What really causes waking in the middle of the night

Friday, October 29th, 2010 @ 7:30PM

Did you wake up at 3:00 again this morning? Turns out, your blood sugar may be to blame.

I have been speaking on waking in the middle of the night for a few of years now and it’s definitely the most common reason people come to my lectures. If the exhausted crowds at my talks are anything to go by, the typical insomnia stats seem to severely under represent this problem.

There are a few common types of insomnia that I will discuss in upcoming blogs. You might suffer from one or more of these slumber stoppers, and each has a distinct cause. This week I’ll explain why you are waking in the middle of the night and what to do about it.

For years researchers at the Vancouver-based Canadian Centre For Functional Medicine heard the same comment from participants in their weight loss trials: “I’m sleeping better”.  Since these were weight loss studies and not sleep studies, researchers didn’t pay too much attention to this added benefit at first. Then they began to employ a new technology that monitored participants’ blood sugar levels continuously for periods of 24 hours and longer. That revealed trends in blood sugar changes that had never been seen before, and it led to an astonishing realization: in most cases waking at 3 am is not a true sleep problem, it’s a blood sugar problem.

Here’s what happens. When people gain weight, especially abdominal fat, blood sugar levels gradually begin to fluctuate more in response to eating. Although you’ve likely heard that having high blood sugar is a bad thing (and it is), in fact, it’s rapidly falling blood sugar that will produce noticeable symptoms.

When blood sugar plummets 2 things happen:

  1. Special brain cells (glial cells) that monitor the glucose levels will drive you to EAT. And not carrots or celery, either. Those craving will be for sweet or starchy foods that will get your glucose back up fast. Do you often feel like snacking from dinner until bedtime, or crave sweets in the evening? That’s a sure sign you are on the blood sugar roller coaster.
  2. The adrenal glands produce adrenalin. This is an emergency blood sugar raising tactic. An adrenalin surge during sleep will wake you up.

As it turns out, people experiencing glycemic fluctuation during the day are prone to a blood sugar crash while they are sleeping, at about 3:00 am, and this causes waking in the middle of the night.

What if you are waking in the middle of the night but you’re not overweight, maybe even on the thin side? Keep reading, slimmy, I’m getting to you. Some (usually thin) individuals report that they need to eat every three hours or they experience hypoglycemic symptoms – they might even carry snacks or hard candy for “emergencies”. If this describes you, then you are also on the blood sugar roller coaster and will benefit from my advice.

Ok, so now you know why you wake in the middle of the night, what are you going to do about it? Stabilize your blood sugar.

  1. Avoid high-glycemic index foods that will cause your blood sugar to spike (sugar, white flour, pop, juice, sugary drinks). Chose whole, unprocessed, foods without added sugar.
  2. Eat regular meals and don’t skip breakfast. In fact, what you eat for breakfast will set the tone for your blood sugar for the rest of the day, so make it a good one.
  3. Have some protein, some fat and lots of fiber* with each meal. These three elements will keep your sugar stable.
  4. Take chromium. 200 micrograms daily helps your body use insulin better and reduces with sugar cravings.

*When is comes to dietary fiber, we often think of bran. Bran is insoluble fiber, and although it will improve regularity and contribute to colon health, it won’t stabilize your blood sugar. That job belongs to soluble fiber, the invisible, complex polysaccharide found in whole, unprocessed fruit, veggies, legumes, nuts and seeds. Soluble fiber will absorb water to form a natural fiber gel in the stomach. The gel will combine with sugar to release it more slowly into the blood stream, buffering the impact on blood sugar levels. For more info about soluble fiber that balances blood sugar click here.

What if you started waking in the middle of the night during menopause? Yes, hormones are to blame, but not the ones you might think. Blood sugar stabilizing will still help you, but you might need some additional support. Start working on your blood sugar and I’ll explain the rest of the story next week.

So, are you waking in the middle of the night? Does this info makes sense? Share your thoughts by posting a comment!

