Why Do I Always Wake Up After 5 hours of sleep?

Julia was at wit’s end. She has been suffering from insomnia for the past 10 years, since she entered menopause. She keeps waking up after 5 hours, despite trying every over-the-counter and prescription medication available. She has no trouble falling asleep, but is not able to stay asleep for more than 5 hours, typically waking up at 3AM after falling asleep at 10PM. Oftentimes, she has to go to the bathroom when she awakens, but it’s not too much urine. She even saw a behavioral sleep specialist who offered cognitive behavioral therapy for insomnia (CBT-i), which only helped temporarily. 
Julia’s history is typical for what’s called sleep maintenance insomnia, where you can’t stay asleep or keep waking up after you’re able to fall asleep. This differs from sleep onset insomnia, where you’re not able to fall asleep within 20 to 30 minutes of getting into bed. The accepted explanation for insomnia is that it’s a complex interaction between poor sleep routines, behavior and thoughts, in addition to a baseline hyperarousal of your brain. Essentially, you can’t shut down your brain when you want to go to sleep.
One of the potential consequences of sleep maintenance insomnia is that with continuous awakenings at AM and not being able to go back to sleep is that your sleep clock becomes advanced, or gets pushed backwards. This could potentially lead to advanced sleep phase syndrome, a condition that’s commonly seen in the elderly. In this condition, you’ll want to go to sleep much earlier in the evening, such as 8PM, rather than at 10PM.
I’ve always wondered why people tend to wake up around 3AM,  whether it’s insomnia, nighttime urination, or asthma. The most obvious connection between these three connections is that you spend longer periods of REM sleep (your dream stage), starting around 3AM. Stage REM is also when your muscles are most relaxed, which can predispose you to have breathing problems. I’ve been doing thought experiments about his concept, and I’m convinced that we need to think about sleep maintenance insomnia in a completely different way—perhaps it’s a consequence of a breathing problem.
Before I go over my arguments, a few basic sleep concepts need to be reviewed.
Sleep Position
If you see photos or drawing of people sleeping, you’ll often see sleep being depicted as someone sleeping on the back. However, most modern Western people prefer to sleep on their sides or stomach. One of many reasons is that supine (back) sleep will allow the soft tissues of the tongue and soft palate and fall back more due to gravity when supine.
As women go through menopause, throat muscles will relax somewhat due to lowered progesterone levels. This study found that genioglossus muscle (tongue) activity is lower in post-menopausal women compared to pre-menopausal women. This is why women on hormone replacement therapy tend to sleep slightly better.
Your Circadian Rhythm 
Another major sleep concept that’s important to understand are two processes that are involved in sleep regulation. The first one is the well-known circadian rhythm. For many of us here on Earth, we are on a 24 hour cycle. The circadian rhythm, which is regulated by light, cycles up and down between two 12-hour intervals. This is called the C process. This is what makes you alert during the day and drowsy at night.
Your Drive for Sleep
There’s another simultaneous sleep-related phenomena called the S process. This is your drive for sleep, which is minimal in the morning when you first wake up, but then increases gradually reaching its peak before you fall asleep. Once you’re asleep, it drops back down to the baseline low level at which point you’ll wake up. 
Process S also corresponds to your level of adenosine that builds up in your brain. Adenosine inhibits wakefulness. As the day progresses, adenosine levels slowly increase. Ingesting caffeine from drinking coffee is one way that we block the effects of adenosine. 
The Importance of Sleep Stage 
Now there’s one more piece to the puzzle that’s critical. This is your sleep cycle. Normally, you’ll cycle between 4 defined stages of sleep: Wake, N1, N2, N3, REM. N1 and N2 are the lighter stages of sleep and N3 is deep sleep. During N1 through N3, your muscles become gradually more relaxed, but in REM sleep (rapid eye movement and dream stage),  your muscles are completely relaxed. 
You’ll reach deep sleep (N3) in the early part of the night, but as you progress through 4 to 5 sleep cycles (90 to 120 minutes long), N3 gets shorter and shorter and REM becomes longer and longer. Around 3 to 4 AM is when you begin to have longer periods of REM sleep. 
