenal exhaustion, my morning cortisol is still on range but on the lower end, I have low DHEA, low vitamin D and low testosterone along with estrogen dominance symptoms at 42 years old but these have gone away once I was put on progesterone cream. What bothers me the most and it will stop me from recover is not getting good sleep, I either have troubles falling asleep, or staying asleep, or if I fall asleep I wake up to go to the bathroom so many times that it drives me nuts. Or I wake up and cannot go back to sleep no matter what. I follow a low carb diet with plenty of grass fed and pastured meats, eggs and some raw dairy. Mostly organic vegetables and fruits and very rarely any grains and If I eat grains, only properly soaked, I generally follow the Nourishing Traditions guidelines and also include lacto-fermented vegetables and drinks into my diet. I take some supplements for the adrenals (licorice extract, adrenal assist by Vitanica), fermented cod liver oil, wheat germ oil, bee pollen, amla powder, turmeric, kelp and magnesium daily. I take some slow release melatonin at night but I haven’t noticed even the slightest improvement in my sleep pattern in the 3 weeks that I’ve been taking it, if anything, since I started the progesterone cream, the melatonin and the adrenal supplements, my sleep has gotten worse.I am taking time off from work for 4 months, it’s already been a month of staying home and relaxing, planting flowers and taking walks outside and still cannot sleep and really do not understand why. I have this sort of feeling of restlessness, almost like a panic attack that lasts for hours, I retain water so much that my legs and arms hurt. I am nowhere close to you so I would appreciate if you could at list direct me to someone who can help me re-balance my hormones. Thank you so much for posting these great articles.

    • You can send me an email and let me know where you live and I’ll see if I know of a qualified doc in your area.

      • offor chubby permalink

        Pls Doc, I’m having this problem of insomia for two months now. I sleep and wakes up at 2am. I have catarrh that have lasted for over a month and also a burning sensation just at my back just on my ribs on the right hand side. Tell me what you think about this. Thanks

  17. Kristine permalink

    Hi there,

    Great article! Very informative.

    At the moment I’m doing a figure competition. Training twice a day, and carb cycling. Still having fats in my diet such as cooking with coconut oil and organic butter and supplementing with good quality fish oil and Vit E.

    I’m waking up every night to go toilet though about 2:30 or 3 am. If I concentrate and ‘put myself to sleep’ I’ll go back to sleep other wise sometimes I’m awake for a couple hours if my mind starts wandering. Regardless if I go back to sleep or not I still seem to wake up at about 5am again.

    Very frustrating as at the moment I feel I need all the sleep I can get. I drink two cups of organic coffee a day and I try to make sure I don’t have them after training or after 3pm.

    Any suggestions on what I could do to sleep better? Or will this just continue till I finish the competition and get back to eating normally and training less.

    Thanks again for sharing such a helpful article

    • Kristine permalink

      If you need a bit of background. I’ve been into my fitness and training for about 10 years now and has been low carb, high protein. Since learning about caveman style eating my diet has been paleo for about 2 years now with the exception of pre competition cutting carbs to only having 50g of sweet potato and pumpkin every 3rd day after training and having minimal fats.

      I have had my aldosterone and ADH checked in the past as I seem to always be thirsty and then as soon as I go to the toilet I’m thirsty again. I’ve been tested for diabetes and thyroid as well and nothing seems to show.

      I’m happy to have a Skype consult with you and pay for your time if you do that or if you have a functional medicine doctor in Melbourne, Australia that you know of that you could refer me to that would be great as well. Thanks very much

  18. Great article! Something I have been teaching my clients for a while now – but you have elaborate on things I didn’t fully understand so thank you! Thank you very much, I have just forwarded your article on facebook to a few other health practitioners

  19. Adela Buzescu permalink

    Hi Kristine,

    I too was on a very low carb diet for the past at least 6 months trying to loose weight and I kept gaining. In the end I was diagnosed with adrenal burnout and have the same symptoms as you. Waking up many times per night to go to the bathroom and been very thirsty. Sleep was a huge problem until last weekend. I went back to the recommendations of dr. Diana Schwarzbein (look her up on amazon, you can buy the Program and the other one that has number II in the title). She advocates 3 meals per day plus 2 snacks with real carbohydrates: beans, grains, nuts, seeds. And follow the Nourishing traditions book on the preparation of nuts, seeds, beans and grains, they need soaking up overnight with a starter culture like whey in it. Dr. Schwarzbein explains that not enough carbs in the diet gets the body to make more adrenaline which further depletes the adrenals. All of us out here struggling with sleep have a faulty diet, either too many carbohydrates or too little or too little fats. We were lied to, all these stories with the evolution of the humans have something missing. Ever noticed how all these weight loss diets are painted as healthy? Two years ago when I tried this program I could not digest fats after years of low fat so besides the fact that I gained weight on it (which by the way, she says it would happen, in order for the metabolism to heal, the body will put on fat), I had trouble digesting fats because I did many stupid things, low fat, fasting, low carbing, you name it. So I went back to all I already knew from the Nourishing traditions to see what I missed. I had missed the lacto-fermented vegetables and drinks, in couple of months I was taking coconut oil by the spoon, eating everything full fat and never had an issue with digestion anymore, I also fixed my liver that was hurting all the time, the coconut oil dissolved in hot water with the juice of a half a lemon first thing in the morning along with half a teaspoon of turmeric daily took care of that. Then I wanted to loose weight because I kept gaining. I have to mention that I have a very stressful job, lots of deadlines and regulations along with exposure to highly volatile organic solvents that contributed to the adrenal burnout. And going on the Atkins diet at this moment only gave me a surge of well being for 2 months after which I completely collapsed, depression became obvious, I was crying left and right and they sent me home to take care of myself, I got 4 months to get better so that is the good part. But one month into it and I still don’t sleep even though I got the diagnose a month ago and got put on progesterone cream as the body was stealing progesterone to make cortisol and even with the progesterone cream I wasn’t making enough cortisol. I also got put on licorice extract and a supplement with more herbs (Adrenal assist) plus I am taking cod liver oil, amla fruit (vit C), turmeric, kelp and bee pollen. I eventually got worse, started waking up 7-10 times a night to go to the bathroom and became completely miserable. That was last Friday. On Saturday I quit taking the herbs for the adrenals, started drinking water with Celtic sea salt, Saturday night I slept better, still woke up a few times and was still thirsty, Sunday I slept even better but my back was killing me, I went for a massage and the guy opened my eyes, I needed strength exercises so I picked up one of the books on the Schwarzbein principle (there’s a website too, but read the books, don’t jump on spending money on tons of supplements, your best medicine is food so try that one first) that shows some pictures with what needs to be done in terms of exercise and surprise, Monday night I slept, only woke up ONCE to go to the bathroom but still woke up very early, 5.45 am. Tuesday was the same, woke up at 5.45 am and today I still woke up at 5.45 am but went back to sleep again. I’ve been following the diet since Saturday along with inhaling some lavender oil before going to sleep as she recommends in the book. Obviously it is to early to draw a conclusion but I think this is the way to go, I ordered one of her DVD’s with the work-out and will keep you posted, I will spend the summer in Romania with my parents and my kids but I will follow the diet and everything else very closely now that I have the time. Forgot to tell you: The scale is now moving slowly DOWN for the first time since 2010 and that after I put on over 40 lbs. So maybe I was closer than I thought but the Atkins diet ruined everything even though I was eating plenty of vegetables and only grass fed and pastured meats, eggs and dairy but very little nuts and seeds. Better late than never. Good luck to you all, please feel free to email me, I have a hotmail address for abuzescu if you have questions.

  20. Barb permalink

    Ok so I use to be a really good sleeper until about 9 months ago. I have been divorced for 5 years and 11 months ago I met a wonderful man and fell in love with him (a feeling I have never felt before, not even with my ex) so it was one of those situations where I couldn’t eat, was happy & excited, etc. He was the 1st thing on my mind when I wake up. I would kinda go to bed late because we would text back & forth and I would have to get up early with my kids for school. This usually was not a problem for me as I work 2p-10p and was use to going to bed late and getting up early, but I could also take a nap after the kids went to school if I really needed to. My problem is for the past 9 months or so I cant seem to fall asleep on my own and have “meaningless chatter” in my head. It takes me forever to fall asleep and I wake up a lot. The DR seems to think I developed a sleep anxiety and prescribed me 1mg xanax but i feel so tired the next day and i have tried to only take half but it still takes me forever to fall asleep and I still wake up often tossing & turning. I don’t want to take this medicine. I just don’t understand how you can go from being a good sleeper to not so good. Please help if you can

  21. Fatma permalink

    Hii Doc I am Fatma from Egypt i am only 15 years old i have school holiday now for very long time so i though about having a diet or something because i wanna lose weight but i do it on my own @ home then after days i realized i don’t sleep good i sleep 4 hours then i wake up again then after 4 hours sleep again i was wondering have that diet something to do with what i have or is it something else ?? Thank you very much

  22. sam permalink

    I’ve just started getting this problem recently, I normally stay up till 3/4am every night or sumtimes sleep near 2am, but I find that if I sleep befor 3am I wake up during the night, but now when I fall asleep I hav all these random dreams and wake up 1-2 times from it and find it harder to go back to sleep, and also hav pinz and needles in my hands and arms, and this is really weird because I am normally a veryy deep sleeper! Could it be caffiene? Seeing as I drink energy drinks nearly every day, Please help..

