^ Abad VC, Guilleminault C (September 2018).^ 'FDA approves first insomnia drug for middle-of-the-night waking followed by difficulty returning to sleep'.^ a b ' 'Daytime pharmacodynamic and pharmacokinetic evaluation of low-dose sublingual transmucosal zolpidem hemitartrate'- Human Psychopharmacology: Clinical and Experimental, 2008 23(1):13-20, Thomas Roth, David Mayleben, Bruce C.'Busting the 8-Hour Sleep Myth: Why You Should Wake Up in the Night'. 'Nocturnal awakenings and comorbid disorders in the American general population'. Other clinical studies have reported between 25% and 35% of people experience nocturnal awakenings at least three nights a week. Greater than 50% contend with MOTN conditions for more than five years.Ī 2008 'Sleep in America' poll conducted by the National Sleep Foundation found that 42% of respondents awakened during the night at least a few nights a week, and 29% said they woke up too early and couldn't get back to sleep. Of those who experience nocturnal awakenings, 43% report difficulty in resuming sleep after waking, while over 90% report the condition persisting for more than six months. Waking up in the middle of the night, or nocturnal awakening, is the most frequently reported insomnia symptom, with approximately 35% of Americans over 18 reporting waking up three or more times per week. Sleep restriction therapy and stimulus control therapy as described in insomnia have shown significance in treating middle of night insomnia.

Medication may not be prescribed in some cases, especially if the cause turns out to be the patient ingesting too much fluid during the day or just before they go to sleep. Because most medications usually require 6–8 hours of sleep to avoid lingering effects the next day, these are often used every night at bedtime to prevent awakenings. Some studies have shown that zaleplon, which has a short elimination half-life of about 1 hour, may be suitable for middle-of-the-night administration because it does not impair next-day performance. Middle-of-the-night insomnia is often treated with medication, although currently Intermezzo ( zolpidem tartrate sublingual tablets) is the only Food and Drug Administration-approved medication specifically for treating MOTN awakening. Nocturnal awakenings can be mistaken as shift work disorder. Gastro-intestinal discomfort arising from food that has not been fully cooked, is also a contributor to middle of the night insomnia. Nocturnal awakenings are more common in older patients and have been associated with depressive disorders, chronic pain, obstructive sleep apnea, obesity, alcohol consumption, hypertension, gastroesophageal reflux disease, heart disease, menopause, prostate problems, and bipolar disorders. If interrupted sleep (called 'biphasic sleeping' or ' bimodal sleep') is perceived as normal and not referred to as 'insomnia', less distress is caused and a return to sleep usually occurs after about one hour. Sleep research conducted in the 1990s showed that such waking up during the night may be a natural sleep pattern, rather than a form of insomnia. Excessive daytime sleepiness is reported nearly two times higher by individuals with nocturnal awakenings than by people who sleep through the night. The disrupted sleep patterns caused by middle-of-the-night insomnia make many sufferers of the condition complain of fatigue the following day. This kind of insomnia (sleeplessness) is different from initial or sleep-onset insomnia, which consists of having difficulty falling asleep at the beginning of sleep. Middle-of-the-night insomnia (MOTN) is characterized by having difficulty returning to sleep after waking up during the night or very early in the morning. Sleep maintenance insomnia, Nocturnal awakenings, Middle of the night awakenings, and Middle insomnia. Chronic insomnia raises your risk of high blood pressure, coronary heart disease, diabetes, and cancer.Medical condition Middle-of-the-night insomnia Insomnia can affect your memory and concentration. Your provider may also recommend healthy lifestyle habits such as a regular sleep schedule, cognitive behavioral therapy for insomnia, and medicines to help you manage your insomnia. To diagnose insomnia, your healthcare provider may ask about your sleep habits and ask you to keep a sleep diary. Chronic (long-term) insomnia occurs 3 or more nights a week, lasts more than 3 months, and cannot be fully explained by another health problem. Short-term insomnia may be caused by stress or changes in your schedule or environment. Insomnia can get in the way of your daily activities and may make you feel sleepy during the day.

This happens even if you have the time and the right environment to sleep well. With insomnia, you may have trouble falling asleep, staying asleep, or getting good quality sleep.

Initial insomnia definition