There are many different explanations on what causes us to wake up prematurely in the morning, but it’s probably a combination of  these three processes, along with sunlight that arrives in the morning. When you’re about to wake up, your circadian (wake forces) are beginning to increase from its lowest point, your sleep drive (S) is at its lowest point, and you’re most likely in REM sleep, when muscles are most relaxed, leading to possible obstructed breathing. This  can be a natural, normal waking mechanism. Notice that in many cases you’re waking up during a dream in the morning. Adding sunlight is another cue for you to wake up. 
In addition, the lowest point in the circadian cycle is called the singularity. It typically occurs around 2 hours before your natural wake up time. It’s also the time when your core body temperature is at its lowest. On the C&S figure, notice that this dip is about 2 hours before wake time. We also know that as core body temperature rises, you’re more likely to wake up. 
In the figure below, I’ve juxtaposed the hypnogram (sleep stages) underneath the C&S figure during 8 hours of sleep. 
All of the above is assuming that you have normal upper airway anatomy and you are able to wake up after sleeping 7 to 8 hours without any problems. However, if you have upper airway narrowing due to large tonsils or small jaws with dental crowding, you’re more likely to partially or totally stop breathing, whether it’s for 3 seconds or 25 seconds. Totally obstructed breathing for more than 10 seconds is called an apnea if detected during a sleep study. A breathing pause for less than 10 seconds won’t be counted as a formal respiratory event (apneas, hypopnea or RERA) but will most likely be counted as an arousal. 
We also know that obstructed breathing is more likely to occur during REM sleep, especially when you’re on your back. If you have more narrow upper airways, then the higher the likelihood of more frequent breathing pauses around 3-4 AM, when you’re in longer periods of REM sleep. If you add the various other factors mentioned above (circadian factors, sleep drive, sleep position, sleep stage, light, etc.), then you’re more likely to wake up around this time. 
Brain hyperarousal
One of the hallmarks of insomniacs is the inability shut down the brain when going to sleep, or after a nighttime arousal. It think you’ll agree with me that waking up due to choking and breathing pauses can be a major cause of physiologic, emotional and psychological stress.
Nighttime urination
Some of you may have to go to the bathroom to urinate. This is a common condition (nocturia) in people with obstructive sleep apnea or upper airway resistance syndrome due to a hormone (atrial natriuretic peptide) that’s created by your heart in response to stimulation from obstructed breathing, leading to more urine production. Some of you are able to go back to sleep, but some of you can’t fall back asleep. Whether or not you can fall back asleep may depend on how violently you woke up. If you just had a 30 second choking episode, this will lead to a major stress response, with heart rate blood pressure elevations. It’s unlikely you’ll be able to fall back asleep. 
Putting the pieces together
In medicine, and especially sleep medicine, we like to categorize medical conditions into separate categories. It assumes that obstructive sleep apnea is completely different from insomnia. However, when it comes to these two conditions, there is compelling evidence that there can be a great deal of overlap when it comes to presenting symptoms. 
One example of this overlapping phenomenon is a study performed by Dr. Barry Krakow. He and his colleague reviewed 218 patients with prescription medication resistant insomnia, and 75% were found to have obstructive sleep apnea based on formal sleep studies.
Julia eventually made her way to find me and not surprisingly, she was found to have moderately obstructive sleep apnea (AHI 20).  She began using CPAP, and finally able to sleep for 7 hours again like she used to when she was in her teens. Looking back on her history, she suffered a shoulder about 8 years ago. This forced her to sleep on her back, when she normally preferred to sleep on her side. She began to gain weight later, and began to snore heavily. 
This alternative explanation for sleep maintenance insomnia may seem a bit fat fetched for traditional sleep scientists, but looking at this from a sleep-breathing standpoint, it makes a lot of sense. How many of you keep waking up much earlier than your preferred time? What have to tried so far? Please enter your responses in the text box below.

