Insomnia is a common sleep disorder that makes it difficult to fall asleep, stay asleep, or get quality sleep. It affects up to 30% of adults at some point in their lives. One of the key symptoms of insomnia is waking up earlier than desired and being unable to fall back asleep. So if you have insomnia, chances are you will wake up early. Let’s explore this question and the reasons behind it in more detail.
What is insomnia?
Insomnia is characterized by the following symptoms:
- Difficulty falling asleep at night
- Waking up frequently during the night
- Waking up too early in the morning
- Not feeling well-rested after a night’s sleep
- Daytime fatigue, low energy, irritability caused by lack of sleep
These symptoms persist for at least 3 nights per week and last for over 3 months despite having ample opportunity to sleep.
Insomnia can be classified into three types:
- Onset insomnia – Difficulty falling asleep at the beginning of the night
- Maintenance insomnia – Waking up during the night and being unable to fall back asleep
- Early morning awakening – Waking up earlier than desired in the morning and being unable to fall back asleep
Why does insomnia cause early morning awakenings?
If you have insomnia, especially the early morning awakening type, chances are you will wake up earlier than you want to. There are a few reasons why this happens:
1. Circadian rhythm dysfunction
Our sleep-wake cycles are regulated by the body’s circadian rhythm or biological clock. With insomnia, your circadian rhythm may be shifted earlier or is out of sync with your desired sleep schedule. This causes you to naturally wake up earlier due to your biological drive for wakefulness.
2. Increased cortisol
Cortisol is a stress hormone that follows a daily circadian rhythm, peaking in the early morning hours. Insomnia and lack of sleep can disrupt the normal cortisol cycle, leading to higher cortisol levels in the early morning. The increase in cortisol boosts alertness and makes it difficult to fall back asleep.
3. Lighter stages of sleep
People with insomnia spend more time in the lighter stages of sleep (Stage 1 and 2 Non-REM sleep) rather than the deeper stages (Slow wave and REM sleep). Lighter sleep is easier to wake up from, causing frequent awakenings and early morning awakenings.
4. Heightened arousal
Insomnia is associated with increased mental and physical tension and arousal at night. This heightened arousal persists even in the morning hours, making it difficult to fall back asleep after an early morning awakening.
5. Conditioned arousal
When you suffer from insomnia and have difficulty falling back asleep at night after waking up, you can develop learned associations. Your brain learns to associate the bedroom and morning hours with wakefulness rather than sleepiness. This conditioned arousal to the morning hours makes early awakenings more likely.
How early is too early for an insomnia early awakening?
Most experts define early morning awakening as waking up more than 30 minutes before your desired wake up time. So if your alarm is set for 7 AM but you wake up wide awake at 5:30 AM and can’t fall back asleep, that would be considered an early awakening.
Waking up 1-2 hours before your desired rise time is typical for those with early morning insomnia. However, some people may wake up extremely early at 3 AM or 4 AM and be unable to resume sleep. Waking up any time earlier than desired, before completing your total sleep requirement for the night, can indicate insomnia.
How long does insomnia-related early waking last?
When insomnia involves early morning awakenings, it is not uncommon for the waking to persist for an hour or longer. The early awakenings can last anywhere from 30 minutes to several hours before your planned wake up time.
In fact, research shows the average duration of wake after sleep onset in people with insomnia is 60 minutes or more. This means once they awaken too early, they have difficulty falling back asleep for an hour or longer and end up sleep deprived. Persistent early awakenings lasting hours are one of the hallmark characteristics of chronic insomnia.
What prevents falling back asleep after early waking?
There are several factors that can make it hard to fall back asleep in the early morning hours if you suffer from persistent insomnia and related awakenings:
- Your circadian clock is promoting wakefulness
- Increased cortisol output in the morning
- Alertness and arousal upon waking up
- Repeating negative thoughts and frustration
- Increased heart rate and physical anxiety
- Knowing you have limited time left to sleep
- Exposure to light and noise
These factors enhance cognitive, physiological, emotional, and environmental arousal in the morning, preventing the relaxation needed to resume sleep.
What are the consequences of insomnia early wakings?
Chronic early morning awakenings due to insomnia can take a toll on your health and quality of life in many ways:
- Fatigue, low energy, sleepiness during the day
- Worse mood – irritability, anxiety, sadness
- Problems with focus, concentration, memory
- Reduced motivation and productivity at work or school
- Impaired immune system functioning
- Increased risk for depression
- Higher risk of accidents or errors due to sleep deprivation
Over time, the accumulation of lost sleep and disruption of circadian rhythms due to persistent early wakings can have detrimental effects on physical and mental health.
