This is How to Fall Back Asleep – 8 Things to Try

Within the past year, I was a little desperate to figure out how to fall back asleep upon being woken in the middle of the night. So, I set out to do some research to see if I could find the gold standard for how to fall back asleep.

Some of the stuff I found had me shaking my head.  For example, one of the weirdest I came upon came from a Calm.com poll regarding some potential cures for insomnia, either used historically or nowadays. Coming in at #3 on the list was “Drinking a potion containing the bile of a castrated boar.”

As appetizing as that sounds and as desperate as I was, I decided I was not THAT desperate and soldiered on and decided to move to some better sources (no offense to Calm.com) including the Harvard Medical School Guide to a Good Night’s Sleep amongst others.

Waking Up in the Middle of the Night

It turns out that there is a name for when you wake up in the middle of the night and cannot fall back asleep, it’s called sleep maintenance insomnia.

Now, before we go any further, for those suffering from any stretches of prolonged insomnia it is a good idea to check with your physician to make sure there are no underlying medical conditions that are causing it.

I know for me, my sleep maintenance insomnia is caused by my mind racing and thinking about different things I want to get accomplished. Other reasons for sleep maintenance insomnia could be stress, worry, or several other bad sleep hygiene habits that you may wish to correct.

Arousal – Another Reason Why Many of Us Wake Up in the Middle of the Night

As I said, many of us experience those times when we wake up during the middle of the night and cannot fall back asleep.

As Dr. Pierce Howard explains in Sleep: The Owner’s Manual:

“If you’re awakened in the middle of the night and can’t get back to sleep it’s a good bet you’ve somehow been aroused. What you need to do is shut down your aroused state.” ¹

How to Fall Back Asleep – 8 Things to Try

For those of us who suffer from sleep maintenance insomnia and want to know how to fall back asleep, here are some things we can try.

(1)  Take a Dump…a Mental Dump!

As Howard recommends: “Often sleep eludes us because of our thoughts race around trying to keep from being forgotten. Keep a pad and pen beside your bed and take a mental dump by writing down all those thoughts that are bumping into each other. You can then sleep peacefully and deal with them tomorrow.” ¹

(2)  Get bored again

Many times, we are woken by something that arouses us emotionally such as a phone call or text message. When this occurs, we need to decrease our state of limbic arousal, in other words, we need to become bored again.  Whether we count sheep or read a boring book, the idea is to get bored. One thing you DO NOT want to do is read this entertaining and actionable blog! (I never thought I would tell you to do that!)

(3)  Try Reconditioning

Back in the 1970’s Richard Bootzin, a professor at Northwestern University developed a 6-rules technique to help those with insomnia break the harmful associations between the environment where sleep and wakefulness. The idea was to start to associate the bedroom with sleep.

The 6 rules of reconditioning or “stimulus control” according to Bootzin are as follows:

(1)  Go to bed only when you’re sleepy.
(2)  Use the bed only for sleeping or sex. Do not read, watch television, eat, or worry in bed.
(3)  If you’re unable to sleep quickly, within about twenty minutes—get up and move to another room. Stay up until you are sleepy, and then return to bed.
(4)  If you still can’t fall asleep, repeat step 3 as often as necessary through the night.
(5)  During the sleep reconditioning process, set your alarm and get up at the same time every morning, regardless of how much sleep you got during the night.
(6)  Do not nap during the day.

Lawrence Epstein, M.D. author of the Harvard Medical School Guide to A Good Night’s Sleep explains the steps above as follows:

“Each step builds on and reinforces the next, and all the steps must be followed for the technique to succeed. They establish a positive association between your bed and healthy sleep. By getting out of bed, the negative associations (frustration, irritation, and worrying about sleep) become associated with a site other than the bedroom. Be sure to do non-stimulating, relaxing things while you’re awake to allow the sleep process to begin again. Maintaining a consistent sleep/wake routine and avoiding napping reestablishes a more normal pattern.

 Consistency is a key element to this technique’s success. The six rules sound simple, but perfect compliance can be challenging. People are sometimes reluctant to get out of bed when they can’t sleep. But those who are conscientious in following this regimen often find that reconditioning helps them return to a regular sleep schedule.” ²

(4)  Practice good sleep hygiene

This includes making sure your room is dark enough and the right temperature. Go to the bathroom right before bedtime.  Personally I am careful not to drink too much water before bedtime as I know it will make me get up to go to the bathroom.  ³

(5)  Turn off your electronics

You may think checking your email is a good use of that time when you are awake during the night, but it’s not! The blue light emitted from your phone interferes with your sleep. So put it away, whatever it is, it can wait!