  23. wolfkid94 permalink

    Hi Dr Gangemi

    I’m a 17 year old who is currently having sleep problems. I would wake up at night and go to the toilet, and then find it very hard to go back to sleep – it often takes me one hour to do that. The whole problem seemed to start two months ago when I began weight training. Probably I have been pushing myself a bit way too hard and increased the level of lactic acid in my body , but I don’t want to stop going to gym entirely. Can you give me some advice ? I also want to be able to drink a bit in the evening and not waking up going to the toilet.

    To add a bit more information, I believe that I’m very unfit, both aerobically and anaerobically. I hardly ever go running at all. Should I build my aerobic fitness by going running and doing circuits with light weights first ?

    Also, I saw my doctor and he ordered me a renal function test, which came out to be very fine. But sometimes I have a little pain in my lower abdominal, especially after urinating. I think I also have a bit too much sugar in my diet.

  24. Dave permalink

    Hello Dr. Gangemi,

    Ive always been a light sleeper, but a few months ago i changed jobs at work, had to go in one hour earlier, and then we had a time change, so i lost two hours basically after i started.. Had trouble adjusting to the new schedule, thought it was getting better, but the last month or so its been awful. i can fall asleep, but i wake up at 1-3 in the morning and have trouble going back to sleep. Ive been to my dr. twice, and he prescribed two types of sleep aids. The last one seems to help, but i dont like taking meds, and cant do it forever. He tested my thyroid and said that was within normal range, so i dont know what to do..

    Sometimes when i wake up im hot for a bit, and then i cool off.. Im a 44 year old male. Could it be hormonal?

    Could it be from the schedule change, and if so, why cant i adjust to it?

    Im desperate to get this solved

    thanks

    Dave

    • It could be from the schedule change that was already in the works to occur but was triggered by the 2 hours you lost. People who suffer even when we turn the clocks ahead one hour are typically those with hormonal problems.

      Thyroid normal? Was just your TSH checked or also the free T3 and free T4? Usually it’s just a TSH (which should be between 1.0-3.0). Though even if your thyroid is normal there’s your adrenal glands to consider (most important hormone when it comes to stress) and of course testosterone and melatonin levels.

  25. Dave permalink

    So i should ask my Dr. to have those checked as well?

    Thanks for the quick reply. Ive never experienced anything like this before, and hope to never again

    Dave

  26. Animan permalink

    Hello doc.

    I have RLS and I kick around during my sleep.. But recently i have started waking up during my sleep for 5 mins or so and i again drift back into sleep.. i dont have any dreams. And I always dont want to wake up. however when i wake up, i feel very tired. Whats my problem.

    I am an 18 yr old boy from India.

    • Impossible to say exactly what your sleep issue is, hopefully you can get some ideas after reading BOTH sleep articles and perhaps changing your diet, sleeping area, or something in your lifestyle that is affecting your sleep.

  27. Manu permalink

    Hello Dr Gangemi,

    My dad always complains that he can’t go to sleep. He goes to bed by 9:30pm and gets up around 4 :45am, for work. He even goes for a walk in the evening before dinner. He says he keeps tossing and turning around but he can’t go sleep. Even if he goes to sleep it’s only for a short while. This has been happening for about 6 months now.

    Can you please help?

  28. Jessica permalink

    Hi Dr., I am 36 yrs old, I have no trouble falling asleep, but staying asleep is another story, I wake up at 1 am, for about a week, and then evetually my sleep cylce comes back. here is the thing, my son, who is 8, has to have his blood sugar checked nightly at 3am. I have been doing this for 5 yrs, i normally am able to get back to sleep after the 3am check, and i just go thru periods where i wake up and can’t go back, and then there are months were i have no trouble at all. But what can i do to avoid a 1 am wake up? Thank you

  29. Amber permalink

    Hi Dr. Gangemi,

    Recently I’ve been waking up in the middle of night to urinate. It seems like this problem started soon after switching from pill based birth control to depo (I got the shot a few weeks ago). Should I be concerned? Should I go see my doctor?

    Thanks!

  30. Peter permalink

    Hi Doctor,
    I am 35 yrs old. Till 10 days ago i had no problem getting good sleep. Off late every day i wake up at 3:30-4 am and find difficulty sleeping back, rather no sleep thereafter. I usually sleep at 11pm, and i have no problem commencing sleep. It leaves me about 5 hrs of sleep. Even if I try, I cant sleep at daytime. This problem leaves me fatigued, i have developed back pain and loss of concentration. I live in India and currently season is changing from summer to rainy season, whether this is the cause or there could be any other ailment. Please help.
    Thanks.

  31. Alicia permalink

    Hi Doc,

    I’ve suffered from insomnia for about 6 years now (since I was a young teenage) I am now 21 and still struggle to get sufficient sleep through out the night, I find that my insomnia would happen in cycles is the easiest way to describe it. It start off that for about a month to two months I won’t be able to fall asleep till around 2/3 am waking up at a regular time of 7.30/ 8 am. Then as the cycle progresses for another 2/3 months I would be falling asleep around 5. The next stage is that I would be falling asleep at around 2 am again but waking up 3 hours later this happen for about a month (That’s the stage I’m currently in) until I have what my mom refer to as a crash and for about 1-2 weeks, my body almost shuts down and I sleep for an average of 14-20 hours a day. My mom has been known to have to really roughly wake me up to have something to eat or go to the bathroom because she says that it almost like I’m in a coma. I have tried pretty much everything, I changed my mattress, curtains, eating habits, starting getting into bed earlier, my doctor recommended pilates to help with breathing and muscle control, I cut out all stimulants out of my diet and nothing. I may have a couple of weeks here and there where my sleep pattern is sort of normal but this rarely happen. I’m used to it now because it’s pretty much all I know but is this really abnormal?

    • Sounds hormonal – either adrenal or estrogen dominance, (if you take a birth control pill that would be the obvious answer). Otherwise you might look for a naturally minded doc who is good at figuring out hormonal problems (not an endocrinologist).

      • Alicia permalink

        I’m not on the pill but I do suffer from PCOS, could this be affecting my sleep?

        • Sure could – PCOS is tied in with insulin resistance and insulin – hormonal problems are closely related to sleep disturbances.

  32. Daniel permalink

    Dr. Gangemi,

    I recently found your website and subscribed to your newsletter. While going through your older posts, I found this one on sleep.
    I have many health concerns and I think one reason they just do not seem to improve no matter what I do, is that I am just not able to get a restful nights sleep.
    Every night I have to get up several times to urinate even if I don’t drink anything several hours before retiring.
    In your article you mentioned that Thiamine deficiency might be causing this. How can I verify whether this is the case for me? Is there any danger in just starting to take Thiamine in supplemental form in order to find out whether it is helping me? is there a particular brand of Thiamine that you do recommend? I suppose just eating Thiamine rich foods would not do the trick as one would probably have to eat enourmous amounts just to get a meaningful dosage.
    I would be grateful for any tip that you could give me on finding the cause of my nighttime urination.
    On a related note: Are you planning on writing a book sometime soon? There is so much unique health information to be found on your site, I really would like to see that in a book format.
    Also do you do distance or online consultations?

    Thanks a lot and kind regards,
    Daniel

    • Hi Daniel and thanks. Typically trying a supplement won’t hurt and there are many out there. Look for supplement without many binders and fillers. In my office I use certain “physician” brands so can’t recommend a specific one.

      Plans on a book one day. And consult info here: http://sock-doc.com/consult-with-sockdoc/

  33. Turnip permalink

    To control cortisol in the morning some recommend eating protein within the first 30 minutes of waking. Some recommend a 30 minute brisk walk right after waking. Do you know which one of these works better and can you cite any research to support your position?

    I also eat Paleo (for almost two years now) and the AI protocol but what I found is I only lost half the obese weight and some of the AI issues. Same was true of husband. The body adapts and tries other strategies to keep the weight on.

    We are now eating protein only and that is now helping my Fibromyalgia pain and Rosacea which were the hold outs as well as the remaining obesity. No matter how I tried to isolate a certain non starchy carb that was causing issues no certain carbs could be identified as the culprit. It was carbs in general that pushed the AI engine and obesity or leptin resistance. I do think there are some of us who just don’t do well on any carbs. I do wonder if Fibromyalgia is actually insulin resistance caused by non Paleo foods then leptin resistance happens and the fall out is where the muscles are needing glucose and the fat cells just won’t let go of it. The only way around it is to take out all carbs to improve leptin and insulin resistance?

    Some docs have known about carb free diet approach for decades. Have you read this book called Strong Medicine by Dr. Blake F. Donaldson who started treating patients just before WWI and learned early on in his practice about a Paleolithic diet approach? It makes for some interesting reading.