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Categories: Insomnia

28 Comments to "What really causes waking in the middle of the night" add comment
Deborah Lapointe
2012/01/20 at 1:46 am

I am 50 yrs old 5 foot 4inches and 135 lbs and went through menopause at 47. I have been on bio identical estrogen and progesterone for 2yrs now. it has helped with a lot of my symptoms but I have had problems with sleeping for many years. I am able to fall asleep but am always awake by about 3:oo or 4:00 am every night and toss and turn until I have to get up at7:00 am. I do notvdrink caffeine or smoke and have tried all the bedtime remedies I can think of. No problem falling asleep….can’t stay asleep and alwayscfeeling tired. Any help would be appreciated.

doctorkate
2012/01/20 at 8:11 pm

Have you checked out the two blogs I have posted in this, Deborah? Usually waking at this time of the night means blood sugar fluctuations are at the root of the problem. I have had great results with patients taking PGX to stabilize their blood sugar. Other signs of fluctuating blood sugar include cravings, especially for sweets or starchy foods, a desire to snack in the evening after dinner and an energy slump around in the afternoon. Check out those blogs and let me know what you think.

Susan DeLaney
2012/07/21 at 3:50 pm

I have been waking up at 3 or 4 am consistently for some time. I take ambien a couple times a week so I can get a least a couple good nights of sleep, but I know it is not a solution. I am so glad I found your article. I believe this is the answer I need, and I plan to put your advice into action asap. Thank you so much!

Stephanie
2012/11/10 at 3:33 pm

JUST now read this blog (directed from Healing Thyself’s 10pm bedtime challenge). This totally makes sense. I’ve been on a “healing my gut” journey for about 3 months and have been eating less junk and more real food (as I can afford it). My staple snack is a raw almonds, pecans and raisin mix. That would explain the ‘less interrupted’ sleep last night as I went to bed early. It sounds like I would benefit from taking chromium, just to help stabilize my blood sugars more. Once my body begins to heal itself properly, I will work on the weight. I have about 40 lbs to go. Thanks for these posts. I’ll visit again!

Eddie
2013/03/15 at 10:19 pm

After going one this specific diet how long will it take to improve one’s sleeping pattern? Thanks.

Jai Latif
2013/05/11 at 8:29 am

I have been waking up at night on a regular basis around 4.00 am or 5.00am (although yesterday I woke up at 1.00 am). I then have a binge where I eat biscuits, chocolates or sweets. I think this has contributed to my lack of weight loss, in spite of my exercising regularly. I’m glad I read your article. I hope I will be able to stop doing this now.

doctorkate
2013/05/11 at 5:41 pm

It depends on how serious you blood sugar swings are and how closely you are following the diet, but some people report improved sleep within a week and most people within two weeks.

Ryan
2013/05/24 at 10:41 am

I’m a healthy 41 male who drives a truck
For a living.
I wake up almost every hour or 2 thru
Out a eight hour sleep period. What can I
Do to improve my sleep better?

doctorkate
2013/05/24 at 6:21 pm

Waking up that frequently can mean you are not getting into the deepest stages of sleep or aren’t staying asleep between sleep cycles (which are about 90 minutes long). Try L-theanine, it’s an amino acid that helps relax you and improves sleep quality. Taking 100 mg at bedtime, or even an hour or two before bed, promotes much more restful, uninterrupted sleep. Let me know how it turns out!

Eddie
2013/06/04 at 1:30 am

Thanks Dr. Kate for all your replies.

PS: do you have any articles on Heavy Metal Detox?

ArtV
2013/09/28 at 2:23 pm

So glad I found your site … I’m a healthy 60 yo male, but I’ve been waking bolt upright – heart pounding very consistently just about every night at 3AM for years, takes an hour or so to get back to sleep … thought it might be a health issue got many things checked but nothing significant was ever found, doc suggested a sleep study or possibly was sleep apnea, but since I was already asleep for 4 or 5 hours he said it was not likely it was sleep apnea …

I always thought it might be my wife stirring (I’m a light sleeper) or the cats or something like that. I never considered that it might be my overnight blood sugar level.

