Waking long before your alarm?

How much sleep came before early waking?

Early awakening means waking much earlier than planned and being unable to get back to sleep, although you would like to sleep longer. Think of the last morning like this and answer these questions:

• What time did you go to bed and what time did you wake?
• How much earlier than you wanted did this happen?
• Did you manage to fall asleep again?
• How long have early awakenings been happening, and how many days a week?
• Do you feel rested after waking?
• Do you have marked tiredness, sleepiness or reduced concentration during the day?

If you wake early but rested, this may simply be your rhythm. If you are short of sleep and lack energy during the day, look at the section “An early schedule or unwanted waking?”.

Awake at five: stay in bed or get up?

When sleep ends at five in the morning, you want to get back to sleep at any cost. Something else helps more:

• Not lying there tense. If you cannot get back to sleep for a long time, get up briefly, do something calm in dim light and go back to bed when you feel sleepy again.
• A stable wake-up time. Do not try to make up for early waking by staying in bed too long or going to bed early without feeling sleepy.
• The clock and alcohol. Do not keep checking the time, and limit evening alcohol: it can contribute to earlier waking and broken sleep.

For persistent sleep problems, cognitive behavioural therapy for insomnia (CBT-I) is an effective non-drug approach.

The same early morning, a different day

Halyna and Ivha are short of sleep, Petro gets enough, and for Sava early waking comes with a heavy mood in the mornings. What matters is not the time on the clock but whether you are rested: the section “An early schedule or unwanted waking?” covers this.

If at least one of these stories resembles yours, note how many hours you slept before waking early. If none of them fits, go back to the questions in the section “How much sleep came before early waking?”.

Who to talk to about early waking

For new or persistent physical symptoms, start with a family doctor. Further investigations depend on your symptoms and examination, not a standard checklist. Mood or anxiety difficulties can also be discussed with a psychiatrist.

If you decide to discuss your sleep with a psychiatrist, the initial psychiatric consultation page shows in advance what the meeting consists of. The profiles on the clinic’s doctors page can help you choose a specialist.

Early waking or another sleep difficulty?

Early waking is only one form of disturbed sleep. Compare which is closer to yours.

• Frequent night awakenings. Sleep is interrupted several times a night, not only towards morning. See the page on frequent night awakenings.
• Insomnia. The difficulties affect both falling asleep and the night. The page on insomnia explains how its forms differ.
• Unrefreshing sleep. You wake on time but do not feel rested. Read more on the page about unrefreshing sleep.
• Depressed mood. Mornings are the hardest, as for Sava in our example, and sadness lasts through the day. Compare with the description of depressed mood.

These changes often occur together, and one of them on its own decides nothing. If you recognised yourself in several points, tell your doctor about all of them.

An early schedule or unwanted waking?

An early waking time may suit your rhythm, as with Petro in our example, or appear together with stress, insomnia or changes in mood. What matters is whether you are rested and can fall asleep again, not the time on the clock.

If low mood and loss of interest in life persist along with early waking, a doctor may also assess for depression. Early waking on its own does not yet mean that you have this disorder.

When early waking is a reason to seek help

1. If your need for sleep has sharply decreased and at the same time unusually high energy, increased activity, rapid speech or thinking, impulsivity or noticeable changes in behaviour appear, an immediate consultation with a specialist is necessary.
2. If sleep problems come with persistent low mood, loss of interest, marked anxiety, chronic pain, loud snoring or pauses in breathing during sleep (apnoea), a consultation is especially important.
3. If early waking occurs regularly over several weeks, shortens your sleep or noticeably affects your performance, concentration and wellbeing, see a doctor.
4. If early waking started recently and you understand why, start with the steps in the section “Awake at five: stay in bed or get up?”.
5. If sleep is also interrupted in the middle of the night or you do not feel rested in the morning, compare your state with the descriptions in the section “Early waking or another sleep difficulty?”.