    You can read it here on line:

    http://babel.hathitrust.org/cgi/pt?id=mdp.39015003228171;page=root;view=image;size=100;seq=7;num=iii

    Some of it is antiquated but surprisingly enough there is a lot of solid stuff in this book that still holds true. They may not have understood the mechanisms but did understand what was working and wasn’t.

    Also in this book they found that if you lost more than 3 lbs a week that you were susceptible to wrinkles or sagging skin, is this true and can you cite any research supporting your position on what is the maximum amount of weekly weight loss which prevents sagging skin?

    Thanks!

  34. Chickenlegs permalink

    Hi Steve
    I’ve always had to get up at least once during the night to urinate. Then I read this and tried the lemon juice drink before bed and amazingly I sleep through the night unless woken up by the kids or outside noises. Now in the morning by bladder isn’t even completely full. Weird stuff but it definitely works never thought it was a real problem before and never worried about it but the unbroken sleep is great. Some of your ideas seem a bit wacky when I first read them, but when I try them they usually work.
    The low sugar is the hardest one especially when my wife makes great biscuits (cookies to you Americans).
    Love both the Sock-Dock and this sites, great information about health, lifestyle and training.
    I keep coming back for more.

    Cheers,

    Chris Southby

  35. katie permalink

    Hi, I am 16 and it takes me 1-3 hours to get to sleep at night, I usually go to bed when eveyone else has (between 10 and 11.30) but it takes me hours to go to sleep and if I don’t set my alarm I will wake up between 11am (earliest) and 3pm (latest) sometimes I wake up randomly at 6 or 8am but go back to sleep right away. Also I can wake up with my alarm clock if I have to do. Do you know why I do this? Thanks.

    • Hard to say why you need to sleep 12+ hours but for a 16 yr old girl I’d think hormones. Have your thyroid checked. (Ask your parents to get your medical doc to check your TSH, free T4, free T3, and TPO & TG antibodies.)

  36. Jong Wock Kim permalink

    When you wake up and want to go to the toilet at night time, if you “lie down and wish it to go away”, will it affect your bladder ? What if there were too much water in my bladder at that time ?

  37. Tyler permalink

    For the past year I have been having issues sleeping. So I decided to visit my doctor and he prescribed melatonin. For a while this helped me sleep, but after working for months it began to stop working almost immediately. When this happened I found myself once again having a hard time falling aslee. I would bee up until two in the morning, only to get up three or four hours later. So I went back to the doctor and informed him of the problems I was having. All he did was up the dosage of the melatonin and sent me on my way. Once again the medication helped me for a while and after a short period I began to notice once again it was not working. So instead of waiting to go to the doctor like I did before I quickly made an appointment. I informed him that the medication was not working. For a while I was on some medication (I can’t remember the name but it was an antidepresent). After the antidepressant my doctor once again wrote me a new prescription for clonidine. And I have been using it for the past six months without a problem. But recently I have decided to get back in to routine. And I take the medication around 10 pm and I fall asleep around 11. It work but at different points in the night I will wake up. For instance 2:30 or 5:50. Sometimes I notice that I am waking up every hour on the hour. Even though it is for a short period of time, waking up anywhere from two to five times a night can be disrupting.

  38. Catherine permalink

    I’ve read your article and many others and I’ve even talked to my doctor about it. I wake up around 3:30am which has to do with the lungs. My doctor said that it has to do with grief or loss or it could be a drop in blood sugar. I’ve tried to eat something before bed but it doesn’t help so I’m just left with no remedies at this point. I understand what I’m being told, it’s what do I do about it? Lungs, grief or loss – what do I do with this information to help me? I feel like this lack of sleep is affecting my weight. I’m steadily gaining weight even thought I’m eating the same and I feel stress from that so it’s a vicious cycle that I don’t know how to stop.

    • I wouldn’t be able to narrow that down for you w/o seeing you. When someone wakes up at 3:30 it is more often blood sugar/hormonal or emotional than it is lungs.

  39. Carrie permalink

    Hi. i have been struggling with sleep since i was 22, i am now about to turn 26. when i was 22 i went for a period of about a month without getting a wink of sleep. after exhausting all options my dr placed me on ambien which i was on for 2 years. I was sleeping great with no meds up until about 1 month ago. I am having the same problem everyone is talking about- i wake up at 245/3 am every night and fail to go back to sleep – i always wake up with the urge to pee. My dr tried to put me on trazadone but even with the high dosage it is failing to work. she wants to put me back on ambien, which at this point im fine with because im exhausted!! i find myself being very stressed and self concious about my dark circles – which i have hereditarly anyway. I am taking a birth control pill. if this is an adreanal problem how can i fix that?

    • As the article states 1-3am is liver. You’re on The Pill so that’s where I’d look first. Hormonal therapies stress the liver.

      BTW: Dark circles under your eyes are NOT heredity, it’s just a lot of people have them. That’s gut/liver toxicity.

  40. Sam permalink

    well, right now, its 4:39AM, and i feel tired, like usual, but every time i try to sleep, its like my body is exhausted, but my mind (eyes) won’t stay closed. I had it so i was in a normal sleep pattern, but it slowly goes back to this, “i’m up all day and most of the night, then fall asleep in the late morning” phase. also, i’m diabetic (type 2, with high blood sugars), i have high blood pressure, and high triglycerides. i take meds for all these, and was recently put in an anti-depressant. i’m currently struggling with some issues, and i live at home with my parents (even though i’m 21). i don’t really want to be a burden, but its hard for me to find a job when my sleep pattern constantly changes. Is there some advice you could possibly give me?

  41. Will permalink

    This article seems to address ME perfectly.

    I’m 44 and haven’t slept through the night consistently for 4-5 years. I fall asleep quickly (I admit that I take melatonin and, often, a Unisom). I sleep DEEPLY until 3 am and then wake suddenly. At this point, I have kicked off all of my blankets and am burning up – often covered in sweat. My mind (and body) seem to be racing. “Wired and Tired” is exactly the best description. I’ve told my wife, “if I wasn’t so exhausted, I feel like I could go run a marathon at 3 am” – that makes no sense to her, but it is how I feel.

    It takes 2-4 hours before I “wind down” and fall asleep again – usually just in time to hear the alarm go off. I’m exhausted all day – trying to sneak in naps every chance I get. I feel horrible all day and struggle to concentrate. By 9-10 pm I am exhausted and ready for bed…and then cycle repeats itself. The need for naps is overwhelming. I’ve tried to “power through” the day in hopes of being able to sleep better that night…but it completely backfires and I wind up sleeping WORSE that night.

    Background: I’ve always been a fitness/weight training nut. Very strict diet that follows a low-glycemic/paleo/Mediterranean way of eating. No sugar. Limited grains…and they are whole wheat or oats, etc.

    Usually one cup of coffee in the morning prior to my weight training workout. I suspect that I might be overtraining, however. Usually 4-5 intense weight workouts weekly. I am 6′ 2″, 185 lbs, very low bodyfat, etc. People look at me and my lifestyle and always comment on how “healthy” I am – but they have no idea how miserable my sleep is and how miserably tired I feel throughout the day. I would give ANYTHING to sleep well again.

    I should also note that when I wake up at 3 a.m. – I usually end up going to the bathroom every 20-30 minutes until I fall back to sleep (regardless of how much I drank before bed time).

    My doctor wants to throw Ambien at me, but I have resisted. I am quite certain that my sleep issues are NOT a result of a lack of Ambien in my system.

    -Will

    • Tough one to point you further here Will as you sound like you’re a “healthy guy”. You could consider running some functional tests to check your cortisol/melatonin levels during the day (especially at night when you’re wide awake); and we could always try a couple phone consults.

      Check out this ASI lab here that you might find of interest: http://www.diagnostechs.com/Pages/AdrenalStressIndex.aspx

  42. Hi Dr. Gangemi.

    I have read all your replys, very good info, and it sounds like my liver may be playing a role in waking me between 2 and 3:30am. I only started waking up like this after I found out I had an elevated bilirubin. I was very stressed out because my pcp referred me to a GI, which had me concerned, this is when I started waking up at this time of the night and still have a hard time falling back to sleep. I have known for a while that by bilirubin was elevated but I had never been referred to a specialist. This really had me worried. Well after going to the specialist and had more blood work and an US, everything came back wnl. but now i STILL seem to wake up at these times…any suggestions or recommendations?

    • High bilirubin is not uncommon – it’s actually called Gilbert’s Syndrome (or Disease), and I have never seen it be the reason for a liver-sleep problem in the many patients I’ve seen with elevated bili counts. So you need to look at what else may be stressing your liver – diet, high intensity exercise, emotional stress, or maybe a supplement or medication.

  43. sunflower permalink

    Hi i am 28 and a full time worker…i used to be perfectly healthy…slim…a great sound 8 hr sleeper…a much more productive person…then last year i had a baby..she is 9 months old now…but all my sleep habits are gone…i cannot sleep at night at 11 or 12…like i used to.. also im getting up twice or thrice every night even if my baby coughs or makes some sound in her crib…then i cannot go back to sleep…every morning i get late to work…i got swollen puffy eyes…i have gained weight…i feel tired and lethargic da whole day…i dont want to go for exercise…my productivity has gone way down….i dunno what to do…pl help…its affecting both my personal and professional lives….

