Dear doctor;

Whenever my wife stirs awake at night, like at 3am, she fails to sleep again. But the regularity of this habit is worrying me. How do I help her?

James, 26.

Dear James,

You have not been specified whether she gets sleep easily and sleeps soundly up to that time or her sleep is difficult and interrupted. Does she get any physical problem after midnight like cough or breathlessness?If she sleeps early and has a sound sleep, getting up at 3am is no big deal.

This may be becoming a routine. Depression is a major cause for making one get up at an odd time and then finding difficult to sleep again. Sleep apnoea, where one snores during sleep and airways get obstructed, can make a person get up after midnight.

Also, diseases such as asthma, heart failure, cause breathlessness around or after midnight, compelling the patient to sit up. If the blood glucose goes low early morning, sleep can be disturbed and there may be associated symptoms like sweating, fatigue, palpitations, etc.

If she has no physical or other problem, just make sure that she is kept happy. She ought to avoid caffeine products in the night as they also tend to cause insomnia. The time for sleeping should be delayed by keeping her busy.