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33 thoughts on “Why Do I Always Wake Up After 5 hours of sleep?

  1. Dear Dr. Steven Park:
    Is it true that some expert said CPAP could not lengthen the time of sleep but just improve the efficiency of sleep?
    What can we do if we want to increase the sleep cycles from 3 to 4?

  2. Around 1996 I was diagnosed with a thyroglossal duct cyst and underwent a procedure to remove the hyoid bone. My health and weight was excellent. Over the years I gradually gained weight and began snoring. Currently my weight is about 228 lbs at 5’10”. For several years my sleep patterns had been very poor. Often waking up several times in the night. Sometimes being excessively tired during the day. My children complained of my snoring and my wife was concerned that by my pause in breathing during my sleep. Finally at her insistence I saw a doctor who prescribed a sleep study. I was quickly diagnosed with sleep apnea. I now reluctantly use a CPAP machine. I have been using the machine for about 6 weeks. I must admit my sleep is better and I feel more rested. That said I still wake up after 4 to 5 hours. Then go back to sleep about an hour later. I believe the combination of my thyroglossal duct cyst surgery and weight gain has contributed to my sleep apnea. I was unaware that my waking up after 4 to 5 hours even when using a CPAP device may still be related to my breathing. I always suspected but didn’t know that my prior survey could also contribute. Thank you for your website information. I would be interested in learning if there are options available to correct prior thyroglossal duct cyst surgery that are worth the risk.

  3. Mr. Cox,

    Thanks for sharing. I’ve always suspected that thyroglossal duct cyst surgery may worsen sleep quality by relaxing the tongue and epiglottic structures. Poor sleep then will aggravate weight gain, and the vicious cycle continues.

    Unfortunately, there’s no formal way of reversing your surgery, except for the standard surgical treatment options for obstructive sleep apnea. It’s not something that most ENTs and sleep doctors may acknowledge. Your best bet is to better optimize your current CPAP treatment. Good luck.

  4. Zing,

    I have seen many people lengthen their sleep time significantly on CPAP, with more uninterrupted sleep cycles.

  5. I’ve probably been waking up between 3 and 4 for much of my life, but the problem has become more acute in the past year, leading to considerable fatigue (but no more sleep). I start out sleeping on my side, but I usually have flipped on my back before I wake up. Sometimes, I feel like I’m holding my breath when I wake up. I’ve had sleep studies in 2004 and 2016, but neither showed any breathing problems. In the past few months, I’ve learned about how many sleep studies will not detect UARS. I’ve also discovered, through working with dental and orofacial providers, that I a) breath through my mouth when I sleep, leaning to morning dry mouth; b) had a tongue tie (until I had a frenectomy last month; and c) had TMJ and a rethrognatic jaw. I’ve had some success with mouth taping/breathe-rite strips, the frenectomy, and a Farrar mandibular advancement device, but sleep is still too short and unrefreshing (although my dreams seem to run longer, suggesting that R.E.M. is getting better). I have an appointment on Thursday with a sleep doctor who trained at Stanford and has published popular and scholarly articles about UARS (Dr. Gerald Meskill). I am hoping for a diagnosis (since it’s kind of weird going around saying that you think that you have an undiagnosed sleep disorder) and some ideas for the path ahead.

  6. Dr. Park,
    This is me every night, sometimes less than 5 hours perhaps 3-4 hours. I have moderate OSA and I’ve been using a SomnoMed oral appliance (used to have CPAP but sleep doctor encouraged me to use an oral appliance because of my orofacial structure).
    I still feel tired daily – I try to compensate for wake ups by sleeping longer but seems to have no effect. I would love to have 7+ hours of uninterrupted sleep.
    Also, I remember a lot of my dreams so I’m getting into my REM sleep but I find it strange since my sleep is slightly interrupted – my AHI is between 4-6.5 (95% hypopneas, 5% apneas), maybe its my few apneas that is throwing it all off – I get that one big apnea and I’m awake?. My dentist suggests doing another sleep study to determine if i should move my lower jaw forward. Probably just to confirm the previous study. I would really prefer to stick with the oral appliance than go back to CPAP but feeling tired all the time is causing me to consider CPAP again, maybe just to compare.
    Do you know of patients that alternate between CPAP and oral appliance or is it best to stick to just one? My Somno is ideal choice but I’m trying to be realistic and want to keep moving in a positive direction towards uninterrupted sleep – this is my biggest goal in my life.
    Not sure why my dentist is being so cautious since my SomnoMed is not that far ahead either.