Going to work on this and check back with my results to the group …

Best Regards and Thanks …

Art

Kim
2013/10/08 at 8:27 pm

I have always awaken in the middle of the night in search of sweets.
Actually all my siblings do. We blamed our dad since he does te same.
I had a brief period where it stopped not sure why but it did not last long.
I have to get something sweet or I will not go back to sleep.
We literally keep candy in the night stand by the bed.
I will begin making the suggestions changes and see if that works.
Thanks for the advice.

Julie Chismar
2014/02/10 at 8:10 am

Tried clicking on the HERE button for soluble info above and did not work. Here is info found on the web:
Soluble vs. Insoluble Fiber

Soluble fiber dissolves in water. Insoluble fiber does not. To some degree these differences determine how each fiber functions in the body and benefits your health.

Soluble fibers attract water and form a gel, which slows down digestion. Soluble fiber delays the emptying of your stomach and makes you feel full, which helps control weight. Slower stomach emptying may also affect blood sugar levels and have a beneficial effect on insulin sensitivity, which may help control diabetes. Soluble fibers can also help lower LDL (“bad”) blood cholesterol by interfering with the absorption of dietary cholesterol.

Sources of soluble fiber: oatmeal, oat cereal, lentils, apples, oranges, pears, oat bran, strawberries, nuts, flaxseeds, beans, dried peas, blueberries, psyllium, cucumbers, celery, and carrots.
Insoluble fibers are considered gut-healthy fiber because they have a laxative effect and add bulk to the diet, helping prevent constipation. These fibers do not dissolve in water, so they pass through the gastrointestinal tract relatively intact, and speed up the passage of food and waste through your gut. Insoluble fibers are mainly found in whole grains and vegetables.

Sources of insoluble fiber: whole wheat, whole grains, wheat bran, corn bran, seeds, nuts, barley, couscous, brown rice, bulgur, zucchini, celery, broccoli, cabbage, onions, tomatoes, carrots, cucumbers, green beans, dark leafy vegetables, raisins, grapes, fruit, and root vegetable skins.
How Much Dietary Fiber Do You Need?

Most Americans get only about 15 grams of fiber per day in their diet. But the 2005 Dietary Guidelines for Americans recommends about 25 grams for women under 50 and teenage girls. Teenage boys and men under 50 (who consume more calories than women) require upwards of 30-38 grams of dietary fiber daily.

Don’t worry about what kind of fiber you are taking in unless you are seeking a specific health benefit, such as eating more soluble fiber to lower cholesterol. Instead, focus on eating a healthy diet rich in fruits, vegetables, whole grains, legumes, nuts, and seeds. This will provide a variety of soluble and insoluble fibers and all of the health benefits.

As you increase the fiber in your diet, you may experience more intestinal gas. Increasing fiber gradually will allow your body to adapt. Because some fibers absorb water, you should also drink more water as you increase fiber.
________________________________
Thank you for your info on blood sugar. You explain it so well. Will work on regulating the blood sugar.

Blaine Leonard
2014/03/08 at 4:15 pm

I have for years gotten up in the middle of the night and eaten. It’s usually multiple times and always something super sugary. Sometimes I walk up to the corner store at 4am for donuts and cookies or something around thoes lines. I have done this every night for years and my mom does the same thing. I am 38, 5 foot 10 and 180 pounds. I am not over weight but would like to loose 3 inches off my waste.

doctorkate
2014/03/12 at 7:33 pm

You have severe nocturnal hypoglycemia. Not everyone with this condition is obviously overweight – some of the worst cases appear to be slim – but the fact that you want to lose inches off your waist along with the nightly sugar cravings suggest you likely have deep abdominal fat (around the organs) and are headed down the path of diabetes. All of the suggestions in my blog post, avoiding wheat and stabilizing blood sugar are important for you. Another tip would be to engage in brief, high intensity resistance training. Check out Body by Science by Doug McGuff. As an added bonus, if you are doing this program properly you can get away with eating more carbs.

