Insomnia: Too Much Alpha Wave Activity at Night

The brains of people with insomnia are active at night, even during quiet sleep. This activity isn’t often noted in sleep studies, where the point is to identify dominant wave forms. But looking closer, scientists are discovering slight but crucial differences in insomniacs’ brain waves at night, which may explain our trouble falling and staying asleep.

“Alpha wave intrusion” is a term used to describe the wake-like brain activity observed during the deep sleep of people with fibromyalgia and major depression. Now a new study in the Journal of Sleep Research presents evidence of abnormal alpha wave activity in insomniacs’ brains at night. Here are the two main findings:

Insomnia is characterized by greater alpha wave activity at nightPicture the brain at night. It’s mostly quiet except during rapid eye movement (REM) sleep. Then clusters of neurons in the brain stem start firing away like mad. These bursts of activity are perfectly normal during REM sleep, alternating with periods of quiet non-REM sleep through most of the night.

The brains of people with insomnia are more active at night—even during non-REM sleep. This activity isn’t often noted in sleep studies, where the point is to identify dominant wave forms. But looking closer, scientists are discovering slight but crucial differences in insomniacs’ brain waves at night, which may explain our trouble falling and staying asleep.

Alpha wave intrusion is a term used to describe the wake-like brain activity observed during the deep sleep of people with fibromyalgia and major depression. Now a new study in the Journal of Sleep Research presents evidence of abnormal alpha wave activity in insomniacs’ brains at night. Here are the two main findings:

Trouble Falling Asleep

The descent from wakefulness into deep sleep occurs fairly quickly in healthy sleepers. The pressure to pay off the day’s sleep debt is strong, compelling a rapid descent into deep (slow-wave) sleep.

But in people with sleep onset insomnia, who typically take more than 30 minutes to fall asleep at night, the descent takes quite a bit longer, research shows. Insomniacs—for unknown reasons—seem to have reduced sleep pressure. Not only does it take us longer to fall asleep. It also takes us longer to descend into deep sleep, the really restorative stuff.

Why the Slow Descent?

The research team investigating alpha wave activity looked at the sleep studies of 18 good sleepers and 10 insomniacs and found one difference that occurred before sleep began. Alpha waves—associated with a relaxed, meditative state of consciousness that occurs when the eyes are closed—are predominant in the period leading up to sleep. They’re generated by neurons firing at frequencies of 7.5 to 12.5 cycles per second.

As the healthy sleepers in the study were falling asleep, the alpha rhythms in their brains began to fluctuate and decay. But the alpha wave activity in insomniacs’ brains continued going strong.

Sleep onset insomnia may have something to do with decreased alpha variability, the researchers concluded. Insomniacs are relaxed and ready for sleep—yet (again for unknown reasons) we remain stuck in alpha mode.

Waking Up at Night

Alpha waves may also play a role in sleep maintenance insomnia. Polysomnogram studies show that normal sleepers awaken at least a few times a night but are mostly unaware of these awakenings.

People with sleep maintenance insomnia, in contrast, are conscious of waking up at night. These awakenings make our sleep feel fitful and less restorative. (And some sleep maintenance insomniacs are told their problem involves alpha wave intrusion following a sleep study.)

Adults spend up to 80% of the night in non-REM sleep, and in the alpha wave study, different kinds of alpha activity occurred in the brains of healthy sleepers and insomniacs throughout non-REM sleep. Brief arousals in the healthy sleepers were characterized by alpha waves that stayed well below the frequency of alpha waves during conscious wakefulness.

But the alpha frequencies in participants with insomnia rebounded to wake levels. In this situation, a sleeper might be easily awakened by noise or movement and memories could be formed. It might account for why so many insomniacs complain of light and/or broken sleep.

The Take-Away

Higher alpha frequencies during brief arousals and lower alpha variability at the approach of sleep fit with the hyperarousal theory of insomnia, which suggests that people prone to insomnia experience higher levels of arousal around the clock. As for how to correct these alpha abnormalities, we’ll have to wait and see.

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.

Q & A: Will Melatonin Keep Me Asleep?

Can melatonin supplements be used to cut down on insomnia and middle-of-the-night awakenings?

There are two issues to consider here: safety and efficacy.

Pill-PoppingUse melatonin to cut down on insomnia and middle-of-the-night awakenings? A reader, following last Friday’s blog, posted this question on Ask The Savvy Insomniac:

“I don’t have any problems falling asleep. I go to bed around 10 and I’m out cold. But then I wake up at 1 a.m. and can’t fall back to sleep. I’ve talked to my doctor about it, and he recommended taking melatonin at bedtime. So I started with 3 mg but I kept needing more. Now I’m up to 15 mg, but I’m still waking up. My doctor says it’s OK to take more. What do you think?”

Hmmm. There are two issues here: safety and efficacy.

Safety

Supplements of melatonin—a sleep-promoting hormone produced by the pineal gland—are known to be safe in doses up to 20 mg. Melatonin doesn’t usually cause morning grogginess nor, under experimental conditions, have subjects developed tolerance to it. Higher dosages of melatonin have yet to be tested for safety.

Efficacy

It’s the efficacy issue that has me scratching my head. Taken several hours before bedtime, melatonin can help people fall asleep sooner than they normally would. It’s often recommended for night owls wishing to fall asleep at an earlier hour, or for jet lag. But the man writing above is asleep by 10 p.m.; his problem is insomnia in the middle of the night.

Would a 15 mg dose of melatonin taken at bedtime help him sleep through the night? It depends. Many melatonin supplements sold over-the-counter in the United States have a very short half-life: 20 to 45 minutes. (Half-life refers to the time it takes for a dose of a drug in the blood plasma to decrease by half.) Melatonin supplements lose strength too quickly to help users sleep through the night, reviewer Rüdiger Hardeland says. Higher doses of melatonin—50 or 100 mg—have been proposed as a therapy for people who have trouble sleeping through the night, but they have yet to be tested. (For more information, see my blog on Melatonin Replacement Therapy.)

A Controlled Release Version?

A controlled release version of melatonin is sold in Europe and many other countries outside the United States. It’s called Circadin and is approved for insomnia patients 55 and older (and obtainable by prescription only). Some studies—but not all—have shown it improves the sleep quality of older people with insomnia, whose natural melatonin secretion may have declined due to a weakening of the circadian system or to calcification of the pineal gland. This drug might have more to offer older insomnia sufferers whose problem is waking up in the middle of the night.

Update

I wrote this blog post over 3 years ago and, since then, timed-release melatonin supplements have become available in the United States. They’re made by several different companies and sold over the counter. If you’re using melatonin supplements for middle-of-the-night insomnia, try a controlled-release formulation.

Has taking melatonin improved your sleep? How?

Management of Insomnia

Melatonin Prolonged Release