Tuesday, March 29, 2011

Waking up at 3 in the morning?

If you are one of the many people waking up at 3 in the morning and can't get back to sleep, you might want to read this...

While you could pop a prescription or over the counter sleep aid, I recommend against it. First off, you are facing a laundry list of side effects, but also people with sleep aids often do sleep but the sleep they get is not productive. In other words, they get no rejuvenating deep sleep so they find themselves just as tired the next day. Of course, in some cases they might work okay on the short term. In the long term they might lead to dependencies.

So maybe you could just pop a natural supplement, right? What's the harm? The most often recommended sleep aid is melatonin. But melatonin is a hormone and it's nothing to play with. First off, this approach still will not get to the root cause of your issues. Secondly, taking hormones brings a whole other level of complications. Did you know that if you take a hormone, your body will be flooded with it and therefore the receptors that respond to it will down-regulate over time. So this means you will need more and more of it to produce the same effect. You ever heard of women taking progesterone in some form and then saying it worked for a while but became ineffective overtime? Or a man taking testosterone, feeling like a million bucks for a time, then getting worse? In the case of testosterone supplementation there are other pretty well known body processes going on as well (excess testosterone may convert to estrogen for example) but this is just to underscore that supplementing with hormones should come as a last resort and with supervision.

So what's one to do? Staring at the ceiling wide awake at 3 am is really not that much fun. Especially if the next day you feel like a wet rag. 

The solution to the root cause of the problem is blood sugar control. More than half of Americans - and I'd argue over two-thirds - have improperly balanced blood sugars. Messy sugars overtime will lead to insulin resistance, then pre-diabetes, then ultimately Type 2 diabetes. That's the bad news. The good news is, that in most cases this is not that hard to support nutritionally. 

So maybe you are not convinced. Maybe you are normal weight- or even underweight and you just don't see how you might be headed for diabetes. Fair enough. Keep in mind though, the progression of this imbalance might take decades. But just answer these questions:

- Do you get shaky, irritable, or lightheaded if you miss meals?
- Do you get tired after meals? 

If your answer is yes to either one of those, you do belong to those with blood sugar imbalances. The first answer generally indicates reactive hypoglycemia (low blood sugar), the second tends more toward higher blood sugar. You might even have both symptoms which just means you are probably transitioning from low to high blood sugars.

What does this all have to do with you waking up at 3am? A lot. Let's look at a typical day in a person who wakes up at 3 am. 

"Alice's alarm goes off at 7am. She pushes the snooze button 3 times by the time she finally gets up to get ready for her job. No time to eat breakfast, so she grabs a quick muffin and a cup of coffee in the morning. She has some deadlines to work on and immerses herself in her work. At about 10, she finds herself unable to concentrate. She grabs another cup of coffee and a candy bar. She feels better, full of energy. She gets that pressing project finally done and on the boss's desk by noon. Then she grabs a chicken sandwich and some salad with fat free dressing plus a bag of baked chips at the corner fast food place and hurries back to work. Within a half hour, she is yawning. Contemplating a cup of coffee, she decides she is going to pull through and just eat a banana she threw in her purse that morning. But that really didn't help much and by 3pm, she is eagerly waiting for the coffee maker to be done. She gets a second wind after that, then it's time to leave work, pick up the dry cleaning, and go to the gym. Dinner is a slice of veggie pizza at 7pm. She watches a movie and decides to fight her urge for a snack. She goes to bad at 10. She falls asleep right away but finds herself wide awake in the middle of the night. She looks at the clock: 3:30. Why do I always wake up at the same time? - she ponders. Then she starts counting sheep, she tosses and turns for what seems like forever, then she drinks a glass of warm milk. Finally she falls asleep - but the alarm goes off almost immediately. It's 7 am. She presses snooze 3 times like every morning."

