Waking up once or twice throughout the night is normal. But spending eight hours tossing and turning, and getting restless sleep night after night, can lead to low energy, trouble focusing, and poor health — and that’s not to mention how unenjoyable a night of restless sleep is.
Below, we’ve covered everything you need to know about restless sleep, including the causes, symptoms, and how to fix it. Plus, we’ve shared how the RISE app can help you sleep through the night.
“A night of restless sleep every now and again is nothing to worry about," says Dr. Chester Wu. "If it’s happening regularly, look at your sleep hygiene. That includes avoiding caffeine and alcohol close to bedtime, keeping a consistent sleep schedule, and taking time to wind down before bed.”
Dr. Chester Wu is double board certified in Psychiatry and Sleep Medicine, and provides sleep medicine services, medication management, and psychotherapy to adults at his private sleep medicine and psychiatry practice.
There’s no clinical definition for restless sleep, but restless sleep can be when you:
A night of restless sleep every now and again is normal.
It’s also normal to take some time to fall asleep. If you fall asleep instantly it may actually be a sign of sleep deprivation. And it’s normal to wake up once or twice throughout the night, too.
But if you regularly find yourself tossing and turning all night and not getting the sleep you need, this can start affecting your energy levels, productivity, mood, and mental and physical health.
Restless sleep may also be a sign of a sleep issue like insomnia or a medical condition.
There’s no set amount of restless sleep that’s normal. Waking up once or twice during the night or shifting positions is normal, and a night of tossing and turning every now and again isn’t cause for alarm.
But if you find you’re regularly getting restless nights of sleep or struggling to get enough sleep, speak to a healthcare provider or sleep specialist to determine the root cause and best course of action.
You can check RISE to see if restless sleep is making you sleep deprived. RISE can work out how much sleep you should be aiming for each night (known as your sleep need) and whether you’ve got any sleep debt (the amount of sleep you owe your body).
You can check your sleep debt each morning to assess whether restless sleep is causing sleep loss.
RISE users on iOS 1.202 and above can .
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There are no set symptoms of restless sleep. But, in general, the symptoms of restless sleep include:
Restless sleep isn’t classified as a sleep disorder, so the symptoms are subjective and they may change for you from night to night.
However, (RSD) is a newly described disorder in kids. The symptoms include:
Restless sleep may be caused by sleep disorders and medical conditions, which will have their own set of symptoms.
For example, if restless sleep is caused by sleep apnea, symptoms may include:
Restless sleep can also lead to sleep debt. If you need to wake up at a set time each morning, as many of us do, a night of tossing and turning can cut into your sleep time, causing sleep debt.
The symptoms of short-term sleep debt include:
Long-term sleep debt can lead to:
Heads-up: We all need a different amount of sleep each night. When we looked at how much sleep 1.95 million RISE users aged 24 and up needed, the amount ranged from five hours to 11 hours 30 minutes, with eight hours of sleep being the median.
RISE users on iOS 1.202 and above can .
Even if you’re getting enough sleep overall, restless sleep can still cause symptoms like low energy and poor mood.
is more restorative than broken sleep. And shows sleep interruptions have a bigger impact on your mood than getting the same shortened amount of sleep without interruptions.
Plus, how you feel about your sleep makes a difference to your energy levels the next day. So if you got enough sleep, but felt like you were tossing and turning a lot to get it, this may be enough to make you feel tired.
found how people feel about their sleep had a bigger impact on their daytime fatigue than how much sleep they got. And a found more light sleep and less time awake at night are linked to better sleep satisfaction. A found the more satisfied you are with your sleep, the better your mood and overall life satisfaction will be the next day.
The same goes if you’ve got insomnia — one of the causes of restless sleep. A on those with insomnia found there were no links between fatigue levels and polysomnography (PSG) measures, which are objective measures of sleep done via a sleep study. Fatigue was linked to insomnia symptoms, depressive symptoms, and longer habitual sleep duration (which could mean lots of broken sleep).
Another found more severe fatigue in insomniacs wasn’t necessarily linked to poor PSG-defined sleep. But it was linked to worse health-related quality of life.
Those with insomnia tend to think they slept less than they actually did. So if you feel like you had a night with insomnia symptoms — perhaps restless sleep — this may cause fatigue, even if your sleep was objectively fine.
We’ve covered more on whether it matters what time you sleep here.
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There are many different causes of restless sleep, including drinking caffeine or alcohol too close to bedtime, having a warm bedroom, or being stressed and anxious.
Let’s dive into the common causes in more detail.