Tips for falling back asleep after waking too early
If you regularly wake up hours before your alarm, try these methods to encourage sleep after an early awakening:
Relaxation techniques
Practice deep breathing, progressive muscle relaxation, meditation, or visualization to soothe your mind and body after waking up. This can reduce anxiety and arousal.
Get out of bed temporarily
If unable to sleep, get out of bed and engage in a relaxing activity in low light until you feel sleepy, then return to bed. This prevents building an association between your bed and wakefulness.
Read a book
Reading a book in bed can distract your mind from stressful thoughts and encourage drowsiness.
Listen to calm music
Soothing, ambient music helps relax your nervous system and quiet your mind, preparing you for sleep.
Try the 90 minute rule
It’s harder to fall asleep much sooner than 90 minutes before your normal wake time. If you wake up earlier than 90 minutes before your alarm, it’s best to just get up for the day.
Keep lights dim
Avoid bright light after early wakings, which tells the brain it’s time to wake up. Keep lights low to promote sleepiness.
Do a quiet activity
If unable to sleep after an hour or more, do a calm activity like reading or listening to music until nearing your normal wake up time, when it’s easier to fall asleep.
Don’t watch the clock
Clock watching can raise anxiety and frustration about not sleeping, further inhibiting sleep. Keep clocks out of sight after early waking.
When to seek help for early wakings
If you regularly wake up several hours early and are unable to fall back asleep, despite trying self-help strategies, it’s a good idea to seek medical advice. A doctor can diagnose any underlying disorders causing insomnia and provide effective treatment options.
Seek help for chronic early wakings if:
- They occur 3 or more nights per week for over 3 months
- You feel severely sleep deprived and distressed
- Your insomnia doesn’t improve with self-help
- Insomnia is interfering with your daily functioning
Your doctor may recommend cognitive behavioral therapy for insomnia as the first-line treatment. Sleep medication or other therapies may be considered as well if needed.
Medical problems that can cause early wakings
Sometimes early wakings are a result of other medical or psychological conditions that need to be addressed, including:
- Sleep apnea – breathing interruptions during sleep
- Restless leg syndrome (RLS) – urges to move the legs at night
- Chronic pain conditions
- Neurological disorders like Alzheimer’s or Parkinson’s disease
- Mood disorders such as anxiety or depression
- Drug or alcohol withdrawal
- Dementia
Treating any underlying disorder causing disrupted sleep can help minimize early wakings.
When early wakings may indicate depression
In some cases, insomnia with early morning waking is a symptom of clinical depression.
Depression is linked to both sleep onset and sleep maintenance insomnia issues. Early awakenings that persist for weeks to months may signify an underlying depression.
Other symptoms suggestive of depression along with early wakings include:
- Fatigue and loss of energy
- Feelings of sadness, guilt, worthlessness
- Loss of interest in activities
- Difficulty concentrating
- Appetite and weight changes
- Thoughts of death or suicide
If morning insomnia occurs alongside these depression red flags, a psychological evaluation is recommended. Treating the underlying depression can improve the associated sleep disruption.
The role of aging in early awakenings
Advancing age is also associated with an increased risk of early morning awakenings.
In older adults, early waking is often due to:
- Age-related circadian rhythm advances
- Increased nighttime trips to the bathroom
- Overall reduction in quantity and quality of sleep
- Increased prevalence of medical problems
- Higher use of medications that impact sleep
Implementing good sleep hygiene practices can help minimize premature wakings in the elderly, along with getting screened for underlying disorders contributing to sleep disruption.
Lifestyle changes to prevent early wakings
Making certain lifestyle adjustments can help reduce the likelihood of unwanted early morning awakenings:
- Maintain a regular sleep-wake schedule 7 days a week
- Exercise regularly, but not too soon before bedtime
- Limit napping during the day to 30 minutes max
- Establish a calming pre-bed routine like taking a bath or reading
- Cut back on stimulating nighttime activities like computer/TV use
- Avoid caffeine, alcohol, and heavy meals close to bedtime
- Optimize your sleep environment – cool, dark and quiet
- Go to bed when sleepy and remove clock watching
Healthy sleep hygiene habits can improve sleep onset and maintenance issues, reducing the chances of unwanted early awakenings.
The takeaway
In summary, insomnia commonly causes early morning awakenings due to disrupted circadian rhythms, increased cortisol, and heightened arousal. Awakening more than 30 minutes before your desired wake up time is considered early. staying awake for an hour or longer upon early wakings is typical.
Chronic early wakings can impair daily function and health. Relaxation methods, brief activity, light therapy, and seeking medical treatment can help manage morning insomnia. Rule out underlying disorders like sleep apnea, RLS, depression, or chronic pain if early wakings persist despite self-help strategies.