    • Have your thyroid levels checked, that is very common postpartum. Free T3, Free T4, TSH, and even the antibodies (TG & TPO) may worth the check too. Also adrenal gland issues can be the culprit here – which a holistic physician (chiropractor, acupuncturist, or naturopath) should be able to help you with.

  44. Melinda permalink

    Dear Dr. Gangemi,

    I have had sleep problems for almost 3 years. The first year I was awake for almost 6 months. I was taking zoloft and tramadol for 6 months and stopped and got into a “regular ” sleep pattern of urinating 2-8 times each night and waking several times. More recently I have been waking very suddenly from deep sleep feeling wide awake. Also I have often woken up about 4am since I was a young child. I am 45 and in Perimenopause. Any ideas or suggestions?
    Thank You

    • Usually the jolt awake is from a cortisol or adrenalin spike. Sometimes this can be dietary so try eating 20-25g of protein an hour or so before you go to bed and see if that helps. If it doesn’t then you have to look for other areas of stress. If you’re in perimenopause at 45 (too young) it’s because your progesterone levels are too low as they’ve been used over the years to make the stress hormone cortisol.

  45. Molly permalink

    I wake up 3 times a night every night. The times I wake up are usually, 130am, 330-4am, and 6am. I’m a very light sleeper and I’m not too sure if this is to blame or if something else is affecting my sleep. Sometimes I can fall right back asleep while other times I’ll lay there for 30mins to an hour. During the day I’m so tired and I wonder if it’s because I’m not going into my deepest sleep so I’m not really get a goods night sleep. What can I do? I’m 20 years old and healthy.

    • Those are most often stress hormone (cortisol) spikes. So something is probably stressing you out – emotionally, physically, or nutritionally.

  46. Kate permalink

    Hi

    I cannot seem to be able to sleep past about 4.30/5am. I have a baby who often will wake at this time and cry but put himself back to sleep so I am thinking that it is anxiety related to potentially hearing him cry at this time. Baby usually wakes for the day at around 6.30am but I have been up for 2 hours already. I feel ok after a shower and a coffee but used to sleep really well and its doing my head in. I have not been eating that much during the day and certainly not being as healthy as I should. probably too much sugar. I only have 1 coffee a day.Any ideas?

    Kate

    • I’d say you should follow your own thoughts there and cut back on the sugar. Good place to start!

  47. talia permalink

    Hey.
    So I don’t think I’ll ever be a good sleeper. I wake up every night to use the bathroom, for as long as I can remember. It takes up to an hour for me to fall asleep, and I usually wake up several times a night, before an dafter waking up to use the bathroom. I’m 5’3, 113 pounds. I work out everyday and I eat healthy. Have been an organic vegan, vegetarian. I consume fruit, salads, beans and fish, little to no meat. Water and tea. Caffeine/ coffee only once a week. I even bought melatonin, chewable’s from Trader Joe’s and nothing, I think I I slept worse. Took 2 shots of tequila the other night and slept like a baby.

    • When alcohol helps it’s because you’re “wired” and you need something to chill out your nervous system >> some underlying stress hyping you up.

  48. Emmylou permalink

    I am an nurse that works the night shift 3 nights a week. What is the best way for me to sleep?

    • That’s tough. Clean up your diet as much as you can (sugar & caffeine >> stimulants) and then you do your best to quickly adjust on your first day off to get back on a “normal” cycle and catch up before you do it all again.

  49. Moni permalink

    Hi Dr. Gangemi,
    It is a great article. I suffer from insolmnia for twoy years now. I am suer that is due to adrenals altough I live in middle Europe, and there is no possibility to test hormones in saliva. I can only do morning or 24h cortisol test.
    I eat Paleo for a long time. No sugar, no friuts, no dairy, no legumes and grains. I eat a lot of sauerkraut, coconut oil and bone broth. I suplement with mgenesium, zinc, MSM, vit E, vit C, B-compex, fish oil and vit D.
    I don’t drink coffe. I workout 5 x week for 30 minuts (weight training,HIIT, interval and sometimes yoga). I goto bed every night at 9.30 PM, sleep in dark room in silence. I don’t have any health issues besides that one.
    I fall asleep easily but I wake up after 4 hours. I alwayes have to go to bathroom (I think it’s due to low aldosteron – i eat a lot of sea salt to help with that issue) and mostly I can’t get back to sleep. My brain sometimes is pulsing and foughts are racing. I did adrenal test with a light and pupil and it was positive.
    I tried melatonin, gaba, tryptophan, 5-HTP, Tyrosine in the morning, meditation, accupuncture, eat protein before sleep, eat carbs before. When I wake up I sometimes check my blood sugar level and it’s alywayes in normal range (80 – 90).
    I’m taking ashwaganda, schirizada, gotu kola and relora in a blend for 3 months. Nothing seems to help.
    I don’t feel tired the next day and have no problems to focus, but I feel that it’s not my best and sleep affects my life a lot :(
    What can i do more? In my country holictic healing or natural medicne dosen’t exist, nor good tetsing. My doctor gave my a sleepin pill, I didn’t take them. I am so miserable and hopeless. Even when I am taking some time off (vacation) i still can’t sleep, but I am sleeping a little bit better.
    Could you give me some advice? Maybe something that could help me get back to sleep when I wake up? Counting things, suplements, workouts, walks, books…doesn’t help :(

    • Few comments here:
      > Eating salt does not help with aldosterone levels.
      > If those supplements are not helping you might consider stopping them; they could be aggravating the problem.
      > Most of your exercise is anaerobic – HIIT/intervals/weights. Maybe stop that some and add in aerobic (45 min walks/easy runs 4-5X a week)

  50. Cathy permalink

    Hello

    Ironacclly its 2:50 am n I am writting to you! For years I have been getting up at around 2:30 am — I do have sleep apnea n have the CPAP machine( new ) I have tried sleeping pills and presently taking Melintonin to see if that will help. During the day I take the following vitamins as it seems to help with aching joints: Omega 3 , vitamins C, B12, CALCIUM N MAGNISIUM, n a multivitamin. I walk everyday for exercise aswell my current job is on my feet for the whole shift. Stress is high as I am presently looking for a better job than the one I have. Diet is currently in cheak as far as having vegatables n fruit aswell as meat low in fat and cant forget about good old fibre on a daily bases. I just can not sleep through the night — Any suggestions?

    Thank you

    • Hard to give more personal advice – check out the other comments as the 1-3am time is very common (the most common wake-up time).

  51. David permalink

    Hello Dr. Gangemi,

    For the past 5-10 years, I wake up around 4-4:30 every morning during the week. On the weekends, I don’t wake up at this time. I’ve been in the IT field, which can be very stressful, for over 20 years now. I’m currently a contractor, and so have no health insurance. I was diagnosed with a “mild” form of sleep apnea in 2002, had 3 sleep studies to determine this, and have used cpap and had surgery to remove my tonsils. Neither the cpap or the surgery worked. I was also diagnosed with restless leg syndrome. I wasn’t able to follow up with the sleep center that diagnosed me, due to losing my job at the time and not having insurance. I also was diagnosed with atrial fibulation back in ’97, so I’ve almost completely removed caffeine from my diet. I’ve also started a sugar fast in the past two weeks. This waking up around 4 or 4:30 is really killing me. My alarm goes off at 5 or 5:30, depending on whether or work from home or go into the office that particular day. I go to sleep around 10 or 11 during the week. Sometimes later on the weekend. At the recommendation of a doctor, I’ve used either OTC pain meds that include a sleep aid, or benadryl to help me sleep. I don’t want to keep doing this, because I have concerns about long term use of them. I want to be able to keep sleep without the use of drugs. I’ve been doing this for a couple of years now. I’ve also been taking 1.5mg of melatonin each night, on and off, for the past year. It doesn’t seem to have made a difference. I don’t currently have health insurance, so I haven’t seen a doctor in awhile. The only way that I seem to be able to sleep past 4 or 4:30 without waking up, is to go to sleep after 11, like maybe 12, and to eat late which I know isn’t healthy and so rarely do it. I make sure that all lights are off, and all drapes are closed while I sleep. I’ve used a sleep mask and ear plugs as well, for the past couple of years.

    I did work with a chiropractor at one point, who did mention a relationship between the time I was waking up, and possibly a respiratory issue. They were a holistic chiropractor practice.

    I’m currently using a vitamin b-12 patch, and also using the product Natural Calm plus, a magnesium calcium drink. Sorry for all of the details, but I thought that it would be helpful for you to have as many details as possible. Thanks in advance for whatever help you can provide.

    • Stress is the #1 reason you’ll wake up at those times. When I give a patient melatonin, I give them 2-3 pills which are 1mg each. That’s it. Just a bit to get things going for a few days. I don’t think anyone should be taking melatonin night after night. You could stop your own natural production.