  7. I have had trouble falling asleep since I was a child, however in the past 8 year it’s become progressive harder to fall asleep and we I do fall asleep harder to actually stay asleep. I toss and turn, I can’t sleep on my back (I sue to be able to) and I wake up many times to urinate. I’m fatigue most of the morning then about 7pm I get a surge of energy and struggle to want to go to bed.

    I’m a 33yo female mother of 2yo toddler, I’m not over weight and I don’t smoke. This chronic sleep deprivation is killing me. I work fulltime and I struggle so much to get out of bed in the morning I feel fatigued for hours after awaking up and I find myself feeling depressed and angry. It’s effecting my relationship with my husband and intimately too.

    My sleep study results are high level of hypopnea incidents but no sleep apnea.

    My ENT says there everything looks normal but recommended Pillar Implants as perhaps my soft palate is blocking my airways.

    I think that’s possible but I also this something is going on in my nose, it feels stuffy in the morning. I think when I sleep it’s through my mouth not my nose.

    I wish there was a Dr like you here in Sydney Australia!!
    When you write about the effects of UARS is resonates so much with me it’s like you writing about me and what I’ve been dealing with all these years :(

  8. I’m 62 and my sleep situation in post menopause is similar to “Julia” in your example. Over 5 yrs ago my sleep patterns were steadily transitional from daytime sleepiness after what I thought was a normal 7 hrs of sleep to chronic insomnia wit waking up for no apparent reason and eventually unable to return to sleep after abruptly waking up at 2-3:00am. Years of suffering with sleep deprivation and undergoing Extensive medical tests for other disorders like numbness, ibs, gastritis, afib, urithitis, insulin resistance, restless legs, and more, which I believe were all caused by sleep apnea. Finally after yrs of seeing drs off and on, an NP in a neurology clinic listened to me describe my fragmented and vivid dreams right before waking in early morning. Even though I’m not overweight and don’t have high blood pressure she referred me for a sleep study. I got my slap machine which helps give me more continuous sleep off and on and I get about 5-6 hrs sleep with 0.25 my of clonazepam which I’ve been taking for 2.5 yrs. Would like to wean off that drug so just lately I’ve decided to try OTC bioidentical progesterone Cream. I see it helps some older women sleep better. Hoping it will help improve my sleep breathing, improving airway and tongue muscle. I also have a small jaw, have narrow airway, most likely made worse by extensive tooth extractions and headgear orthodontics in my late teens, early 1970’s.

    Than you for all your research and internet articles and podcasts on sleep breathing disorder and sleep apnea.

  9. Hi Im also experiencing the same issues like julia.. I dont have trouble falling asleep, but i woke up every 4-5 hrs just to pee and after that i cant sleep anymore. Hoping for some answers.. Tnx

  10. Hello my name is Nate and I’ve had the same problem for the last 7 months since I went in to surgery for tonsillectomy,septoplasty and turbinate reduction surgery. I get around 4 hours of sleep every night and for the first 3 months it was hard to go back to sleep after I wake up but lately I immediately go back to sleep and after that I get about 3 hours of sleep where I wake up like 5 times in that period. And I’m exhausted in the day time not able to concentrate easily and having trouble with my short term memory. I wanted to ask if the surgery could have created the issue or if it’s jet lag since I had the surgery overseas .

