5 Scientific Tips for Getting Back to Sleep After You’ve Woken Up in the Middle of the Night

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We’ve all been there: You fall asleep just fine after a long day of work, but at around 2 a.m., something happens. You’re suddenly wide awake, and no matter how many sheep you count or glasses of warm milk you down, nothing seems to get you back to bed. While most people associate insomnia with the inability to fall asleep in the first place, it also applies to people who find themselves unable to fall back to sleep after waking up in the middle of the night.

According to the American Academy of Sleep Medicine, 30 to 35 percent of U.S. adults experience "brief symptoms" of insomnia, while 10 percent suffer chronically, with symptoms three or more times a week for at least three months. Though some severe cases may prompt a visit to the doctor, the occasional occurrence can be helped with these five science-backed tips.

1. PUT THE CELLPHONE AWAY.

When you’re trying to fall back to sleep in the middle of the night, one of the biggest obstacles in your way is light. This is especially true when it comes to that blue light from your smartphone shining right into your eyes. "Electronic devices emit light that can keep you up—especially the ones you hold closer to your face, like a mobile device," W. Christopher Winter, director of the Martha Jefferson Sleep Medicine Center, told Men’s Health.

The temptation to scroll through social media or a few news sites when you can’t sleep can be hard to resist, but yielding to it can turn a 15-minute sleep interruption into an entire night lost. Do your brain a favor and leave the phones, tablets, and e-readers off.

2. IGNORE THE CLOCK.

While you’re ignoring newsfeeds and social media, you’re going to want to stay away from your smartphone’s clock, too. In fact, don’t worry at all about the time when you’re trying to fall back to sleep, because it’s only going to increase your stress.

Think about it: If you need to be up for work at 6 a.m., and you randomly woke up at 4 a.m., you’re likely going to do the classic, “Well if I fall asleep now, I’ll get two more hours of sleep before my alarm goes off.” Then what happens? Nothing. Then you set another deadline, and chances are you’ll get nowhere with that, too. Soon it’s 5:59 a.m. and you’re still awake, thanks to all the undue stress you put on your body to fall back asleep by a certain time.

"The problems occur when people's minds start to race and they start to worry about things," neurologist Brian Murray told CBC Canada. "Looking at the clock will make people feel anxious about not falling back to sleep. That causes the body to release fight-or-flight hormones, which interfere with the sleep onset process."

Don’t worry about the time—that’s already out of your control. Instead, concentrate on practical tips to solve the problem.

3. DON’T BE AFRAID TO GET UP.

Still can’t get back to sleep after 20 minutes? Well, it might to time to get up—for the moment, anyway. In an article for the Huffington Post, James Findley, Ph.D., clinical director of the Behavioral Sleep Medicine Program at the University of Pennsylvania, recommended people get out of bed and do some light busy work after that initial waiting period.

Among the activities he recommends are stretching, light reading, or a puzzle—basically, do anything to get your mind off the fact that you can’t sleep, and with any luck, that will be exactly what you need to doze back off.

4. DO SOME BREATHING EXERCISES.

A tense body likely won’t be falling asleep anytime soon, so you’ll want to make sure you’re actually relaxed while in bed. One way to accomplish this is to do some deep breathing—in through your nose and out of your mouth in a rhythmic cycle. According to Erich P. Voigt of New York University, you can also help lull your mind to sleep by repeating a common phrase or word—like “relax”—in rhythm with your breathing.

5. FOCUS ON WHAT RELAXES YOU.

Sleep experts Ilene M. Rosen and Shalini Paruthi both say that one of the keys to falling back to sleep in the middle of the night is to focus on mental images of what's most relaxing to you. For them, it was imagining themselves on a beach or back at a favorite family vacation spot. "I can feel the Sun’s warmth on my skin, I can hear the ocean waves. I can smell the saltiness of the sea," Paruthi said. This type of guided imagery—where you carefully imagine every detail of a favorite memory or activity to get your mind off your sleep woes—is also recommended by the National Sleep Foundation.

For you, these images could be anything—thinking about a favorite movie, imagining yourself at a Yankees game, or remembering some of your favorite books. It's all about whatever memories or thoughts relax you. So instead of stressful newsfeeds or the mocking hands of a clock, your mind will be on a beach, in your favorite restaurant, or simply remembering the sights, sounds, and smells of a perfect day—and hopefully, you'll be back to sleep before you know it.