Let's look at what happens to Alice physiologically. She has carbohydrates, sugar and caffeine for breakfast. Great recipe for spiking your blood sugar right off the bat. No fat, no protein and probably very little fiber - all the things you need for balanced blood sugar are missing. So after her blood sugar spikes, her pancreas panics. Very high blood sugar sets off alarms in the body. So in comes a bunch of insulin, gets the sugar out of the blood and into the cells and her blood sugar tanks. Another alarm reaction. Without adequate glucose (=sugar) in the blood, her brain starves. She gets sleepy, maybe cranky, might even get blurred vision, inability to think. So she grabs that candy bar and coffee. Blood sugar spikes, probably crashes again. Good thing it's lunch break. For lunch she does it a bit of fiber, but no fat and little protein along with a bunch of refined carbs (bread, chips). Her sugar goes up and maybe that bread was just a bit much adding to the insults of her meals in the morning. This time when insulin comes to the rescue, the cells are unable to accept insulin and the sugar it carries. This is the beginning stage of insulin resistance. Her sugar is still high. To save the day, the liver quickly converts the sugar into fat. This process takes a lot of energy, making her sleepy. In comes the banana, then the coffee, etc. 

So I'm hoping you can see what a roller coaster this diet is causing her. When she finally goes to bed, you can only guess what her high carb dinner (pizza) is doing to her blood sugar. But when the food goes thru her, then her body tries to adjust for the fluctuations and ultimately fails. After 3 am her blood sugars dip so low, that her body experiences an alarm reaction. The brain can't function without glucose. The body can't function without the brain. So a massive stress hormone release happens: adrenaline and cortisol come to the rescue, suppressing her sleepy hormone: melatonin. She wakes up wide awake and can't get back to sleep for hours. Will it help her to eat something? Probably. Would that warm milk help her? It might - even if it's cold since it will provide her with some glucose. But ultimately this scenario could have been completely avoided, if she had just had a blood sugar balanced diet throughout the day. 

If you are "Alice" but you still don't believe me, try this simple trick. Don't even go as far as a blood sugar control diet. Just do this: Before going to bed (yes, I'm talking 10 pm or right before your head hits the pillow), eat a healthy snack rich in complex carbs, fat and protein. Try one of these: A green apple with a handful of almonds. A pear with some cheese. A piece of turkey and some baby carrots. In addition, you could keep a handful of raw nuts by your bedside, and pop them in your mouth when you wake up very early in the morning.

Now this might not work for you right off the bat, but if it does I hope you know what that means. It means you have whacky blood sugar. If it doesn't work, your blood sugar might just be too messed up for a simple trick like this to work. 

If you would like to go further, and want to fix the root cause of your issues, you can go on a blood sugar control diet. Here are the basic rules:
  • Eat 3 square meals a day plus 2-3 snacks.
  • Combine good fats, protein, and complex carbs with each meal. 
  • Never skip meals
  • Never eat a carbohydrate on its own
  • Avoid sugar
  • Eat breakfast within an hour of waking
This is not that hard - and I could go on for hours about people whose lives this simple strategy has changed forever. For the better, of course! 


  1. This is great information. I'm going to give it a try. Is there any research that suggests this becomes more of a problem as you older? Thanks Kate!

  2. Doesn't everything become more of a problem as you get older? But in all seriousness, sleep problems of all kinds get more common as people age. BTW, thanks for the comment. I was beginning to think I was just talking to myself on this blog...

  3. I tried this the other night when I woke up at 3:15 a.m. When this has happened in the past, it usually meant I was up for the rest of the morning--or I would take some sleep aide. This time, I went downstairs and had some raw almonds and milk. I was able to read some and then get back to sleep by 4, which was great. What I noticed most was that my mind really mellowed out after the little snack; normally it would be going 90 miles an hour. Now, I am trying to get that high protein snack before I go to sleep so I can STAY asleep.
    Thanks Kate

  4. Just found this searching on the Internet. I have been reading and love it. I don't wake up in the middle of the night but I'm always tired and feel like I'm hypoglycemic. Been trying to change my diet. It's a slow process. I'm very into food matters. Great information there. Where do I go about finding a good nutritionist. I would love to see a holistic doctor but I'm not rich. Will definitely start following your blog. Thanks again.