(6)  Utilize relaxation techniques

There are several relaxation techniques that we have discussed on this blog previously that can be used for how to fall back asleep by lowering your level of arousal.

Deep breathing     

One method of deep breathing you may want to try is called the 4-7-8 method.

It works like this, you hold the tip of your tongue on the tissue right behind your front teeth, then you simply:

  First exhale through your mouth, making a loud whoosh sound.

  Breathe in through your nose for a count of 4 (with your mouth closed).

  Hold it for a count of 7.

  Exhale through your mouth for a count of 8 (again making the whooshing sound).

  This is one cycle. Repeat the cycle 3 more times.

Some tips:

  Keep your tongue behind your teeth the whole time.

  I do it lying down, but it is recommended to do it sitting with your back straight when learning how to do it.

  Breathe in quietly through your nose.

  If you can’t hold your breath for that long, it’s fine. It is the ratio of 4:7:8 is what is important – so just count a bit faster.

  I don’t just do it to fall asleep, but also if I am feeling tense or stressed.

  Some people feel light-headed when doing it – if so, slow your breathing and get up slowly.

  It is recommended not to do more than 4 cycles for the first month of doing it, but you can up it to 8 cycles after a while.

According to Dr. Andrew Weil, the reason it works is that “This breathing exercise is a natural tranquilizer for the nervous system. Unlike tranquilizing drugs, which are often effective when you first take them but then lose their power over time, this exercise is subtle when you first try it, but gains in power with repetition and practice.” ⁴

Simple Meditation

Simple meditation is a practice where you engage in concentrated focus to pay attention to your breath, a sound, your body, attention itself, etc. to become more aware of the present moment.

Body Scan Meditation

This isn’t one that we have discussed but it has worked wonders for me and is another method I use for how to fall back asleep.  For me, I simply relax and breathe through my abdomen. Then I focus on my head and bring awareness to it and then systematically bring focus to each part of my body going from body part to body part until I reach my feet.  Then I go back up to my head and repeat. I find that after a few times through I am back asleep.

(7)  Cognitive therapy

Cognitive therapy is an approach that helps you come up with new ways to think about and then do things. With respect to insomnia, the idea is to change your negative thoughts and feelings regarding sleep into good ones. Many times, those who suffer from insomnia become preoccupied with being unable to sleep and the consequences of not being able to sleep.  This worry makes it even harder to relax and sleep.

As Dr. Epstein explains:

“A cognitive behavior therapist helps you replace these maladaptive beliefs with accurate and constructive thoughts and habits, such as “All of my problems do not stem from insomnia,” “I stand a good chance of getting a good night’s sleep tonight,” “My job does not depend on how much sleep I get tonight,” and “Even if I don’t fall asleep quickly tonight, it’s not such a big deal.” The therapist also provides structure and support while you practice new thoughts and habits. Success requires practice and multiple sessions.” ²

(8)  Speak to your doctor

Again, if your sleep maintenance insomnia persists, definitely see a physician so you can find out your options with respect to getting a good night’s sleep.

Hopefully One or More of These Ideas Work for You…

…but if not, there is one more thing you may want to try.

According to some, eating onions can help you sleep better. ⁵

Just don’t expect a goodnight kiss!

Until next time, sweet dreams, pucker up, and as always…PYMFP!
–Rick

Use it Or Lose It

For those of us who suffer from sleep maintenance insomnia and want to know how to fall back asleep, here are some things we can try:

(1)  Take a Dump…a Mental Dump!
(2)  Get bored again
(3)  Try reconditioning
(4)  Practice good sleep hygiene
(5)  Turn off your electronics
(6)  Utilize relaxation techniques
(7)  Cognitive therapy
(8)  Speak to your doctor

When to Use It

Use these tips for how to fall back asleep when you wake up in the middle of the night and cannot get back to sleep.

What Do You Think?

Have you used any of these tips for how to fall back asleep? Do you know of any other tips for how to fall back asleep that we didn’t discuss? Please share your thoughts in the comments below!

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References

¹ Sleep: The Owner’s Manual by Dr. Pierce J. Howard

² Harvard Medical School Guide to a Good Night’s Sleep

3 Fiorentino L, Martin JL. Awake at 4 AM: treatment of insomnia with early morning awakenings among older adults. J Clin Psychol. 2010;66(11):1161–1174. doi:10.1002/jclp.20734

4 https://www.drweil.com/health-wellness/body-mind-spirit/stress-anxiety/breathing-three-exercises/2/

5 https://www.colorado.edu/today/2017/02/23/dietary-prebiotics-improve-sleep-buffer-stress