  52. Lauren permalink

    Hi
    I am 34 years old. I struggle to sleep because I have this adrenalin/anxiety/hyped up/ shallow breathing feeling that persists – I am not sure if its anxiety or excess cortisol as per your article. Even after I do deep yoga breathing or exercise (jogging) the feeling still persists. I do finally fall asleep but then I wake up between 2am and 3am almost every single night. I then fall into a deep sleep full of vivid dreams at about 5am and then I wake up at about 7am – very tired. Sometimes the adrenalin/ anxiety feeling lasts the whole day and then persists into the night and along with the exhaustion from not sleeping I feel like I cannot focus on work and I feel like I need to crash at about 5pm – I feel like a zombie on most days. I am eating badly, mostly sugary foods just to get through the day and am too tired to exercise properly so I am also putting on a bit of weight which is making me more unhappy. I go through this for two to three week intervals and then suddenly I am fine for two to three weeks, sleeping normally, breathing normally without the adrenalin/ anxiety feeling. And then its starts again and the cycle repeats. I have tried melatonin which only worked for about a month and I have tried herbal anti-anxiety/anti stress tablets which only worked for one or two weeks. My business is being affected, my social life is being affected and this sleep disorder is actually ruining my life. Please can you help with some advice. Much appreciated.

    • If you know you’re eating poorly then that is always the first place to start. You can’t have high quality sleep on a low quality diet.

  53. Joshua Jones permalink

    I am 26 years old, former athlete, that wakes up every night at least once to urinate or roll around. I still train very hard – i am 6’6” 275lbs and roughly 12% body fat now. I lift 5 days a week combined with cardio. I eat extremely clean with mostly complex carbs and lean meats (fish, chicken, steak). My supplementation provides me with additional vitamins, fish oil, essential BCAA’s, occasional cycle with non essentials.

    When I wake up to urinate its a heavy flow (I pee a lot) and for the longest time I felt like I had an energy serge around the same time waking me from my sleep. Sometimes I find myself wishing it was morning in the middle of the night when i wake up! When I finally head into a deep sleep (i think) I wake up to my alarm clock and am groggy every day. The most energy I have is in the gym but, during my day job I am in and out of energy and tiredness.

    I sometimes face difficulty falling asleep as well. I initially thought to switch my evening workouts to morning – this did not help. During the day if I miss a meal or eat after 3 hours between meals I get shaky and its hard to function without eating. For some reason I feel like this issue has something to do with my night sleeping problems.

    I read what you had to say about cortisol – i believe that potentially makes sense for me. I also frequently dream and lucid dream which in a different blog said could be from the effects of sugar/insulin also supporting what you said about potential energy surges in the night.

    Do you have any advice? What type of doctor could I visit to understand these issues coming from an athlete? From my past experience many doctors don’t understand the “healthy” lifestyle involving heavy training.

    Also – When I sleep I sleep without any sheets, my body is so warm when trying to fall asleep and throughout the night I cannot have anything on me. Around 6am my body finally begins to cool down and I sometimes find myself freezing, taking a hot shower to warm my body up.

    thanks for you help.

    • I’d say all those symptoms can be linked to your adrenal glands being taxed. The heavy urine flow is most often from a thiamine (vitamin B1) deficiency. If you can’t go more than 3 hrs w/o eating then you’re not getting enough calories, probably from fat. Of course a lot of this could be from “training hard” as you say.

      Look for a holistic doc – perhaps a chiropractor (who practices applied kinesiology) or a acupuncturist or naturopath.

  54. ms.curious permalink

    Greetings!

    I’m a student so i really need time to study….

    Is it ok to sleep earlier…like 9pm-2am to stay awake whole day
    ,and do some 20 mins. power naps at noon or at any vacant time…?:>

    IN CASE of tight schedule

  55. LRhone permalink

    I am a midlevel provider (PA) in the Emergency Room and we all rotate between night and day shifts. I eat super healthy (no white flour products, no artificial colors, no preservatives, no refined sugars, minimal carbs, and bring my own food to work) I also eat small portions every 3-4 hours. I am not surprised working shift work that I have trouble sleeping when I am switching from nights back to days, but I also get up multiple times at night to urinate. Do you have any suggestions for us shift workers?? Thanks

    • Yeah that’s a tough one; I see several shift workers (nurses). I like to say “fix what you can fix”. In this case you can’t change your hours so you make sure everything else is working optimally – diet, exercise, lifestyle, etc…Keep up the protein levels too – shoot for 1.5 grams per kg of bodyweight.

  56. In my case, my most common issue is, I’ll sleep for like 2-3 hours then if I hear some noises or someone opening my door, I get easily disturbed then if that happens I can’t go back to sleep anymore. I work on a graveyard shift, from 10p-7a and when I get home I try not to sleep yet so that I’ll feel so tired and just knock out, but like what I said earlier, no matter how tired I am if I woke up from sleep, its so hard for me to sleep back again.

  57. Isra permalink

    I wake up every night at around 1am and i cant fall back to sleep .. I have to wake up for school at 5 so i end up staying awake till then. I do everything possible to sleep but i cant.

  58. Mikki permalink

    i’m having a sleep disorder for these passed weeks. I can’t sleep well, and i slept like at 7 am and woke at 2 pm. I’ve no idea why is this happening. I’ve a REALLY REALLY bad headaches and i felt like the earth is spinning wildly. This morning ,my tears just flowing down without me noticing ; nosebleeds and I throw up everything I ate

  59. Kathleen permalink

    I normally go to bed around 10:30pm and wake up around 5:30am. Because of daylight savings, I’ve found that I’ve been sleepy throughout the day because it’s still dark at 5:30am. Last night I went to bed a little after 11pm and woke up this morning at 7am refreshed, as it was light out. Is it alright to go to bed between 11pm and midnight, since my body tolerates this better than the ‘optimal’ time of 10pm-11pm?

  60. Subrata K Saha permalink

    Everyday I automatically wake up between 4am to 5am and cant sleep anymore even I want to. The result the whole day the eyes kept on burning, not able to concentrate at job place and other things.

    Please give me some remedy to this problem which I am facing since last one year

    • Think blood sugar. Check out the Paleo-Type Diet and Two Week Test under Health Topics.

  61. Wow what a great descriptive article! The best I’ve found so far. I’ve been researching these issues for the past 2 months since my sleeping issues started and this really makes a lot of sense to me.

    I’m 26yr old fema extreme le. I’ve been training for 3 years now, but the last year I’ve cranked it up to levels. Coupled with a v stressful job, and freelance work after hours I know this has caused my sleeping issues.

    The problem is I don’t FULLY understand what the physical triggers are so I’m not sure how to fix it. I’ve cut down the exercise to 2/3 times a week, cut down on work demands, cut down refined sugars, stopped any stressful activities after say 7pm….
    I fall asleep really easily…anytime between 10:30 and 11:30 pm. On rare occasions I will sleep straight through, but this is very rare. Every night I wake up between 12:30am and 1:30am. If I’m lucky, I’ll read for 30 mins, then try to sleep again and itll work, but normally I’m tossing and turning for hours…maybe by 3:30am ill fall asleep again.

    I suspected adrenal fatigue, but doctors here don’t seem to believe in it, and have no tests for it so I have no real way of checking.
    My blood tests results are all fine for all the normal stuff, ferritin levels are low (16) but otherwise all good.

    I’m taking magnesium supplements as I’ve read this can help. Otherwise, I can’t seem to get rid of the problem! Since I don’t know for sure it’s that, I’m not super confident this will sort my issue. I’ve tried the pupil test and it does seem to confirm adrenal fatigue, but not sure thats enough.

    When I do some light exercise, the problem is exacerbated and the sleeping issue is much worse!!

    Any advice would be so much appreciate!

    • Waking up 12:30-1:30 is most likely a liver issue – could be stress hormones or sex hormones (estrogen). That’s why you can’t fall asleep again until after 3am (the liver meridian time ends).

      Surprised that light exercise exacerbates – that should not happen if you’re aerobic. Check out the Sock Doc Training Principles and eliminate the refined sugars 100%.

      • Hi Dr!

        Thanks so much for the quick reply. It’s so uncanny that that’s exactly when my body just seems to be able to ‘chill’ and let me fall asleep, around 3am.

        I really want to get control of this, I’m cutting out all forms of refined sugars for sure so thanks for that! I do believe it’s a hormonal imbalance of some sort, though not entirely sure on how to correct that.

        Very interesting article on the Sock Doc training principles page!

        Reading that, starting to think what I consider to be light exercise might not be at all, and perhaps that’s why my exercise isn’t helping.

        What I considered to be light exercise, was 15 mins of interval training on a treadmill, cycling between jogging and running, and then approx 30-35mins of leg work. I guess this isn’t light at all but is infact unaerobic?

        I think I will have to try and build aerobically as the article states…perhaps longer lower intensity jogging sessions and perhaps Yoga I guess.

  62. Brianna permalink

    Without fail, I have to get up every night to pee, and have for a few years. I think some nights it is just habit….if I wake up, I might as well pee so I don’t get waked up again later (and I’m making an effort to just ignore those times). But there are other times where the feeling of needing to go are pretty significant. Ignoring it isn’t an option…but oftentimes there isn’t much there. (this past week, it was consistently around 3am…give or take 10 minutes)

    I am tired all the time and people have commented on it. I have been going to bed by 10pm and getting 7-9 hours of time in my bed…but its not quality sleep .I don’t sleep well any time when I am in any bed besides my own, sleeping lightly and waking a dozen times or so per night.

