Turning the Alarm Clock May Help with Insomnia

By Brandon Peters, MD

What is the first thing you do when you wake up at night? If it’s look at what time it is, you might consider how turning your alarm clock around may actually help your insomnia. Learn how checking the clock may provoke emotional reactions that disrupt sleep even further and how a simple solution may help you to sleep better.

Insomnia is defined as difficulty falling or staying asleep. For many people, it manifests by taking a long time to fall asleep initially or by frequently waking up in the night with trouble returning to sleep. There are multiple causes of insomnia, but paying attention to what time it is can actually make the condition worse.

If you wake up at night and immediately check the clock, there may be consequences to this seemingly innocent action. First, looking to the clock can become a habit. Every time you briefly return to consciousness in the night, rather than simply letting yourself fall back asleep, you may instead wake even further to look to the clock. Depending on what you find, you may put yourself into an emotional state in which returning to sleep becomes even more difficult.

Let’s take an example in which you check the clock and it’s 3 AM. This piece of information may be rather harmless if noted in isolation. It really shouldn’t matter what time of the night it is. However, in the context of your difficulties sleeping, it is a loaded experience. “Oh great,” you might promptly think, “I’m wide awake again.” This may incite a negative reaction, causing you to feel upset, angry, frustrated, or even despondent. How likely is it, when experiencing those feelings, that you will be able to calmly and easily fall back asleep? Quite the contrary, you are more likely to be worked up, aroused further, and stay awake even longer.

To counter this tendency, set your alarm for the time you wish to wake up in the morning. Then, turn the clock around so you can’t see the time. When you awake in the night, you may check it a few times until you remember that you can’t see it any longer. If you awake, tell yourself that you do not hear your alarm blaring, therefore, no matter what time it is, you can return back to sleep. Whether you awake early or late in the night, this will help you to doze off more easily. There will no longer be emotional reactions that can further disrupt your sleep.

There is no reason to keep track of the time at night. It only will further your difficulty returning to sleep. Instead of checking the hour, allow yourself to remain quiet and comfortable until sleep resumes. It is normal to wake up at night – to change positions, adjust the covers, even roll over – but it becomes a problem when this wakefulness persists. Use relaxation techniques such as breathing, muscle relaxation, or guided imagery to distract yourself from any effort related to falling back asleep.

If you find yourself checking your alarm clock at night, the simple step of turning it around may allow you to ease yourself back into sleep. This step can be an important part of other interventions offered by cognitive behavioral therapy for insomnia (CBTI). For those with persistent insomnia, you may wish to speak to a sleep specialist about your treatment options.

How the Best Sunrise Alarm Clocks Make Waking Easier

By Brandon Peters, MD

It is pretty normal to use an alarm clock to wake up. What is not as common, however, is for the clock to mimic a sunrise and wake you with a gradually increasing amount of light. How do the best sunrise alarm clocks make waking easier? Learn how a dawn simulation light works, why it might be preferable to an audible alarm, who benefits most from its use, and what alternatives exist that may help to enforce a circadian pattern, easing insomnia and making it easier to wake and get up.

What Is a Sunrise Alarm Clock?

A sunrise alarm clock, or dawn simulation light, is an artificial light source that is integrated into a standard digital clock. It is timed to gradually wake a person at a selected time. It does this by mimicking the steadily increasing light of sunrise, often over 30 to 40 minutes, but some models may allow the timer to be adjusted from 15 to 60 minutes.

These simulators may have a full-spectrum white or yellow LED lightbulb. The color spectrum, or color temperature (think of this as the “warmth”), of this light may vary slightly from one model to the next. Most are of modest intensity, often 100 to 300 lux, with less light than a standard light box.

There are a variety of models, most costing less than $25 to $100, including:

• Philips Wake-Up Light HF3520

• Philips HF3505

• Philips Somneo HF3650

• hOmeLabs Sunrise Alarm Clock

• Mosche Sunrise Alarm Clock

• INLIFE Wake Up Light Alarm Clock

• NATPLUS Sunrise Alarm Clock

• iHome Zenergy Bedside Sleep Therapy Machine

• totobay

• Sharp Sunrise Simulator

• Lumie

The add-on features also vary widely from one product to the next. Many have the ability to adjust the light intensity, snooze features, and associated standard alarm sounds or music. There may be USB ports integrated for charging devices. Beyond encouraging a gradual awakening, some can even dim light gradually (a so-called sunset feature), making it feel more natural to fall asleep.

How Do Dawn Simulation Lights Work?