  11. Hi. You are describing me. i am now awake in the middle of the night. when i wake, i am always on my back and my throat and airways are swollen and i also have a slight headache. I was precribed an anti inflamatory inhaler in the past as a result of breathing problems while walking and i think that eventually helped me stay asleep for longer, but I have been off that for a while and I am back to waking up etc. My younger brother was diagnosed with apnea and had a heart attack at 30 years old. Another brother was diagnosed with asthma 30 years ago as a child who he does not have trouble sleeping(I guess being on constant inhalers and also perhpas because he is much lighter in weight than us two) So the airways do seem to be a big factor and short episodes of non breathing would explain being too alert to go back to sleep. I was also told recently that I snore very loud too! This all makes sence to me. Thank you. I will stay on the preventative inhaler and see if things improve . If you have anything to add please do. regards

  12. Hello doctor, I am waking up consistently after 5-5.30 hrs of sleep.. no matter what time I go to sleep.. I have been suffering with this for the past 11 months… It’s so difficult to fall back asleep… I had taken petril tablet for a month during the beginning stages of this problem.. it helped a little but was not effective. It seems I have even developed bengin prostatitis due to lack of sleep for so long.. and can’t get by a day without sitting in hot water for 15-20 mins.. pls help me cure my sleep problems.

  13. My body just refuses to fall asleep till the time window of midnight – 2 am. I’ve tried going to bed “early”, like 10pm. It doesn’t work. I just lay there till that time window. Once I do fall asleep, I wake up around 5 hours later, and then I have 2-3 hours of insomnia. Once I do fall asleep again, I need 5 more hours of sleep to end up having a day where I have mental clarity and a functional amount of energy. Also muscle pain and weakness levels correspond to the amount of restorative sleep I get. If I am forced to get up during that last sleep segment (say 8 or 9 am) it wrecks my whole day. I take 6 mg Cymbalta daily and 25 mg Hydroxyzine nightly. Problem still persists. 2 Sleep studies found no “disorders”. Needless to say, it’s really hard to accomplish necessary things like housekeeping, grocery shopping, cooking, etc., and it’s impossible to hold a full time job, when I spend more than half of our daily alotted 24 hours in bed just trying to get restorative sleep! Looking for suggestions!

  14. So what is it when youve had a polysomnography in a lab, your AHI is only 2.9 and you still have sleep maintenance issues?

  15. I am at normal weight, though if I practice totally relaxing my throat…it does seem to close pretty tightly. My mother snores incredibly loud and it sounds like she doesn’t breathe regularly in her sleep…Ive been told that I snore a little bit sometimes :(
    Something unique about me however, I had a brain injury in my temporal lobe…and when I was recovering from the left sided paralysis in the hospital, my brain regularly woke up at 3 or 4am and I would fool around reading or on my phone until I fell asleep again…about 20 min or less. These episodes have continued occasionally over two years and I find my thoughts at these wake up times are usually anxious ones – work being a common theme. (Now I’ll ditch the phone and write what’s on my mind down so it’s not worrying me) I’ve attributed waking up like this to anxiety but the REM total relaxation period has made me think otherwise!! I didn’t suffer apraxia./aphasia but maybe there were some internal left side involuntary throat muscles that didn’t bounce back as strong as they could have!! Hmmmm

  16. Thank you, Ive only read through halfway so far but it was very interesting. I have a background in respiratory therapy but we only touched on the basics of polysomnography. I may need to forward this to my psychologist and primary care physician. Though I may have other things compounding the issue as a QEEG had shown signs indicating traumatic brain injury (I had a few head injuries as a child & teen). The concern over a sleep disturbance, even after my last polysom showing the AHI of 2.9, was in the QEEG, during eyes closed, showed “a precipitous descent into stage II sleep” so my psychologist kept asking me about sleep apnea. The last polysom was actually my 2nd, had los significant weight since 1st, but with the first sleep physician he did note my tonsils were a +3. Lots of things to consider, thank you again!

  17. I wake after about 4-5 hours and have trouble falling back asleep. As a result I am quite tired. I got on an APAP and reduced my RDI from about 20 to 1.0 or less. Plus I had a turbinate reduction surgery that greatly helped my breathing. Yet, still have the sleep maintenance problem. The only thing that gets me through the night is klonopin (valium). I was on that a couple months and felt very good, but have since weaned off and am back to the original problem. This has not been lifelong, but just started a couple years back. I do follow good sleep hygiene. Any advice would be welcome.

