Why Do I Wake Up Every Two Hours at Night?

“Beauty sleep” is called so for a reason.

“Beauty sleep” is called so for a reason. We need a minimum of six to eight hours of undisturbed sleep for a healthy body and an alert mind. Frequent awakenings and poor-quality sleep have been known to cause obesity, hypertension, and even diabetes. Most of us wake up three to four times during the night for varied reasons, and this is considered a part of a normal sleep pattern. However, a lot of us wake more frequently, sometimes even every two to three hours in the night. This is a reason for concern.

If the sleep problems are persistent, they indicate serious health conditions. So, it is prudent to be aware of the reasons that may be disturbing sleep every few hours at night.

1. Causes pertaining to the surroundings:

Table 1. Environmental factors

Cause

Explanation

Tips

Room temperature

A room that is too cold, too hot, or too humid may cause frequent awakenings.

Most doctors recommend keeping the thermostat set between 60-67 °F to get good sleep.

Room lightening

The bedroom should be completely dark.

Using room-darkening shades or curtains may help.

Social media

The Facebook, Twitter, and Instagram updates may be messing with sleep.

The eBooks, mobiles, or tablets that emit blue light disturb the sleep pattern.

Try to switch off social media an hour or two before bed.

Try using the blue light guards.

Physical causes

An uncomfortable bed.

Choose breathable, light-colored, clean bedsheets, a medium-firm mattress, and a good quality pillow.

2. Sleep apnea syndrome: One of the important causes of sleep awakening, sleep apnea is often caused by obesity or poor muscle tone. Sleep apnea causes the tongue to fall back over the throat in sleep leading to a pause in breathing for a few seconds. These episodes often result in night-time awakening. The syndrome is diagnosed by sleep studies and managed by weight loss and a continuous positive airway pressure or CPAP device.

3. Upper respiratory tract issues: A stuffy nose may cause frequent night-time awakenings due to dry cough and throat irritation. Several conditions may cause a stuffy nose and sore throat. Visit an ear, nose, throat (ENT) specialist if any of the following problems is suspected:

• A deviated nasal septum
• Seasonal allergies
• Cold
• Sinusitis
• Nasal polyps
• Large tonsils or adenoids in a child
• An overly large tongue

4. Sleep disorders: Various sleep disorders (see Table 2) that disturb the normal sleep patterns may often result in night awakenings. These need to be diagnosed by a health professional and treated accordingly.

Table 2. Sleep disorders

Disease

Explanation

Treatment

Restless leg syndrome or periodic limb movement disorder (PLMD)

A genetic disease with an uncontrollable urge to move the legs.

The jerking of legs in sleep causes awakening.

Benzodiazepines

Opiates

Anti-epileptics

Shift work sleep disorder

Seen in the individuals working nights or rotating shifts.

The changes in the sleep period often disturb sleep patterns and cause frequent awakening.

Melatonin

Benzodiazepines

Narcolepsy

The person involuntarily falls asleep at regular intervals throughout the day.

This causes fragmented sleep at night.

Xyrem (sodium oxybate)

Wakix (pitolisant).

Ritalin (methylphenidate)

Serotonin-norepinephrine reuptake inhibitors (SNRIs)

Selective serotonin reuptake inhibitors (SSRIs), such as Prozac

Jet lag

Disturbed sleep due to air travel across different time zones.

Melatonin

Benzodiazepines

Stress or anxiety

Stress over days. This may be work-related, study-related, or general stress.

Sleep hygiene

Mild sedatives

5. Gastric issues: Often the issues, such as acid reflux, heartburn, and indigestion, can keep a person from having a good sleep. Having a smaller meal in the evening, avoiding spicy foods at bedtime, and limiting caffeine intake can help prevent heartburn. Medication and antacids will help as well.

6. Increased need to urinate: Frequent need to pee can also result in night-time awakenings. These may be seen in several cases.

Table 3. Diseases that cause frequent urination

Disease

Preventive measures

Diabetes mellitus

Get the blood and urine tested for sugars. Once the sugars are normalized, the frequent urination will stop.

Prostate hypertrophy

Seen in males aged 50 years or older. An enlarged prostate can cause frequent urination.

Treatment is medications or surgery.

Overactive bladder

Seen in people who consume a lot of caffeine and alcohol or have weak muscles, nerve damage, multiple sclerosis, Parkinson’s disease, multiple myeloma.

Treatment is Kegel exercises and medications.

Urinary tract infections

Get the urine tested and start medicines for the same.

Other urinary tract issues

Urinary stones, pressure over the bladder due to a prolapsed uterus, a stent placed in kidneys after kidney surgery may cause frequent urination. The management is treating the cause.

Drugs

Diuretics (water pills) if taken at night may cause increased urination.