    Any suggestions or help, more information, etc would be greatly appreciated

    • Best I can offer a non-patient is to look at everything that is causing you stress. There may be some benefit to taking vitamin B1 (thiamine). I can’t tell you to take this, but you could look into it.

  63. Lindsay permalink

    Hi, Dr.! You mentioned that there are inexpensive tests that can be done to text cortisol and estrogen? What is the best way to go about getting these tests done? Through a dr or…? I have a hard time finding a dr that wants to find the root of my sleep issues and more find them prescribing meds for rls, pmdd, and depression. I find common threads to all these issues but I have no dr to help me know for sure what supplements to be taking etc. So, I am left to research on my own and pray I find the solutions. (I have had insomnia since puberty and am now 30)

    Linds

  64. Ell permalink

    Hi,
    thank you for this great article!
    I have trouble sleeping, and it is literally driving me insane.
    For starters, I will lie in bed for two hours, tossing and turning, before I can fall asleep (when one of my friends told me that it takes her about 15-20 minutes, I almost cried). This has been going on for a long time, and I don’t know why. Secondly, I will wake up at 5:40 every day (6am if I am lucky), and that is it. I go to bed exhausted, can’t fall asleep, and wake up early after too little sleep. As a teenager, I fear that this unhealthy sleep pattern is not suitable for a growing person.
    I care a lot about my health, and so recently began to chart my amounts of sleep per night, which were often 6 or 7 hours; far too little for a teenager.
    I have tried everything I can think of, no computers or light before sleeping, a warm shower, glass of milk, counting sheep…. the list goes on!
    I will often try to be home at 7 and have dinner at 6 (if I am going out somewhere), SPECIFICALLY so that I can go to bed at 8pm. It makes me want to scream that I do all of this just to wake up, still tired, while my body laughs at me. I try so hard to take care of myself, but apparently, 6 hours sleep is good enough for me! The longest I have ever slept (and I hadn’t slept more that 6 hours in the last 2 nights) was 11 hours, and I felt refreshed!! I have had 10 hours, but I still needed to go for a swim to feel awake and energise myself….

    Please help me, what can I do to sleep LIKE A NORMAL TEENAGER!!

    Thankyou.

    PS. I read that waking up early could be due to a problem in my large intestine; I’m not sure if that is the case. I looked up healthy bowel movement and showed signs of healthy digestion and bowel movement, and no signs of problem in the large intestine as I am neither constipated nor have diarrheoa (sorry for the spelling!)

    • Sorry Ell – past what I can tell you here most sleep problems are too complicated to try to figure out and advise on-line.

  65. lieselq permalink

    I had severe insomnia for years and years…about 10 to 15 years…slept almost not at all. Once I got off of the western meds…and even as I was in the process of doing so…my sleep quickly began to improve. I’m very interested that you tell us waking in the night is not normal (good, healthy, etc.). I’m down to one waking during the night yet still usually up at 4-5 a.m. even though I would desire to sleep longer. So I am thinking lungs, large intestine. Is that correct? I was also interested in what you said about the gut flora…will have to find your more in depth article(s) on that issue…I do not know particularly how to correct that yet as I was reading (between 5 and 7 a.m.), had a strong desire to drink water (added some lemon and bit of sea salt)…then I had a desire to drink a small amount of good apple cider vinegar…then I remembered a bit of aloe still in the fridge and so poured that in a cup…I do not know if these things help the gut, yet it was what my body said to do. Is my body telling me correctly? I suppose I will know quickly enough if/when I sleep past 7 a.m.! Acupuncturist also mentioned on last visit lactic acid and said slow, steady breathing helps to release lactic acid build up. (Which she said would result in fewer scattered thoughts and more calm.) Right now slow deep breaths produce coughing as my lungs are somewhat congested…nonetheless, am breathing as well and as slowly and as deeply as possible. (Taking immuplex and some other supportive supplements…have been reading your articles and thought of some others to add…I do not believe in pill cures, even through supplements, necessarily, yet my body got so incredibly out of whack that I believe for now it needs extra support…)

    If you suggest anything else, I will absolutely do it, take it…thanks!

  66. Vikki permalink

    Good Day Doc!

    After I’ve read your great article and know the different issues of waking up early morning and you mentioned in your article that waking up between 3am to 5am is having a lung issue or allergies. I am suffering this sudden wake up between 3am to 5am (not dreaming at all) for the past few weeks, Is it mean that i have problems in my lungs then whats the connection of the two?
    Thank you and any response from you will be much appreciated.

    • For lungs think air quality, asthma, new products in house (furniture) that may be releasing chemicals in the air. But more often waking up at that time is a cortisol (stress hormone) – blood sugar handling problem.

  67. Kathy permalink

    Just as I am falling asleep I get a shot of adrenaline/fear that wakes me up and I find it hard to get to sleep. This can happen repeatedly for a few nights in a row, then stop for many weeks/months before it happens again. Suggestions?

    • Not really with that pattern. You’d have to think of what is causing you to have such stress during those times each month. For a woman, check to see if it correlates with a specific time in your monthly cycle.

  68. Lindsay permalink

    I absolutely see a correlation b/n my sleep issues and my cycle (as do the women in my family). From the time that I ovulate to the time that my period starts I have horrible sleep (along with other pms symptoms). Do you have any suggestions to help this issue off the bat or is that not enough info to draw conclusions?

    • You’d have to investigate ways to help you better detox estrogen or evaluate your progesterone sufficiency. Really best done by finding a holistically-minded doc.

  69. Kellie permalink

    I’m 32 years old and for the past 6 years i’ve had trouble sleeping all night. At first i thought it was from working the NOC shift, but I haven’t worked that shift in 4 years. So it can’t be that. The problem is once I fall asleep, no matter what time I fall asleep, I will wake up an hour after, then I wake up every 2 hours on the dot. I’ll get up, use the bathroom & then go have a snack in the kitchen. This is my routine for the first hour and every 2 hours following. How do I get into a normal sleeping pattern?

    • Got to be some trigger causing you to have a stress reaction in the night (releasing cortisol). Try a bit of protein before bed – 20g about 30 mins before you sleep. Worse case it just won’t help.

  70. David permalink

    Hello,

    I fall asleep quite easily every night between 10 and 11 PM. I have a good sleep environment and a comfortable matress. The problem is that I wake up every night between 3 and 4 AM and often have a very hard time going back to sleep. My brain function kicks into high gear and I can’t seem to relax even though I feel tired. My heart rate also speeds up and I can’t seem to slow it down. What may have been a concern on my mind at bedtime has blown up to a problem many times the size it was when I went to bed. Sometimes it helps if I get up, get some kind of carb like cereal, and go to a different place to sleep, like a couch. I have tried multiple forms of over the counter sleep aids and natural remedies but my 3 AM problem seems to be geting worse. I am a 50 year old man in reasonably good shape and not overweight. I realy need some suggestions! Thanks for your website.

  71. EmmaLee permalink

    Im only 13 years old and I have this issue too, waking up around 3 am every morning and then I cant fall asleep till around 4 or 5am. I had this problem since I was 6 or 7. It only happends on certain ocasions but its now becoming a weekly problem, my problem stopped for a while but it came back just recently and it seems to be a pattern. So I was wondering, is it bad?

    • Yeah it’s bad. Think if something you eat too much of – sugar? Caffeine? Other junk food?

  72. Isaiah permalink

    Ohh thank GOD. People were saying it was ghosts or something because of the Witching hour. I was getting freaked out. Ironicly as I was typing this my door randomly opened. It was just my cat though. I’m I guessing the medication I started taking kinda added to it though. I usually wake up at around 3:30am but never have seen any paranormal activity.

  73. Narveer permalink

    Hi,

    I am 32 years old and having High BP problem since 4 years and i will get sleep properly if get sleep also at least 2 to 3 times i will woke up for Urinate and i will be disturb with this. But when i take alcohol a minimum of 4 pegs i will get nice sleep but i will wake again early morning 6 am and when i dont take alcohol i will get sleep late but again morning i will get up very late. Please advise?

  74. KAREES permalink

    Hello Dr. Gamgemi!

    Thanks for this information!

    I have been struggling with my sleep after the birth of my son 5 years ago!!

    After my son was born, 7 months later I was diagnosed with COMPLETE ADRENAL BURNOUT & CHRONIC INSOMNIA!

    ONE YEAR after that I was diagnosed with GRAVES DISEASE.

    After being put on a plethora of meds, I weaned myself off of them, changed my diet and made REMARKABLE improvements. However, I am NOT where I should be.

    I gained 25lbs in 2 years inexplicably. My hair is so thin. I have anxiety sometimes and CANNOT handle LIGHT stress well.

    I don’t eat sugar and if I do which is RARE it’s a glass of organic lemonade. I am gluten and dairy free. This REALLLLY helped. I’ve done detoxes and cleanses and I know this is why I can function MOST of the week. I work out 3-4 times per week and CANNOT loose 1 pound!

