Cut Down on Nighttime Wake-Ups: A Survey & Advice

Who would you guess wakes up more frequently at night because of stress and anxiety? Adults who are young, middle aged, or old?

What the Sleepless Nights survey tells us about middle-of-the-night awakeners, together with a dash of commentary and advice.

Sleep is less deep & restorative when disrupted by wake-ups in the middle of the nightWho would you guess wakes up more frequently at night because of stress and anxiety? Adults aged

(a) 18 to 24

(b) 25 to 34

(c) 35 to 44

(d) 45 to 54

(e) 55 and above

According to a recent survey of 1,000 adults in the United States, the youngest adults lead the pack, with 46% of the 18- to 24-year-olds reporting stress-related wake-ups at night.

Does this surprise you? Maybe so and maybe not. But data can sometimes contradict expectations. Following are a few more findings taken from the Sleepless Nights survey conducted October 19 by OnePoll,* an online market research firm, together with a dash of commentary and advice.

Waking Up in the Middle of the Night

It’s not unusual to wake up once or even a few times during the night. In fact, in the OnePoll survey, less than 1% of the respondents reported never waking up at night. But having lots of nighttime awakenings is a problem. It’s a symptom of sleep maintenance insomnia.

You might think the total amount of sleep you get is actually more important than the number of wake-ups you experience. But this isn’t true. Sleep interrupted by frequent wake-ups is not as restorative as the same amount of sleep gotten all at one time, according to a study published in the November issue of Sleep. People who sleep in fits and starts miss out on a significant amount of deep sleep, the study shows. They report feeling unrefreshed in the morning, and waking up in a bad mood.

In addition to waking up in the middle of the night, 39% of the respondents in the OnePoll survey reported feeling exhausted on awakening in the morning—and this complaint was more frequent among the young and middle-aged than in adults 55 and older. This suggests that quite a few Americans aren’t getting the amount or type of sleep we need.

Reason #1: Bathroom Calls

About 74% of the respondents reported that one reason for their middle-of-the-night wake-ups was the need to go to the bathroom. This is not surprising given the ages of the respondents (43% were 55 and older). But not only does having to void several times at night decrease sleep quality. It also puts you at greater risk for developing chronic insomnia.

So if your nighttime wake-ups are due to an overactive bladder, have a look at the blog I wrote last December on ways to cut down on the need for bathroom calls at night.

Also, a few preliminary studies I’ve seen in the past year suggest that supplements containing pumpkin seed extract, alone or in combination with soy isoflavones, may reduce symptoms of overactive bladder. If you’re game to try the pumpkin seed extract/soy isoflavone supplements, keep in mind that like most plant-based medicines, they may need to be taken a few weeks before you notice effects.

Reason #2: Temperature Changes at Night

About 36% of the respondents reported usually waking up in the middle of the night because they were too hot, and about 19% reported awakening because they were too cold.

Some of this may have to do with changes in core body temperature at night. From a high in the evening, your temperature falls by about 1.5 degrees Fahrenheit during the night, bottoming out a few hours before wake-up time and then rapidly rising again. No wonder that during the first part of the night you’re piling the covers on and in the last part, throwing them off.

Especially if you tend to sleep hot, my blog on tips for overheated sleepers may help.

Reason #3: Stress and Anxiety

Finally, 32% of all survey respondents blamed their nighttime wake-ups on stress and anxiety—which isn’t so surprising. But the suggestion that the youngest adults are the most prone to stress-related wake-ups gives pause.**

Pressure to get into a good college, find the right job, land securely among the “haves” rather than the “have-nots” at a time when in the United States the haves and have-nots are growing farther and farther apart . . . Is young adulthood more stressful now than in times past?

What do you think?

* Results of this poll, which I accessed on 12/4/2015, are no longer available online. Use the contact form on the menu bar if you’d like me to send you a copy.

** Only 37 adults aged 18 to 24 participated in the survey, so the findings on young adults may not be very reliable. Yet other research has shown at least that the number of young adults who experience insomnia is actually quite high.

Sleep Better with Fewer Bathroom Calls

Nothing ruins the night more than an overactive bladder. If you’re lucky you’ll fall right back to sleep when you return to bed. But getting back in the groove is not always easy. Sometimes your mind latches onto a problem and you lie awake for hours.

Here’s how to reduce the urge to go at night and get a better night’s rest.

Reducing bathroom calls at night will improve your sleepNothing ruins the night more than an overactive bladder. If you’re lucky you’ll fall right back to sleep when you return to bed. But getting back in the groove is not always easy.

“I wake up at 3 to go to the bathroom,” Becky, an acquaintance, told me recently. “Immediately I say to myself, ‘Here we go, I need to go the bathroom really quick and try not to wake too much and try not to think about anything and get right back into bed.’ But of course that doesn’t usually happen. Then I start to have a lot of anxieties—tension I can feel in my body, and a general feeling of stress. My mind starts racing and I’m not able to quiet it enough so that I can fall back to sleep.” Often that’s the end of her night.


The need to void at least once a night is common among seniors. Three-quarters of adults aged 65 and older say having to use the bathroom is the most frequent reason they wake up at night. But nocturia is not just a problem for seniors. Forty percent of younger adults attribute most of their nighttime awakenings to it, as do 58 percent of adults in middle age.

Statistics show that nocturia interferes with getting a good night’s sleep. It’s a risk factor for both insomnia (75% increased risk) and reduced sleep quality (71% increased risk). It’s associated with shorter sleep duration, poorer sleep efficiency, and greater daytime dysfunction as well.

Also, in a telling measure of just how big an impact it has, people with overactive bladders are less likely to benefit from insomnia treatments such as CBT-I (cognitive behavioral therapy for insomnia) and BBTI (brief behavioral treatment of insomnia). Consequently, say the authors of an analysis recently published in the journal Sleep, nocturia should be treated before or during the behavioral treatment of insomnia.

Cut down on nightly bathroom calls by changing what you consume and what you do:

  1. Keep yourself hydrated during the daytime but avoid drinking fluids after dinner (especially alcohol and beverages containing caffeine).
  2. Don’t eat foods high in liquid—soup and fruit, for example—for dinner.
  3. Avoid heavily salted foods later in the day. These foods cause your body to store extra fluid and increase urine production at night.
  4. If you are on diuretic medications (water pills), take them earlier in the day.
  5. If your bathroom trips at night are caused by swelling in the ankles and legs, elevate your legs during the daytime and wear compression hose.
  6. Do pelvic floor exercises. Squeeze the muscles that control the flow of urine and hold for a count of 10. Repeat 4 or 5 times. As your muscle control improves, increase the length of time you hold the muscles and the number of repetitions you do.
  7. If none of these strategies work, talk with your doctor about the possibility of taking a medication to reduce bladder spasms and the urge to go at night. Desmopressin and imipramine are two medicines that may help.
  8. Talk to the doctor about the advisability of surgery. Surgical options that relieve the urge to go at night include a device implanted under the skin near the tailbone and procedures for reducing enlarged prostates.