A Generic EpiPen Coming in Early 2019 Could Save You Money

Brand-name EpiPens at a Congressional hearing on the escalating cost of the drug in 2016
Brand-name EpiPens at a Congressional hearing on the escalating cost of the drug in 2016
Alex Wong/Getty Images

For an incredibly common, life-saving medication, EpiPens (epinephrine auto-injectors) are surprisingly difficult for many consumers to get ahold of. Their cost has skyrocketed in recent years from less than $100 for a pack of two to more than $600. They’ve gotten so expensive that some EMTs have resorted to using syringes to manually administer epinephrine rather than purchasing the standard auto-injectors, which are almost exclusively made by the pharmaceutical company Mylan. Generic options have been slow to come to market, but according to Business Insider, a recently approved EpiPen rival is coming in the first few months of 2019, and it could save consumers a significant chunk of change.

The drug’s developers have had an unusually hard time getting the new EpiPen alternative, called Symjepi, onto store shelves. The drug was approved in 2017, but the company, Adamis Pharmaceuticals, had trouble finding investors. Now, Novartis, the Swiss-based pharmaceutical giant that manufactures drugs like Ritalin, is releasing the drug through its Sandoz division (perhaps most famous for it role in discovering LSD in the 1930s).

Symjepi will cost $250 out-of-pocket for a pack of two doses. That’s 16.6 percent less than the Mylan-authorized generic EpiPen or Teva’s generic EpiPen, which both sell for $300. It differs a bit from its rivals, though, in that it’s a pre-filled, single-dose syringe rather than a spring-loaded auto-injector. Auto-injectors are plastic, pen-like devices that keep the needle shielded until the moment of injection, and are specifically designed to help make it easier for untrained (even squeamish) people to use in an emergency. With this version, patients will need to remove a needle cap and inject the needle. Just like the EpiPen, though, it’s designed to be injected in the upper thigh, through clothing if necessary.

If you have health insurance, the difference in cost may not matter as much for you as a consumer, depending on your plan. (I personally picked up a two-pack of Mylan-authorized generic Epipens at CVS recently for $0, using a manufacturer’s Epipen coupon to knock down what would have been a $10 copay.) But it will matter considerably for those with high-deductible plans and to insurers, which, when faced with high costs, eventually pass those costs on to the consumer either through higher co-pays or higher premiums. It also affects agencies that buy EpiPens for emergency use, like local fire departments. And since EpiPens expire after just a year, the costs add up.

However, there’s currently a shortage of EpiPens on the market, according to the FDA, making it more important than ever to have other epinephrine drugs available to those at risk for serious allergic reactions.

[h/t Business Insider]

Brain-Eating Amoeba Kills Seattle Woman Who Used Tap Water in Her Neti Pot

CDC/Dr. Govinda S. Visvesvara, Wikimedia Commons // Public domain
CDC/Dr. Govinda S. Visvesvara, Wikimedia Commons // Public domain

If you use a neti pot to clear out your sinuses, there's one important rule you should always follow: Don't fill it with tap water. Doing so could land you a sinus infection, or worse, a potentially fatal disease caused by a brain-eating amoeba. Although the latter scenario is exceptionally rare, a 69-year-old woman in Seattle died from doing just that, The Seattle Times reports. Experts are also warning that these infections could become more common as temperatures in the northern hemisphere continue to rise.

Physicians at Seattle's Swedish Medical Center initially thought the woman had a brain tumor. She was brought into the emergency room following a seizure, and a CT scan of her brain seemed to reveal a tumor-like mass. The only other known symptom she had was a red sore on her nose, which was previously misdiagnosed as rosacea. When surgeons operated on her the following day, they noticed that "a section of her brain about the size of a golf ball was bloody mush," neurosurgeon Dr. Charles Cobbs told The Seattle Times. "There were these amoeba[e] all over the place just eating brain cells. We didn't have any clue what was going on, but when we got the actual tissue we could see it was the amoeba."

She died a month later of an infection called granulomatous amoebic encephalitis (GAE), according to a recent case report published in the International Journal of Infectious Diseases. The disease is caused by a single-celled amoeba called Balamuthia mandrillaris, and it's extremely deadly. Of the 109 cases between 1974 and 2016, 90 percent were fatal.

According to the FDA, some bacteria and amoebae in tap water are safe to swallow because acid in the stomach kills them. However, when they enter the nasal cavity, they can stay alive for long periods of time and travel up to the brain, where they start eating their way through tissue and cells. Another brain-eating amoeba called Naegleria fowleri can cause a similar disease, except it acts faster and can cause death in just a few days. Although it's also rare, it's usually found in warm freshwater, and infections start by getting contaminated water up one's nose while swimming or by using a nose irrigation device filled with tap water.

Dr. Cynthia Maree, an infectious disease doctor at the Swedish Medical Center, said the changing environment could facilitate the spread of these infections. "I think we are going to see a lot more infections that we see south (move) north, as we have a warming of our environment," Maree says. Researchers say these amoebae are still little-understood. Future studies would need to be conducted to learn more about the risk factors involved.

[h/t The Seattle Times]

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