Caffeine doesn’t just keep you up. A found caffeine can:
And caffeine can last in your system for more than 12 hours, meaning a seemingly innocent afternoon coffee can cause sleep disruption.
Alcohol acts as a sedative at first, but this effect after a few hours. This leads to fragmented sleep in the second half of the night.
Alcohol can also trigger night sweats, sleep apnea, and the need to pee more often — all of which can add to a night of tossing and turning.
If you have dinner close to bedtime, digestive issues like acid reflux, bloating, or IBS may cause a troubled night of sleep.
And even if digestion goes smoothly, late-night eating can still cause restlessness.
found eating or drinking within an hour of bedtime increases the odds of waking up during the night.
Exercise can help you fall and stay asleep, but if you do intense exercise close to bedtime, it may have the opposite effect.
shows vigorous exercise within an hour of bedtime can lead to taking longer to fall asleep, getting less sleep overall, and having a lower sleep efficiency (the measure of how long you spend sleeping while in bed, which takes into account falling asleep and waking up in the night).
Light, noise, or a too-warm bedroom can make it harder to fall asleep and could be the reason you’re waking up often during the night and struggling to get back to sleep.
Sleep disturbances could come from a snoring partner, noisy neighbor, or hot summer’s night. But there are also disruptions you might not think of.
For example, shows sleeping with the lights on can lead to more nighttime awakenings and a found owning a dog was linked to higher odds of having trouble sleeping. Having a restless dog in bed will certainly lead to a restless night for you, too.
The light you get, or don’t get, during the day can also mess with your sleep.
One found evening exposure to short-wavelength light — the light you get from screens — can disrupt sleep continuity.
And shows those who get later first exposure to more than 10 lux of light each day had more awakenings the next night.
FYI, an overcast day is about 1,000 lux. So getting outside in the morning, even on dark days, can help improve restless nights.
Among RISE users, stress and anxiety are the biggest challenges stopping them from getting a good night’s sleep.
If you’re feeling stressed and anxious, you may struggle to switch off and relax, and racing thoughts may keep you awake either at the start of the night or in the middle of the night once you’ve woken up.
If stress easily affects your sleep and causes insomnia, you may have high . shows once you’ve been exposed to stress and developed insomnia, your sleep reactivity can increase even more and it may not return to pre-insomnia levels.
In short, more stress = more restless nights.
Pain and discomfort may stop you from falling asleep, wake you up, and cause you to frequently change positions to try and get comfortable.
This can be caused by your body — like lower back pain, an injured shoulder, or arthritis — or something in your bed — like a lumpy mattress or too-firm pillow.
Tossing and turning can be a sign of insomnia.
Types of insomnia include:
If you often have restless nights, you may develop conditioned arousal. This is when your brain makes the link between your bed and being awake at night.
And worrying about restless sleep may cause even more restless sleep.
Counterintuitively, the more you try to control sleep (known as sleep effort), the worse your sleep can get. Sleep effort can even .
You may also suffer from , which is when you obsess over sleep data you get from your wearable device or sleep tracker. It’s easy to get so caught up trying to get a perfect night of sleep that you add to your restlessness.
That’s one reason we keep things simple at RISE and only track sleep debt, instead of time spent in deep sleep or REM. Sleep debt is one of the biggest predictors of how you’ll feel and function on a given day. We measure it over 14 nights, too, as one bad night doesn’t make or break your sleep health.
Sleep apnea is another sleep disorder that can cause restless nights. Sleep apnea is when your breathing is cut off during the night and your brain has to wake you up to kickstart it again.
You may be woken up several times an hour and struggle to get back to sleep once you’re awake.
Beyond insomnia and sleep apnea, restless sleep can be caused by sleep disorders such as:
Medical conditions could be waking you up in the night or making it harder to sleep.
These include:
Medications for certain medical conditions can also cause restless sleep. These include:
Hormone changes can cause:
And all of these symptoms can get in the way of restful sleep.
You might experience hormone-related restless nights when:
Your circadian rhythm is your internal body clock. It runs on a roughly 24-hour cycle and helps to control your sleep cycle.
If you’re trying to sleep out of sync with your circadian rhythm — i.e. during the day if you work night shifts or at different times each night — you may struggle to sleep soundly.
You might also be out of sync if you’re suffering from jet lag or battling against your chronotype (like when a night owl tries to sleep early).
RISE predicts the timing of your circadian rhythm and shows you when your body naturally wants to go to sleep and wake up.
RISE users on iOS 1.202 and above can .
We’ve covered more reasons you wake up in the middle of the night here.
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Restless sleep can look different at every age, and it can be caused by different things, too.
Here’s what restless sleep looks like by age group:
