Middle-of-the-night insomnia is extremely common and can cause a variety of mental and physical health problems. Several options for treatment are available.
Sleep is an essential part of human health — it allows us to rest our bodies, recharge our minds, and replenish our energy. But for millions of people across the country with sleep disorders, good sleep can be difficult, or even impossible, to come by.
In fact, the National Sleep Foundation suggests that anywhere from 10% to 30% of adults in the United States live with insomnia, a condition that can greatly impact a person’s quality of sleep.
Middle insomnia, or middle-of-the-night insomnia, is a form of insomnia that causes difficulty staying asleep and often results in frequent nighttime awakenings. Ahead, we’ll explore what you need to know about middle-of-the-night insomnia, including symptoms, treatment, and resources for managing this condition.
- Initial insomnia: This condition makes it difficult to fall asleep.
- Middle insomnia: This leads to difficulty staying asleep.
- Terminal insomnia: This causes frequent early awakenings.
Because middle insomnia makes it difficult for someone to stay asleep, it often leads to increased awakenings in the middle of the night, hence the term “middle-of-the-night” insomnia.
The history of sleeping through the night
First sleep usually happened earlier in the evening, before a period of wakefulness that happened around midnight or 1 a.m. During this period of wakefulness, people would often engage in light activities, like chores, eating, or socializing. Second sleep happened shortly after and continued through until early morning, when the day would finally begin.
Monophasic sleep, or sleep that happens in one segment, is believed to be a relatively modern style of sleeping. Some research suggests that sleep disorders like insomnia are more common in modern society because humans, historically, are not made for monophasic sleep. However, more research is still needed in this area to determine just how much of a role our ancestral sleep patterns might play in sleep-related disorders.
Middle insomnia can cause not only sleep-related symptoms but also difficulty with day-to-day tasks due to lack of sleep. Symptoms of this condition can include:
- difficulty staying asleep
- not feeling refreshed after sleep
- excessive daytime fatigue
- severe tiredness and lack of energy
- poor mood or increased irritability
- difficulty with cognitive or physical functioning
The effects of insomnia on the mind and body
According to the
In addition, insomnia may also increase the risk of developing various chronic health conditions, including:
If you have middle insomnia, there are a number of treatment approaches that can help improve the duration and quality of your sleep.
CBT is an approach that focuses on identifying and changing thoughts and behaviors that may be making the symptoms of certain mental health conditions, like anxiety and depression, worse. With CBT-I, the focus of the treatment is on changing the sleep-related thoughts, feelings, and behaviors that are fueling the insomnia.
People living with insomnia also benefit from making certain lifestyle changes that can help improve sleep quality, such as:
- getting regular exercise
- getting regular sun exposure
- limiting caffeine intake
- creating a pre-sleep routine
- following a set sleep schedule
Medications for middle-of-the-night insomnia
Some people may also find that taking medication can help improve the quality and duration of their sleep.
- over-the-counter medications, including melatonin and antihistamines
- benzodiazepines, such as estazolam and quazepam
- benzodiazepine receptor agonists, such as zolpidem and eszopiclone
- melatonin agonists, including ramelteon
- antidepressants, such as trazodone and mirtazapine
Some medications for insomnia may carry the risk of side effects or dependence, so you and your doctor will closely weigh the benefits and concerns before beginning treatment. Because of these risks, it’s important to only use insomnia medications under the guidance of a healthcare professional.
If you’ve received a diagnosis of middle insomnia, any necessary treatment you need for the condition, including therapy and medication, should be covered under your health insurance plan.
However, every health insurance plan is different — so it can be helpful to double-check if a treatment or medication is covered before moving forward. If necessary, you can ask about coverage under the ICD-10 code “G47.00”, which is the specific diagnostic code for insomnia-related disorders.
Living with insomnia
Living with insomnia can be difficult, especially when it impacts your day-to-day life. If you’re looking for more resources and support for people living with insomnia, whether for yourself or a loved one, here are a few to check out:
- The Centers for Disease Control and Prevention’s
sleep resources page
- The American Academy of Sleep Medicine’s sleep education resource
- The Sleep Foundation’s website
- The Center for Clinical Intervention’s sleep resources page
- The Substance Abuse and Mental Health Services Administration’s treatment locator
Insomnia affects a great number of people across the world — impacting as much as 30% of people in the United States alone, in some capacity.
Middle-of-the-night insomnia can cause a significant impact on someone’s day-to-day functioning and quality of life. Not only can lack of sleep from insomnia cause immediate mental and physical health effects, but insomnia has also been shown to increase the risk of chronic health conditions.
If you or someone you love has received a diagnosis of middle insomnia, the right treatment can help restore both sleep quality and overall quality of life.