  18. I have had the issue of waking after 4 hrs sleep since my mid 40s. I do use a cpac machine and has been calibrated for me correctly. I have no problems falling asleep but yet I still wake up after 4 hrs. I become slightly aware that I’m not asleep. My mind will start to become more active at that point. I’ll try to keep my eyes closed but then sometimes enter a semi concious dream state where I’m somewhat aware of my surrounding. I may have some dreaming during this time. More often though I will remain in the fully aware state after 4 hours sleep. If after 30 min I’m still awake I will take quarter dose of zopiclone to get back to sleep. So the time during which I’m in that semi dream state I’m not sure if I’m in rem state or my is mind is pretending to be asleep. So very frustrating.

  19. I am a 47 year old woman and I have the same trouble with sleep maintenance. It runs in my family- my mom and my daughter have it as well. I fall asleep just fine…but wake up after about 5 hours of sleep feeling “wired up”, needing to pee, and unable to fall back to sleep.

    Finally, about a year ago, I found a solution which sounds odd, but has really helped me. I set my alarm clock for 2-3 hours after I go to bed. I wake up at that time, go to the bathroom, and take a couple of ibuprofen (ibuprofen tends to relax me along with helping my back pain). Sometimes if I feel really wired up I will also take a half a valium. Usually I fall back to sleep within 15 minutes and sleep another 5 hours!

    Somehow breaking the 5 hour sleep cycle by interrupting it with a brief wakening earlier in the night changes every thing for me. I am finally (usually) well rested! I hope that this easy solution can help someone else.

  20. I’ve tried everything and nothing works but zopiclone but I don’t like taking pills so I stopped after 3 days I haven’t slept a night through for 18 days. I feel myself coming undone. I keep waking up after 3 hours of sleep. It takes me hours to fall asleep. Usually I sleep 2-5am or 6 am if lucky. I don’t get tired at night anymore. I’m an under weight young woman what could be going wrong? My heart seems to wake me up when I try to fall asleep. It skips a beat. Then I wake up from the slightest noise or I have to pee. Then there is no sleep after that. I’m going to loose my job. Can someone be super skinny and who’s never be known to snore have sleep apnea? My doctor thinks it’s hormone and stress related. But nothing they gave me helps.

  21. have you had your Vitamin D levels checked recently? Im back to sleeping straight through the night, unless my bladder wakes me up. Turns out I was very deficient in vitamin D and even prescription strength at 50,000 UI per week hasnt brought it up much (from 15 to 22 with above 30 being optimal)

  22. I usually wake after about 5-6 hours sleep and (sometimes) get back off again. I usually have to go to the bathroom. I know that I have apnea but just CANNOT bring myself to use those awful CPAP machines. In this day and age why are there not simple alternatives to CPAP?
    I don’t feel refreshed in the morning but not sleepy, just brain “fog” and sometimes slight headache. It’s no life I know (and I also have Tinnitus, which is great fun !!)
    Kind regards, Roy Davis

  23. 53-year old male here with very similar issues to many in the comments. All my life I have been a very light sleeper and hyper-sensitive to sounds, so have used a white noise maker (usually a fan) since my teens. My hyper sensitivity led to many sleep issues once I married, as my wife is sometimes an “active” and vocal dreamer…but not always.

    Starting around 5 years ago my inability to sleep more than 3 – 4 hours manifested in full. Even when she sleeps in another room I wake up. Even nights when she is quite still and a sound sleeper, I wake up. My wife is from Europe and summer of 2017 she and my kids spent the summer back there visiting family, so I slept alone for 6 weeks and still I woke almost every night, unable to fall back asleep.

    I mention that background because I always assumed that my sensitivity combined with her frequently waking me during the night messed up my sleep patterns enough that maybe I’d need 6 months alone to return to a normal sleep cycle, but now I wonder if it’s not something else (like apnea) affecting me.

    I am fit, about 6′ and 185 lbs, and work our regularly, but from what I gather I don’t have to be overweight to have this issue. How do I test for it (besides sleeping at some center where I can be monitored)? When I wake up I don’t feel like I was holding my breath, but do have a “startled” sensation. Could this be an indicator?

