Sleep Concern

I can't stay asleep

Frequent awakenings throughout the night disrupt your rest.

Educational information — not medical advice. Talk to your care team about what's right for you.

Overview

Sleep-maintenance insomnia is the experience of falling asleep without much trouble but waking repeatedly through the night — sometimes for minutes, sometimes for hours. Each awakening fractures the natural sleep cycle, and the time spent awake in the dark can become its own source of anxiety. By morning, sleep has felt more like a series of naps than a single, restorative passage.

Common Causes

Heightened physiological arousal that lowers the threshold for waking during the night.
Environmental disruptors — noise, temperature, light, or a partner's movements.
Nocturia (frequent urination), which pulls you out of sleep repeatedly.
Alcohol, which fragments the second half of the night as it metabolizes.
Mood conditions such as depression and anxiety, which classically present with early-morning awakening.

What You May Be Experiencing

Waking one or more times per night and struggling to return to sleep.
Long periods awake in the middle of the night with a racing mind.
Early-morning awakening with no ability to fall back asleep.
Sleep that feels light, shallow, or 'half-awake.'
Daytime tiredness despite having spent adequate time in bed.

Dr. Morse's Approach

Dr. Morse frames sleep-maintenance difficulty as a signal worth decoding rather than a nuisance to suppress. Each awakening has a reason — physiological, environmental, or emotional — and her method is to identify the pattern before prescribing a fix. She combines CBT-I techniques with careful attention to the timing, triggers, and quality of the awakenings, so that the plan addresses why sleep is breaking apart, not just how to fall back asleep once it has.

Treatment Options

Behavioral

Stimulus control and sleep compression to strengthen sleep continuity and reduce time awake in bed.

Lifestyle

Optimizing the sleep environment, managing fluids and meals before bed, and addressing alcohol's effect on late-night sleep.

Medical

Evaluation for underlying contributors — mood, pain, nocturia, or breathing — with treatment directed at the specific cause.

Your Night-time Routine

A practical, step-by-step wind-down built around this concern's specific drivers. Follow it consistently for two to three weeks — rhythm, not perfection, is what resets sleep.

1
6:00 PM
Limit fluids to reduce nighttime trips to the bathroom (nocturia).
2
7:00 PM
Last meal — avoid reflux triggers and heavy food close to bed.
3
8:00 PM
No alcohol — it fragments the second half of the night as it metabolizes.
4
9:00 PM
Cool, dark room with steady white noise or a fan to mask disruptive sounds.
5
10:00 PM
Sleep. If you wake and can't return within 20 minutes, move to a dim, quiet activity until sleepy — don't lie awake in frustration.

Take this guide home

A printable PDF of this concern's full overview, routine, and treatment options.

Articles on this concern are being written. Check back soon, or browse the full Sleep Laboratory.

When to Seek Help

Nighttime awakenings that persist for several weeks, occur with pain, breathing pauses, frequent urination, or low mood, or that leave you significantly impaired during the day, warrant professional evaluation. Awakening with chest pain, severe headache, or gasping should be assessed promptly.

Educational — Not Medical Advice

This content is provided for general educational purposes only and does not constitute medical advice, diagnosis, or treatment. It is not a substitute for consultation with a qualified healthcare professional. Submitting a question or receiving a reply does not establish a doctor-patient relationship. Always seek the advice of your physician or other qualified health provider with any questions about a medical condition, and discuss any changes to your care with your own care team.

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