Inna B
2014/03/24 at 7:04 am

Hi ,

I have been suffering from waking up in the middle of night at 3 am for some time now.
I have been getting up and feeling like a have a panic attack and this feeling used to be with me through out the day after that.I was prescribed cipralex 10 mg and i started sleeping again and felt better.
But now, couple of month after , i started to wake up at 3 am again, not feeling so nervous like before but still- it hurts me as i feel tired during the next day.
I dont eat healthy at all, and i started to neglect my health about a month ago, started eating a lot of sweets, pasta right before bed, a lot of coca cola and stuff.

Does my waking up at 3 am has to do with your article? can you please advice .

doctorkate
2014/03/24 at 9:26 am

Hi, Inna. Yes you are waking for the same reasons I outline in the blog. When blood sugar drops, adrenalin goes up. In addition to waking you from sleep this can cause feeling of anxiety – sometimes severe. Many people report they wake up with their heart pounding at 3 am, this is all part of the same picture. The fact that you crave sweets and carbs, especially at night before bed, is typical of this condition.

Laine mclaren
2014/04/15 at 9:21 pm

Hi, I am 47 yr old female and have been waking up between 1am and 2am for about 6mths wanting to eat. I have been drinking either peppermint tea or a chai tea instead of eating for the last month, are these tea’s OK IN RELATION TO BLOOD SUGAR CAUSING MY WAKE UP’s. Kind regards Laine I usually get up drink tea and read a book for 20 mins then I can return to sleep. I have been On a weight loss journey for about 2 yrs. I weigh 74kilo’s.

Sylvie Balsillie
2014/04/23 at 3:43 am

After waking up at 3am most nights and failing to get back to sleep for hours, I decided to try a lower carb diet. The result was almost immediate and I now rarely wake at this time so this article ref blood sugar totally makes sense to me. Another significant benefit for me is reduced period pain….going from a pain score of 8-9 each month to a 1-2. I would advise anyone to read into a lower carb/anti- inflammatory diet with similar problems.

doctorkate
2014/04/23 at 10:30 am

Hi Laine,
Chai tea usually has caffeine in it so that’s not great for your sleep. Other than that, as long as the tea doesn’t have sugar in it and it helps you get back to sleep that’s fine.

DeNaide D
2014/06/26 at 12:29 pm

Hi, I am a 27 year old female and have been waking up in the middle of the night for over thirteen years now. I wake up and have a intense craving for sweets and foods packed with carbohydrates. I sometimes wake up with a pounding heart. As I’ve gotten older the syptoms seem to worsen. I usually make a point to get in the bed by 9:30 since I know that I generally wake up about every 1-2 hours. The crave for the foods that I eat is unreal. I would love to quit but my body won’t let me. I honestly feel like I’m a different person at night. During the day I’m ok. I don’t crave sugary foods and I eat like a normal person. But at night it’s like a switch that flips. I’m really worried about health and the inability to sleep. I’ve been prescribed numberous amounts of sleep aid’s and none of them will help me sleep. My doctor has checked my blood to see if I’m a diabetic but found nothing. I told her that I feel fine during the day but it’s at night when the problem arises. I’m 5 ft. 6 in. and with about 170 lbs. I know that I’m a bit overweight but the ability to lose weight seems impossible when i can’t kick the night time sugar. What do you recommend that I do?

April Nicholson
2014/07/03 at 8:00 am

Hi Dr. Kate! Very interesting article. I am so perplexed however? I find your information spot on but I seem to be the exact opposite and am looking for answers. I have been a great, deep sleeper for years with no issues. However, for other health reasons (hashimoto’s, chronic migraines, high blood pressure, fibromyalgia, colitis) I decided to eliminate wheat and sugar from my diet. I have been grain free and sugar free (I do eat berries, cherries and apples occasionally) for 10 days. It has been miraculous how I feel! The pain is gone and I expect other ailments to improve in the future. The problem is I began to wake up around 3:00-4:00 as your article states. I’m not sure how mine could be a blood sugar issue as I feel I don’t have spikes anymore and zero cravings but this did start with the elimination of grains/sugar. I read that this could have something to do with my liver? Thank you for any input you might have!

