All About Sleep Maintenance Insomnia


September 13, 2023 4 MIN READ

Sleep maintenance

All About Sleep Maintenance Insomnia

Insomnia is the most common sleep disorder, and sleep maintenance insomnia, or middle insomnia, is one of its challenges. But what is it exactly, and what can you do about it?

What Is Sleep Maintenance Insomnia?

Struggling to fall asleep indicates sleep onset insomnia; difficulty staying asleep, getting back to sleep, and waking too early all point to sleep maintenance insomnia.

Difficulties getting back to sleep after awakening in the middle of the night at least three nights a week for three months or more create the diagnosis of sleep maintenance insomnia.

Headaches, daytime drowsiness, poor focus and concentration, anxiety, and irritability frequently accompany sleep maintenance insomnia. As with all insomnia challenges, problems like poor focus and impaired reaction times can severely impact the ability to drive, operate equipment, or perform well at work or school.

Failure to get adequate rest often creates substantial problems for daily life and can eventually have significant physical and mental health consequences that can reduce life expectancy and quality regardless of the reason; sleep maintenance insomnia is no exception.

What Causes SMI?

The primary culprit in the vast majority of insomnia cases is stress, sleep maintenance insomnia included.

When we stress, our flight or fight response kicks in, increasing our breathing and heart rate. Hyper-arousal and a racing mind frequently show up to make it almost impossible to get back to sleep.

Many SMI sufferers complain of nightmares that abruptly awaken them from a deep sleep in the middle of the night. Although children typically have more nightmares, half of adults have occasional nightmares. As many as 8% of adults regularly endure such dreams.

Consuming food or drink too close to bedtime can substantially impact the quality of your sleep. Your body needs to restore itself during the sleep cycle and not spend that time dealing with a midnight snack. Foods high in sugar and fat are particularly troublesome in this regard.

Drinking alcohol or beverages with caffeine, like energy drinks and coffee, also has a detrimental impact on your ability to sleep. The effects of caffeine can last for up to 10 hours so that mid-afternoon cup of joe is still harassing you at bedtime.

Pain can also contribute to sleep maintenance insomnia. It may be due to a chronic condition, a recent accident, or some other physical trauma, regardless pain often contributes to SMI.

External disruptions like outside noise and intrusive light are often problems that can bring about sleep maintenance insomnia. Any noticeable changes or disruptions to your normal sleep environment can trigger SMI.

Sometimes our spouse, roommate, or children can unintentionally contribute to our insomnia. Maybe your bed partner snores or takes up too much real estate. Children sometimes seek comfort in their parent’s bed, disrupting the sleep cycle. These scenarios and more have the potential to foster sleep maintenance insomnia.

Medical conditions like diabetes, sleep apnea, asthma, and thyroid issues can cause frequent sleep disruptions and significantly increase the chances of developing SMI.

Likewise, medications can often cause sleeplessness and sleep maintenance insomnia. Steroids, antihistamines, decongestants, amphetamines, and beta-agonists can all be problematic.

It is prudent to check with your physician regarding your medications if you are suffering from any form of insomnia.

What Can You Do?

If you believe you suffer from sleep maintenance insomnia, you first want to talk with your physician and get an accurate diagnosis. You always want to ensure you are addressing the right problem appropriately.

The primary treatment for insomnia is CBT-I (Cognitive Behavioral Therapy for Insomnia). This treatment shifts negative thoughts and behaviors preventing sleep to positive perspectives to improve and eliminate insomnia.

One particular component of CBT-I specifically challenges sleep maintenance insomnia – Sleep Restriction Therapy. Typically, at the outset of the CBT-I process, the clinician will ask the patient to restrict the time they spend in bed while not sleeping; they should only remain in bed when sleeping or falling asleep.

Spending too much time in bed while not sleeping can create sleep anxiety in association with the bed and bedroom. Conversely, minimizing the awake time and only staying in bed when sleeping will link the bed and bedroom to sleep.

Anyone enduring insomnia should make a point of practicing good sleep hygiene. Only staying in bed when sleeping is one of many good sleep hygiene practices.

Taking brief breaks between tasks throughout the day builds space for you to relax and eliminate some of the pressure of the day that might otherwise keep you awake that night.

Keep a regular bedtime that matches your sleep-wake cycle or your chronotype. Aligning your bedtime routine and schedule with your body’s circadian rhythm (your internal 24-hour clock) natural sleep/wake cycle is critical to getting the best sleep possible.

Avoid caffeine and alcohol, especially in the late evening and before bed. But remember, caffeine has a fairly long half-life, so watch the clock when having that cup of coffee in the afternoon.

Hold your bedroom sacred; keep your sleeping environment reserved for sleep and sex only, not for watching TV, your smartphone, or reading in bed. These other activities keep you awake and associate your sleeping environment with anxiety, arousal, and sleeplessness.

Turn down the lights as bedtime approaches and ease your way to sleep through a more natural process.

Practice relaxation techniques like deep breathing exercises, progressive muscle relaxation, yoga, meditation, or any discipline you find helpful in fostering sleep pressure and helping you achieve restorative rest.

Final Thoughts

Insomnia is an insidious and harsh taskmaster that can make life virtually unbearable and sleep all but impossible. But there is hope.

You can stop this horrible cycle and return to restful nights and happier, more productive days with proper treatment and support.

Take advantage of the Sleep Science Academy difference and get the support, skills, and tools necessary for a lifetime of restful nights and refreshing sleep.

Sleep Science Academy’s empowering, successful Dynamic Sleep Recalibration (DSR) program is a natural insomnia remedy incorporating numerous methods and techniques, including CBT-I, pairing clients with their certified sleep coach for a uniquely individualized treatment plan.

Ready to start sleeping better? 

Contact us today to schedule your complimentary sleep consultation with a certified sleep coach and learn how to move past insomnia for a lifetime of restful nights and happy, productive days.