    THE PROBLEM is I know my adrenals are still weak and I’m sure my thyroid is not normal still. My insomnia has greatly improved. My sleep is just soooo inconsistent, IE, I never know if I’m going to sleep through the night or if it’s going to take a long tome to fall asleep. The MAJOR issue is I wake up EVERY morning between I think 4am-5am like clockwork! I can feel it inside my head like something is being pumped through my blood and jolts me like,”Time to get up!”, and I am WIDE awake, but sooooo tired. My head is thick and tingly and heavy and I dread not falling back asleep. I have to drink wine to put myself back to sleep4 -5 times per week. I fall asleep about an hour later. At 8am, I get that stream of wake up juice again and after that there’s no hope. I CANNOT sleep past 8am or that 4-5am period if my life depended on it. Most nights I sleep pretty ok from 10:30pm until that first jolt, but IF I don’t get back to sleep, I am a TOTAL WRECK!

    I am completely incapacitated for the entire day. This is my adrenal problem. I am not a normal person that can get a bad night of sleep and make it though the day…I CAN’T!! I’m tired of this and IF I COULD JUST SLEEP THROUGH THE NIGHT FOR A SOLID 9 HOURS I FEEL PERFECT!

    I read your sleep article and I’m not sure if it’s my lungs or large intestines. The period I am waking up is right at the END of the lungs and the beginning of the large intestines…I am more awake between 5-7am than I am between 3-5a, but still smack dead in the middle of those two ranges!?!?! I NEED some SPECIFIC instructions. I get so aggravated with the general change your diet and lifestyle advise that I read all over the Internet..I’ve done that. What is waking me up at the same time every night!!!!

    TO confuse things even MORE, somenights I wake up alll times of the night. SO now i wonder if it’s a CORTISOL ISSUE, PARASYMPATHETIC NERVOUS SYSTEM ISSUE, HP axis????
    Pretty sure my adrenals are the main problem.

    I’m tired of my 5yr old getting a mean useless mommy. HE doesn’t deserve this.

    If I’m so tired why won’t my body let me sleep!? I can deal with me not loosing weight and my hair being thin. At this point, I’ve been sick for 5 years and I’m so tired..I get angry when I’ve slept good for 5 days in a row because I know in the next 2 days I won’t sleep good and I’ll have a miserable day and that bad sleep is just making it IMPOSSIBLE for my adrenals to EVER heal. This sub-par life is draining me and I can see the finish line.

  75. alexes permalink

    it is 220am and I found myself reading article after article on sleep. As a kid I could be sleeping with my alarm on full blast and my mom from the ither end of the house would come in yelling at me to shut it off. If only that could be my problem now… I am tired nonstop. it doesnt matter how much sleep I get. I wake up from moving all night. Im dizzy from standing up, ive always had that problem, I try to drink more water… it doesnt make a difference. some nights my leg, foot, or arm will go numb… im sleeping on a tenperpedic mattress so uts nit springs cutting it off. my hands and feet are always cold. I do dream though. The dreams are always crazy. I especially hate when im doing things from work in my dreams.Ib high school I woke up from shouting a coubtry out bc I was studying geography for ab exan the next day. All day long I forget things. Today was the secind time I forgot I took my medicine and took it twice. Im only 23!!! Ive been takibg vyvanse for ADD, thank god bc I dont think I could make it awake everyday. I waje up drink coffee abd take my vyvanse. I switched from adderall to vyvanse bc I couldnt eat on adderall. so I regained my appetite. I take an antidepressant called remeron at night. I was having trouble with sleeping before these medicatiobs were introduced. I took benedryl for a week to help me but all that does is make me super tired but I dont sleep well on it at all. I really am at a hopeless point in my life. exercising makes me wired…. im way to tired to get up early to do it in the morning… in all honesty, I feel I get the best sleep after I hit that snooze button at 645am… from then to 730 when I finally get up running late for work is the best 45minutes of sleep that I dont want to end. What could be my problem? oh id kike to add on the weekends I dont take any ADD medication and that doesnt make a difference. I will be honest and admit that marijuana is one thjng that has helped going to sleep… byt again im 23 and work in a profprofessional setting that snoking marijuana is unacceptable nit to mention illegal…so thats not an option.

  76. Laura permalink

    Hello, I am a 32 year old who now has a 16 month old child. I started having trouble sleeping right before he was born, mostly due to anxiety. However, once he was born I had terrible insomnia for about 3 months where I got perhaps 2-3 hrs of sleep per DAY, mainly due to anxiety again (my mind would not “shut off”). I had to go on ativan at that point.

    I thought my sleeping problems would get better over time, but now my child is 16 months old and I still struggle to get 5 or 6 hours of sleep a night. I can usually fall asleep fine, just to wake about every 1 1/2 to 2 hours for the entire night. Frequently visit the washroom when I wake “just in case” and sometimes stay awake in the night (maybe from 3:30-5?) not able to fall back asleep.

    Of course, some of this is that I am a light sleeper and my son still wakes at least once per night, but it is obviously a bit more than that seeing as it is not getting better. I hate taking sleeping pills, and have also tried melatonin which sometimes works. I am a healthy weight, get some extra exercise above and beyond chasing around a child at home, and don’t over-eat carbs (I don’t think), and don’t drink large amounts of alcohal or caffeine, and have a very good sleep routine to wind down at night!

    Please let me know what your thoughts are. I would love to get more than 5 hours of sleep without having to take a supplement.
    Thanks!

  77. Anni permalink

    Hello I am 25 years old.I started to have sleep disorders when I was in High School when I was taking my exams to get to university.The doctor recommend xanax.I was taking half pill and I was ok..I continue to have sleep problems but the last three months I am taking xanax almost every night I manage to stop it but after 2 weeks the problem comes back.I want to stop taking xanax.Some times I double the dose because I just want to sleep. My job has a lot of stress, I spend 3-4 hours in order to eat something and the last 2 years I stop work out because I don’t have time.If you have any advice for me how to stop taking this pill and start sleep please let me know..

  78. Ireland permalink

    Hello, I have suffered from insomnia tremendously for the 2 and a half years, though at 32 I have never been a good sleeper. I workout out 6-7 days a week, eat a balanced diet, don’t drink often, and am a non smoker. No caffeine past 10 am. I often experience difficulty falling asleep and then staying asleep as well. Wake up almost exactly 1 hour after I fall asleep each night, and the pattern continues until the morning. I have tried xanax, valium, nyquil, benadryl, soothing teas, warm milk, no tv in the bedroom, cool air temperature, calming ocean music, breathing techniques etc. Prescription sleeping pills are not an option, I believe them to be unsafe.
    Have suffered from an iron deficiency as well this past year, and receive iron infusions about every 2 months. Most nights when I can’t sleep, I find myself lying awake in bed, worrying, or making a list of the things I need to do the next day, it is as if my brain will not “take a rest”. Or I will get up and go in kitchen and have a snack, several times a night. Sleeping no more than a total of 4 hours a night, is taking it’s toll, and I feel as though I am missing out on living life, from being so worn out and exhausted due to the lack of sleep. Any suggestion would be helpful! Just plain old tired of being tired. Had lots of lab work done, thyroid is good, b12 is low, taking shots now as prescribed by hematologist.

  79. Eleni permalink

    For the past two weeks, I’ve been consistently waking up between 1-3am and staying awake for hour or two. I have no trouble getting to sleep but staying asleep seems to be an issue.

    I do exhibit anxiety a lot more than the average person over anything big or small (and sometimes I feel anxious before I can think of any reason to be). I don’t drink coffee, I’m not really eating at scheduled times throughout the day so sometimes I do skip meals or end up eat at weird times. I try to eat balanced but I don’t think that I do. I was thinking that maybe my change in sleep has been due to the fact that it has been change in temperature in these past two week, and so I’ve been waking up early and such so I thought this might be contributing to my strange sleeping behaviour. I do have a laptop on my bed that I watch shows on to fall asleep sometimes, which I know is a bad idea.

    In your online opinion, what do you think could possibly be the cause of my erratic sleeping behaviour?

  80. Nico Miller permalink

    Hi,

    I’ve been waking up every hour through the night for all of my life! I’m now 21-years old male. I don’t stress for going to sleep and waking up during the night because it’s so normal for me. When I wake up, I don’t gasp for air or feel chocked. It’s more like tossing and turning through the night. I never see nightmares, but I see really vivid dreams every night, something around 5 – 10 dreams per night. I don’t have sleep apnea (I had sleep study done) just fragmented sleep with lots of waking ups.

    Any advices? All my blood works were good (full thyroid panel, full testosterone panel, many vitamin tests B12, zinc, magnesium etc..)

    Only weird thing is that my cortisol was little bit off the scale on morning when tested. I have some lower back pain and my nasal is always congested. It’s just hard to believe that small amount of pain or small reduction of airflow would do this much damage for all of my life.

    Could it be anxiousness? I don’t feel depressed or anxious at all during the day but my elementary school time wasn’t the best because of being bullied. Those day are gone but could I still be suffering old trauma? I was really sensitive back in the day.

    Long post, if you could give me some advice I would be really happy :)

  81. TilHenzo permalink

    Hello, does anyone have any tips about the most simple way to get their infant to sleep all night?

