There’s no denying that a sound night’s sleep is a sublime experience, especially when we awaken feeling refreshed and energized in the morning. But does waking up during the night get in the way of restorative sleep?
A sleep disruptor can be something as small — and normal — as turning over and fluffing your pillow, or as glaring as a wide-awake-and-can't-fall-back-asleep halt to your body’s overnight rest.
“There is a certain level of normalcy to nighttime awakenings — the goal isn’t sustained unconsciousness,” explains Dr. Chris Winter, a neurologist and Sleep.com advisor. “The goal for good sleep is to not feel sleepy, fatigued, or tired during the day.”
According to Winter, for some people, awakening during the night introduces panic and fear that creates a self-perpetuating problem where sleep becomes a form of performance anxiety. In these cases, a person might worry about being able to get back to sleep after being awakened, and that worry may impede their ability to fall asleep again.
To get a better sense of what’s waking us up most often, we teamed up with SleepScore Labs, our partner in sleep data and science expertise, to look at the most common sleep disruptors and how they vary for men and women at different ages. Thirty-five thousand people were asked what regularly disrupts their sleep.
At the top of the list was needing to visit the bathroom, followed by environmental temperature issues, bed partners, outside noises (from the street or neighbors), hot flashes (or other body-temperature discomfort), and pets. Less commonly, participants reported that light, children, noises from electronic devices, chronic pain, and heartburn symptoms disturbed their sleep.
Sleep disruptors can be internal and external
From another vantage point, some things that regularly wake us are nuisances to be addressed, but others are things we love — our bed partner, our children, and our pets.
In more general, simple terms, though, some sleep disruptors stem from our own internal issues, such as needing to use the bathroom, experiencing hot flashes, chronic pain, or heartburn symptoms, while some are caused by what’s in our sleep environment — room temperature, our bed partner, outside noises, pets, light, children, and noises from electronic devices.
There aren’t definitive reasons behind every awakening. Both internal and external disruptors may be a chicken-and-egg issue: For instance, does needing to go to the bathroom actually wake someone up? Or, does the person wake up, then notice they have to go to the bathroom? Similarly, does the heat of a woman’s hot flash actually wake up her bed partner, like a heatwave traveling under the covers? Or does the partner rouse because the woman awakened drenched in sweat and moved around in bed?
This much is clear: “A sleep disruptor may causally disrupt sleep, but disrupted sleep may also increase sensitivity and arousal during sleep, contributing to nighttime hyperawareness of several disruptors,” says Elie Gottlieb, Ph.D., applied sleep scientist at SleepScore Labs.
And a bed partner can gain a nighttime hyperawareness too. The data shows that men report being awakened by their bed partners the most between the ages of 50 and 55. If they share a bed with a woman of the same age, that timing corresponds with when women are most likely to reach menopause (the average age is 51 in the U.S.). Women in this age group are also more likely to snore and experience obstructive sleep apnea, both of which could also be what’s disturbing their partner’s sleep.
It’s an unfortunate round robin, indeed.
Large gender differences in sleep disruptions
SleepScore’s data found that women are 59% more likely than men to report that each disruptor regularly wakes them up.
That’s right — men didn’t out-report women on a single disruptor.
“I was most surprised by the persistent gender differences,” says Michael Ruder, data scientist at SleepScore Labs. “For each disruptor, women were more likely to report an issue, but our objective data shows women tend to have better sleep quality.” Indeed, research backs this finding up as well, pointing out that sex-related differences in sleep start at puberty. Menstrual cycles can change sleep cycles, quality, and how fast one falls asleep.
A 2009 study found that in the general population, women have a higher percentage of sleep time, a lower percentage of stage 1 sleep (the lightest phase), and a higher percentage of slow wave sleep (stage 3, or deep sleep), compared to men.
Studies also show that women tend to sleep 11 minutes longer than men on average, and that women are significantly more likely than men to perform unpaid (or household) work. Whether the responsibilities include childcare, general domestic duties, and/or the invisible mental load of maintaining a home, this labor can certainly justify the need for additional sleep, though there isn’t a way to quantify how much additional sleep would offset the work.
Those extra minutes of sleep don’t fully translate towards sleep recovery either. Research has also found that women have a 40% higher risk of developing insomnia than men do — and the risk increases with age.
“The prevalence of insomnia comes close to doubling in postmenopausal versus premenopausal women,” notes Dr. Clete Kushida, an academic sleep-medicine physician and researcher in California. “This increase may be associated with an increase in sleep or medical disorders, sleep changes due to age, and hormonal changes.”