doctorkate
2014/07/08 at 1:47 pm

Hi April,
Hmm, interesting. I’m glad to hear that you feel good and other symptoms are improving, but the new sleep troubles are perplexing indeed. I would try one or two scoops of whey protein during the day or in the evening. This helps provide amino acids that make sleep-friendly neurotransmitters and balance blood sugar. (FYI, there’s a big debate around isolate versus concentrate but I like the isolate/concentrate blends.)
You are correct that waking around 3 is connected to the liver. Making a major change in your diet will be something of a surprise for your liver. Some people (like me) find a curcumin supplement at bedtime (like 300 mg of Theracurmin, for example) can make a big impact on sleep. This may be because of its liver-loving action, as well as other reasons. For some people this works well on its own, or with a dose of magnesium citrate. Please keep me posted!

doctorkate
2014/07/08 at 2:01 pm

Hi, you are the classic example of nocturnal hypoglycemia – pounding heart and all – although maybe more extreme since you have been having this since your early teens. The amino acid glycine has benefits for both glucose metabolism, sleep and weight loss, check out a glycine supplement. Also the usual blood sugar balancing principles apply here: try a wheat free diet, PGX granules with meals and chromium. Please keep me posted.

bernard
2014/07/13 at 1:38 pm

I am 35 yo male with middle of night waking up problem for long time. Strangely, it’s always the same time of night. 4:30 AM every times, it’s like I got alarm clock going off in my head.

No cold sweat or sugar craving, just woke up at 4:30 am and can’t get back to sleep until around 5-6 am.

Clare
2014/07/21 at 2:43 pm

Thankyou. This is a lightbulb. I experience the surge of adrenaline in the night and wake with a pounding heart. I never eat in the middle of the night. I am deeply spiritually inclined. I have difficulty applying my intention to be sugar and grain free, and am over-achieving and highly productive. I definitely crave food in general. 5 weeks ago I began to suffer what I recognise to be chronic fatigue and fibromyalgia. The fibromyalgia disappeared after a one-day experience using naproxen and since then no more drug use (I am too naturopathically inclined) and looked at psychotherapy and massive increase in immune-system support including olive leaf extract, fish oil, vitamin b complexes, vitamin d, iron, green smoothies (ie spinach, mint, lemon, celery and mango or pear or apple as sweetener). I have also become serious about eating more vegetables and less refined white flour and sugar. Also I decided to commit to lying in my bed, ie sleeping, in the middle of every day. This is to avoid my highly stressful work ethic. I am definitely improving and see a really obvious symptom after reading your article of sugar addiction and adrenal problems. I consider that the approach to wellness will be along the lines of dedicating and committing to health and rest, as opposed to quick fixes for dealing with life. I found this article helpful, too, and supportive of the idea that a patient with fatigue and adrenal problems generally seems nervous and sensitive and neurotic and unable to commit, and that the road to recovery means a great deal of nurture and support is required over a long period. http://www.fms-help.com/adrenal.htm

Furthermore, I am coming to understand that our psychology as women of these times is rather battered and pushed and rushed and stressed with oftentimes non-fulfilling activities, and that a sort of domination that pre-feminism was attributed to men, has become an inward force – we still dominate ourselves.

So above all I am addressing that and also committing to being balanced rather than dominant/submissive in my behaviour and response to everyday activities. What I mean is, I often would make myself do something of service to anyone but myself out of a feeling of ‘should’ or guilt, and now am not willing to answer to that insistence anymore as I believe it is directly neurologically and psychologically linked to the overuse of the adrenal system.

I think the pain of the fibromyalgia has ‘woken’ me up to this situation and it is a blessing.

doctorkate
2014/07/21 at 3:33 pm

Thanks for your feedback, I’m glad my article helped you make some conections. Those are deep insights into how psychology can affect the adrenal glands. It is amazing when we can find meaning in pain.

doctorkate
2014/07/21 at 3:43 pm

Well, that’s a bit of a head scratcher, Bernard. Most people with nocuturnal hypoglycemia wake between 2 and 4am, even without other symptoms. Grief (death of a loved of a loved one or relationship break-up) will often wake people around 5 am, but that typically resolves over time. You are somewhere in between. If you are looking to sleep through you might want to consider a natural supplement that improves sleep quality such as L-theanine, glycine or curcumin.

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