    I have read many pages with suggestions but I am still finding it very hard.

    Best wishes

  82. Abhishek Mishra permalink

    i used to study till 5 am and at 5:30 i used to go at bed and wakes up between 11 to 12 is it going to harm me

  83. tasha permalink

    Hi
    For the longest time, I couldn’t fall asleep, so I would take benadryl. Recently, I cleared out some spiritual baggage and now I get sleepy at a normal time. I am no longer stressed either. When I fall asleep there are nights when I fall into this state where it seems like I am still awake and all of the same things are happening. It it very foggy and I can’t see or move well in the dream. I try to wake myself up and I can’t I have to fight repeatedly to make myself wake up, and when I do I have to get out of bed and continue forcing my brain to fully awaken otherwise I will fall right back into the same state. The sleep I get while in this state is not restful at all and the whole thing is rather annoying. It only happens when I first fall asleep. Also, when I wake in the morning I still feel sleepy whether this happens or not.

  84. marina xydous permalink

    I am amazed at all the great information available in this article and wish you were my doctor. I have had alot of trouble sleeping the past three months it all began when i felt sick bronchitis. I was given an inhaler and antibiotics and basically i ended up awake for a week plus i went back to doctor who then gave me sleeping pill ambian. I suffer from ptsd and do not take medication she said my ptsd had kicked me into panick mode and i took ambian one night slept and then began to sleep again but i cant stay asleep for anything I wake up a few hours later in a state of insane anziety or even 5 hours later wide awake and feeling super anxious . I am experiencing great anxiety all day and also since i got sick with the bronchitis i have had either great anxiety over my bowel movements or i am simply put constipated i have at this point started taking a stool softener almost daily and trazadone 25 mg everynight not to put me to sleep but to keep me ther i am getting 5 hours per night and i am going to bathroom with some sort of awreness that it does not feel right. I had a battery of tests and they all came back im healthy only deficient in vitamin d and just a tad low in iron they suggested some vitamins.I am curious as to what type of tests i should do to know more about this bowl bacteria or gut fungus you speak of as well as the time i always wake up is 5-6 there is definitely something to what you are speaking of.

  85. Jonathan permalink

    Why do I wake up at 3am every other day I awake at this time, along with this I have to take a leak, I’m a 24 year male, is this normal? It also takes me about 2-3 hours to fall back asleep.

  86. Constance permalink

    Hi, Thank you for writing this e-mail. I’m trying to figure out if I need to get more sleep. I’ve been going to bed at 3:30am to 4am every night, but I’ve am awakened at 5:20am to myself squirming back and forth in the bed holding myself, trying not to pee. I don’t even remember how I got to this point, I just open my eyes and begin to “fight” the urger to pee. I try to calm myself down before I get out of the bed, so that I don’t pee on the floor, but that works for a short while because I will have to use my fingers to block the urine from getting onto the floor. Before I can make it to the toilet bowel, I am dripping urine. DUring the day, if I have an urge to use the bathroom, I can control it by focusing on an object intently and it goes away, but this technique doesn’t work if I have been awakened out of my sleep. DO I need to sleep earlier to stop my urination issues? FYI: I wake up at 12pm or 1pm to carry out my day.

  87. Rhonda permalink

    the adrenal cortisol issue sounds just like me. I wake at 1am cannot for the life of me get back to sleep until 5am. I am peri-menopausal at 47, heartbeat is faster at about 80 at this time, I will sweat.. but even before all this I still woke at say 2am and couldnt get back to sleep until 5 am or so. I some times will get hypoglycemic. So what should I do? I am not a big eater, I am very lean and never dieted, I eat enough to satisfy me. I also cut out gluten and most dairy although I have greek yogart due to it keeping me from being hypoglycemic over night. What else can I do to prevent this? Or what should I eat?

  88. Timo permalink

    This is the single best article about sleep problems that I have ever read (and I have read many dozens)
    Will share it with anyone that needs it!

  89. Thais permalink

    I’ve been waking up at 8 am on the dot for the past 2 weeks. Today I woke up at 9am. I’ve on summer vacation so I haven’t used an alarm to wake up since April. I find it weird cause it just started randomly. Any thoughts?

  90. Ann permalink

    I have an overactive bladder I think. I wetted my bed until I was 12 years old.

    Now I stop drinking past 5-6 am to prevent to have to go to the toilet during the night. Because if I drink at lets say 7 or 8 I have to go like 3 times :/

    My aldosterone is high so no issues there.

    Also went to do many tests as a kid and they couldnt find anything wrong.
    It is annoying tho since I am also a sleepwalker and thus my sleepquality isnt always that great :/ Im going to have a sleep study done I think because sometimes this causes me to be tired during the day. Dont know what else to do.

    • Ann permalink

      I am an extreme morning person btw. I go to bed at 9 and wake up at 5 am, I fall asleep really fast so no issues with that. I do eat a lot of carbs but good ones, I get a yearly bloodcheck as well cause im vegan but I had these things previous to being vegan as well. I am 27 now. The only thing thats off in my bloodtest is that my androstenedione is too high.

      • Ann permalink

        I also wake up very easily from noise, and I sleep next to the street and hear all cars passing by when they do. I also hear others move through the house and close doors and such. I am sleeping with earplugs in now but sometimes this causes itching in my ears, or I can hear my heartbeat, or I remove them during my sleep, and even then sometimes I still hear noise through it and wake up.

  91. bree permalink

    I too am having problems sleeping i also have heart
    Problems as well due to 5 open heart surgeries possibly a 6th one on the way im 20 years old and keep getting up several times throughout the night to urinate sometimes i get hungry as well it takes me forever to fall back asleep tonight i fell asleep around 9 woke up at 11 and havent been to sleep since i also tend to wake up with severe headaches and migrains all the time. The only posistion i find comfortable is my stomach or side because of my back problems i have two metal rods in my back because i had skullyosious and the heart disease i have is called digeorge i was wondering if what i described may be a sleep disorder please help and thanks for listening :)

  92. Chance permalink

    I have a friend who falls into an incredibly deep sleep really easily. And when this happens, the only thing you can do to wake him up is pour cold water on him. Occasionally extreme amount of electricity can wake him up. What would cause this?

  93. Karly Warner permalink

    My names karly and im 16. Every night I wake up at 2a.m. and I don’t get why? I have depression and anxiety but I’m on medication that helps that. Plus I’m really hungry when I wake up, sometimes I eat but not always. Should I see a doctor about this?

  94. Robin permalink

    I’m a 35 year old woman, very active (workouts are always in the morning when I first get up). I wake up most mornings between 3-5 a.m. (usually with the urge to pee – although sometimes this is caused by my cats) and I cannot fall back asleep for at least 1 hours. I do not have any breathing problems I’m aware of (i.e. do not snore). I’ve tried medicial help – melatonin, Robax, Gravol – and it helps me fall asleep but nothing seems to help with this early morning wake-up. Anything you would suggest without more ‘drugs’?

  95. Awangku Sazali permalink

    I am 49 years old. I have a sleep disorder for the past 6 or 7 months. I normally went to sleep at 930pm and will woke up at 1am. I have not use drugs yet. My question is, I am taking calcium together with magnesium supplement, will this help?

  96. Linda Reznik permalink

    Lately I fall asleep at 7pm and am up and awake by 2.30 or 3.00 am. Please tell me how to change my sleep schedule back to normal. Thank You!

  97. Linda Reznik permalink

    Just lately I’ve been falling asleep at 7pm and am wide awake at 3am please help me get my sleep schedule back to normal. Thank you!

  98. Kat permalink

    I will wake up at (for example) 2:34 every morning for about 4 or 5 days . But then the time changes, and then so on and so forth. How can i stop this?

  99. lise permalink

    Hi im lise.
    i know this article was posted a while ago but i have some questions that i was hoping you could answer. I am 14 and have anxiety. I wake up almost every night at 2 and feel Nashua. I usually put on pure therapeutic grade essential oils (peppermint) from young living and if that doesn’t work i take 1/4 to 1/2 dose of pepto, I usually then just make sure i don’t have a panic attack and worry myself and came upon this article. I have a lot of family members with type 2 diabetes and was wandering if i could have a sugar imbalance like you said that can turn into diabetes. Also i get pain throughout my body (mostly around my hips) if i try to lay on my sides or not have my legs a sertan way when i sleep and sit normal. Is any of the things i have mentioned in the article a problem? Thanks for the waunderfull article and all the work you do.

    -Lise

  100. Chris permalink

    Thanks very much for answering a problem I have been having for the past 6 months after quitting alcohol.

    To start with I slept the best I have ever slept after a few days of not drinking. Then for the past 6 months I have been waking up between 2-3am and eating some cereal every night also waking to use the bathroom.

    I am guessing I need to look at my nutrition to prevent this from happening?

Trackbacks and Pingbacks

  1. Why Can’t I Get Enough Sleep?
  2. Primal Journal (Lex26) - Page 15 | Mark's Daily Apple Health and Fitness Forum page 15
  3. Dr. Gangemi's Tackles The Power Of Sleep - Leanness Lifestyle University Blog

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