This combination of being prone to insomnia and being easily awakened by sleep disruptors can make for a difficult sleep situation. When it comes to sleep disruptors that affect women most, noise, light, and temperature (either being too hot or too cold) woke women more consistently than men.
“It may be because the set point [or threshold] for arousal [from sleep] is a bit lower for a woman than for a man,” Winter surmises. In other words, a smaller or more mild stimulus of any kind is more likely to wake up the average woman than the average man.
While women out-reported men on every disruptor in the SleepScore poll, how frequently a disruptor affects women relative to men — called the prevalence ratio — varies by type of disruptor. The three disruptors that came the closest to being reported as equally disruptive between genders were needing to use the bathroom at night; being awakened by children; or heartburn symptoms.
How hot flashes impact sleep
It’s not surprising that hot flashes are nearly three times more likely to be reported as a disruptor by women than by men, given that women experience them due to hormonal changes that don’t impact men. Indeed, hormonal changes are widely known to affect the quality of women’s sleep during the premenstrual phase of their cycles, pregnancy, and menopause, notes Dr. Phyllis Zee, a professor of neurology and director of the Center for Circadian and Sleep Medicine at Northwestern University Feinberg School of Medicine in Chicago.
A 2017 study found that between the ages of 46 and 52, women experience shorter total sleep time, lower sleep efficiency, and more awakenings per hour. The good news: Once women make the transition from premenopausal to menopausal, they regain some of the slow wave (or deep) sleep they had previously lost.
A more surprising finding from the SleepScore data: Women are two times as likely to report that chronic pain wakes them up during the night. This could be because women suffer from chronic pain more often than men do. A 2019 study found that women are nearly 30% more likely to experience localized chronic pain and 48% more likely to experience widespread chronic pain than men are.
“There is a bidirectional relationship — pain can disturb sleep but insomnia or poor sleep, which may be more common in women, increases sensitivity to pain,” Zee says.
Why women are more likely to be woken up by pets than men
The SleepScore data found that women are nearly twice as likely to report being disrupted by pets as men: This may be because women are more likely to share their bed with their pets than men are. Some pets are worse for sleep than others: A recent study found that cat ownership was associated with an 18% increased risk of failing to get the recommended 7 hours of sleep per night.
Though animals can disturb sleep, they offer benefits, too: studies show that some pet owners report lower stress and a greater feeling of security when they sleep with their pets. According to 2021 research in the journal Scientific Reports, people with anxiety, depression, loneliness, and grief, in particular, experience improved sleep when they snooze with their pets.
This aligns with experts’ real-life observations: “For some individuals, the pet provides some sense of security, emotional support, and closeness that may improve sleep quality — it’s kind of like sleeping with your baby,” Winter says.
How does age change the way sleep disruptors affect men and women?
The SleepScore data found that with increasing age, the percentage of people who report zero sleep disruptors declines significantly, and the gap in the prevalence of sleep disruptors between men and women narrows with age. Interestingly, external sleep disruptors tend to wake people up less frequently as they get older.
“The gradual decline of sense-related awakenings we see in the analysis makes sense, but was surprising,” Ruder says. “We know people get less sensitive to sounds as they grow older, but I didn’t necessarily expect there to be less awakenings attributed to temperature and light in older people.”
On the other hand, SleepScore data found that internal sleep disruptors increase with age. No surprise there, given that many health conditions become more common as people get older.
All of these shifts are superimposed against a backdrop of changes in sleep architecture — the basic structural organization of sleep — as people get older. Specifically, decreases in deep sleep (stage 3) and rapid-eye movement (REM) sleep occur, while stages 1 and 2 are increased.
In addition, sleep efficiency — the ratio between how much time someone spends asleep to how much time the person spends in bed — tends to decline as we get older. “The typical sleep efficiency is around 85%,” Winter notes.
This decline in efficiency is influenced by age-related increases in sleep latency (how long it takes someone to fall asleep) and increases in arousals from sleep. “Sleep becomes more fragmented with age,” Kushida says. Given that older people experience more light sleep than deep sleep, compared to younger adults, they would awaken more easily.
Yet, despite age-related changes to sleep architecture, the need for high-quality shut-eye doesn’t change as the decades pass.
As you get older, sleep disruptors make sleep efficiency harder to achieve
Calling back to insomnia and performance anxiety, this 2019 study found that women who were ages 75 and older or who had an anxiety disorder were more likely to have sleep efficiency below 80%. In the bigger picture, researchers also found that pain, nocturia (the condition of waking up frequently to urinate), sleep-medication use, and awakening from bad dreams were associated with an under 80% sleep efficiency in 65- to 96-year old adults.