    I am a technical professional but I can tell the exhaustion from this is affecting my job performance. I do not want to go to any mask or appliance because as sensitive as I am I am certain I will not be able to sleep at all with one. I am also a migraine sufferer and tried an oral appliance decades ago (before this issue arose) due to suspicions by my doctor I was grinding my teeth, but the appliance only made it almost impossible for me to fall asleep in the first place.

    Short of drugs (which do work, but I don’t consider a long-term solution) I am running out of options and growing desperate.

  24. I have increased my exercise time. I use a blue light filter on my phone that decreases problems that may occur due to exposure. I always use the bathroom before bed. I drink sleepy time tea. Less sugar intake and No caffine. I try to go to bed every night at the same time. Still not sure why I can’t fall asleep? I do have depression and anxiety but not sure if that is the root cause?

  25. I am 62 yrs old. I fall asleep quickly and sleep soundly for about 4.5 to 5 hours until I have to use the bathroom every night. Lately I toss and turn until about 4:30 which is when my alarm is set to wake me. I keep a ceiling fan on and have black out drapes. I used to be able to get back to sleep after about 20 min but lately that has become difficult. I work full time, exercise 5 days/wk. and am thin for my height. I am not on any medication, eat a healthy diet of mostly vegetables and high quality protein. I will take sleep meds maybe once a week so I don’t become addicted. I have been going to bed earlier then usual since I am so very tired at night, about 8:30. I would appreciate any suggestions.

  26. Ms. Julie L,

    From your history, two conditions come to mind: advanced sleep phase syndrome (ASPS), where your sleep clock is advanced, making you want to go to sleep early and wake up earlier. Another condition could be a sleep related breathing disorder, such as obstructive sleep apnea or upper airway resistance syndrome. Obstructed breathing causes your heart to make a hormone (ANP) which makes you urinate more. People will typically wake up at the same time in the latter half of the night. You could also have both conditions. For ASPS, you need to stay up later, mainly using bright lights to keep you up for a few hours. For the sleep-related breathing disorders, a sleep study is usually recommended. Good luck!

  27. hello dr. steven park,
    i’m an 19 year old who recently went through a break up. This happened late december and since then i’m experiencing great trouble staying asleep. I tend to wake up after 5 hours of sleep which. Because of this sleeping problem i’m also experiencing depression and anxiety. i’ve tried cognitive behavioural therapy but it doesn’t seem to work. a few tips will come in helpfull and i’m kind of desperate for a solution.

  28. This matches my experience, and I have a deviated septum. A sleep study confirmed that the restrictive breathing was worst when I entered REM sleep.

    Please tell as many people as you can about this cause of sleep maintenance insomnia.

  29. Ive been sleeping very late like around 3-3:30 and wake up 6:30 – 7 for a month now. I fee my body is getting weaker everyday and sometimes it makes me depressed and angry that im not getting enough sleep. I wake up from excess thinking

  30. This sounds exactly like me. I sleep at about 9pm or there abouts. Without fail I wake up after 5 hrs so around 2am. I always without fail need to urinate. I get up to urinate but try not to open my eyes so much. Then get back into bed and can just not fall back asleep. I struggle. I was taking Valdoxan and it helped but the drug is very expensive so I stopped taking it after about 2.5 months wanting to see if it reset my body clock and wouldn’t need it anymore but after stopping it I am back to square 1 with the same issues. I have tried many other medications which don’t work. I have had a sleep test with very mild apnea so they said no need for machine. I did short work for about 3.5 yrs but stopped about 5 years ago. I need some help not sure what else I can have prescribed or done…

  31. I had a sleep study done, and found to have severe sleep apnea. I sleep with a CPAP machine, but I still sleep 5 to 5.5 hours at the most. I am at my wits end to get more than 5 hours sleep. I went to my PCM and he prescribed a sleep aid for a two week period. I was to return to him if after the two week period, I did not have the results I was looking for. Needless to say, I am going back.

  32. Chris,

    It sounds like you have significant obstructions. You can ignore the mild, moderate or severe label. Since it’s a breathing issue, medications won’t work. I usually recommend trying CPAP or dental appliances, no matter how mild your sleep apneas. Good luck.