“The older people get, the less resilient they are in terms of things that disrupt sleep,” Winter says. Winter also points towards a birthing trend that may affect the sleep quality of women in their later years. “If women delay their childbearing years, they may be missing an opportunity for more resilience,” he notes.
There’s no question that most women in the U.S. start having children at a later age than a generation or two ago. The average age for women having their first babies in the U.S. was 21.4 in 1970, and it’s on the rise. The latest stats, from 2014, show that age at 26.3. Between 2000 and 2014, the proportion of first births to women ages 30 to 34 rose by 28%, and first births among women ages 35 and older increased by 23%.
Here’s how this demographic shift can affect sleep: If a woman starts having babies in her late 30s, she’s likely to be awakened by children for several years, then run into perimenopausal symptoms that could last anywhere from four to eight years, leading up to menopause. Between hot flashes, night sweats, and even night terrors in children, this could potentially result in a longer period of interrupted sleep for mama.
As for dad or men with bed partners, growing old with a sleep partner who moves or wakes up a lot does point to more sleep disruption as well. SleepScore data found that as men and women get older, they become similar in reporting that their bed partner wakes them up. Women are especially bothered by their bed partners between the ages of 40 and 50, whereas men’s peak window for being awakened by their bed partners occurs between 50 and 60. This may be partly because “sleep apnea [which is marked by intense snoring] is way higher in men than women before menopause,” Winter says.
The data also found that men are more likely to share a bed later in life than women are. Whether this is because men have a shorter life expectancy than women do or because women are opting for sleep divorces or something else isn’t known.
Other possible sleep disruptors
In the SleepScore poll, 14% of the participants indicated that none of the multiple-choice options for sleep disruptors applied to them. Maybe that’s because they simply don’t experience sleep disruptions during the night (lucky them!) or maybe it’s because what wakes them up at night wasn’t on the list of offerings.
There are other common sources of sleep disruption, according to sleep specialists, including:
- allergic conditions (such as nasal congestion, itching, and eczema)
- sleep disorders (such as sleep apnea, restless leg syndrome, and insomnia)
- eating too close to bedtime
- having caffeine or alcohol in the evening
- smoking
- taking certain medications (such as some blood pressure drugs and some antidepressants)
- mental health issues (such as stress, depression, or anxiety)
“The old adage is especially true for sleep — a ruffled mind makes a restless pillow,” Gottlieb says.
Say goodbye to junk sleep
Whatever may be sabotaging your sleep, it’s important to be proactive and take back your nights from junk sleep. “Awakenings or fragmentation of your sleep are worth paying attention to, especially if there’s been a change,” Winter says. Reclaiming your snooze control can go a long way with positively boosting your health, brain function, and emotional well-being.
In fact, a 2015 study found that when healthy adults had their sleep continually disrupted by forced awakenings over three consecutive nights, they experienced less slow wave (deep) sleep after the first night and a downturn in their moods after the second night; these effects were greater among those who experienced forced awakenings than among a control group that had their total sleep time restricted.
And sleep debt is hard to recover from. Just one hour of lost sleep can take four days to replace, which is why it’s important to make sleep a priority and develop better habits that will set you up for a good night’s sleep, night after night. “Developing good sleep habits early in life and maintaining them in middle age will help to combat the age-related changes [in sleep],” Zee says.
Identifying the source of your sleep disruption is the first step to achieving better sleep. Making progress isn't easy but it's definitely harder if you don't have a target in mind.
Whether you’re affected by one of SleepScore Labs’ top sleep disruptors — needing to visit the bathroom; temperature issues; bed partner; outside noises; hot flashes (or general thermal discomfort); pets; light; children; noises from electronic devices; chronic pain; and heartburn symptoms — or something else entirely, such as sleep apnea, anxiety, or general insomnia, knowing the cause will help put you on the right track to take steps to get more restful sleep.
Whether you’re tackling better sleep hygiene and habits with your partner or alone, we’ve compiled the top sleep disruptors, with tips and tricks to help minimize their impact, and top recommendations for products to get you on your way to dreamland. And, if you’d like to know how your neighbors are sleeping, check out our list of sleep-deprived cities in America.
Or if you're ready to get eight hours of quality sleep per night, sign up for Sleep.com’s 8 Days to 8 Hours challenge, created with Dr. Chris Winter, to help you get on track to that goal of a good night’s sleep.