Dawn simulation lights can make it easier to wake, but how do these devices work? It is important to consider the natural patterns of light and darkness and how the circadian rhythm enforces optimal sleep and wakefulness.

Humans, like most animals, have evolved to sleep overnight during darkness. Light, conversely, has a waking effect on the brain and body. It suppresses melatonin and activates the circadian alerting signal. Light at the wrong time, like from a screen prior to bedtime, may make it hard to fall asleep and contribute to insomnia. In the morning, when incorporated into a sunrise alarm clock, it may make it easier to wake.

Light exerts this impact by traveling from the eyes via the optic nerves to an area of the brain that regulates the body’s circadian rhythm. This area of the brain, called the suprachiasmatic nucleus, lies in the hypothalamus. It is the master clock of the body. Without it, the patterns of sleep and wakefulness, metabolism, hormone release, cortisol levels, body temperature, and other processes would run amok.

Fortunately, light at the proper time may help us to sleep and feel better. Even artificial light, if appropriately timed, may enforce the normal patterns of our body that would exist if we slept in a perfectly natural environment. A gradual increase of light in the morning hours, even in the natural darkness present in winter months at northern latitudes, may reinforce a normal pattern of waking.

Why Is Light Better Than Sound?

The sudden, blaring sound of an alarm clock will definitely wake someone. However, this abrupt shift from sleep to wakefulness can be disorienting. If full wakefulness is not attained, the snooze button may be pressed and sleep may quickly resume. Short awakenings, such as those lasting less than 5 minutes, may go unremembered. If the alarm clock is simply turned off—or smashed into 1,000 pieces—trouble may ensue!

Light may wake a person more gently and more gradually. The transition from sleep to wakefulness is more orderly. This may help to relieve sleep inertia, that profound sense of sleepiness that is difficult to shake when first opening your eyes. It is something that feels more natural. The sky does not go from pitch black to glaring sunshine. As the sun creeps over the horizon, the amount of light hitting our eyes (even through closed eyelids) steadily increases. It may reach a threshold where it finally wakes us. This may make it less likely a person would want to hit snooze repeatedly and fall back asleep. Even the thought of it seems more pleasant.

Who Should Consider a Sunrise Alarm?

Although there are certain groups who may benefit more from using a sunrise alarm, scientific research suggests that many of us could yield positive health impacts.

There are a surprising number of important benefits from the use of dawn simulation lights. Research suggests it may:

• Improve cardiac function and reduce the risk of heart attacks

• Provide a boost to the brain’s function (in select cognitive domains)

• Enhance performance in tasks done immediately after waking

Clearly there are certain conditions or groups of people who would likely enjoy the effects of a sunrise alarm even more. Consider these possibilities:

Night owls

Delayed sleep phase syndrome is a circadian disorder characterized by difficulty initiating sleep (insomnia) and profound morning sleepiness. It affects 10 percent of the population, usually starting in the teenage years. Most night owls feel naturally sleepy close to 2 a.m. and may not naturally wake until 10 a.m. The use of a dawn simulation light may make waking a little easier. In some cases, a light box may be more effective to reinforce an earlier circadian phase.

Winter depression

Seasonal affective disorder, or winter depression, impacts people living in northern latitudes during the winter months when the nights are long and the days are short. Darkness can make it hard to wake in the morning. This may lead to increased depressive symptoms, lethargy, prolonged sleep, weight gain, and other symptoms. An artificial light may help the morning to start a little easier.

Teenagers

As noted above, teenagers are susceptible to delayed sleep phase syndrome. As a general rule, teens are more likely to have a slight delay in sleep timing, even with a less profound shift in the pattern. This can make it hard for adolescents to fall asleep at a desirable time. It can also make it very difficult to wake them in the morning. This can lead to early morning fights with parents, tardiness, absenteeism, and other problems like car accidents, inattention, and academic failure. Consider how desirable it might be to have a gentle light do the waking, and let the drama of the morning fade away.

Shift workers

Those who work atypical shifts—second, third, graveyard, rotating, or even call coverage—are subject to many sleep problems. When the desire for sleep and wake is forcibly misaligned from the patterns of darkness and light, it can be difficult to function optimally. This may lead to increased errors, accidents, and health problems (including a higher risk for cardiovascular disease, weight gain, and breast and colorectal cancers). Artificial light, if properly timed, may help to alleviate some of this misalignment.

Jet lag 

For every one time zone crossed, it can take one day to adjust the circadian rhythm. Traveling across a continent, or an ocean, can lead to significant disruption. The use of a sunrise alarm clock may make this transition easier. The optimal timing of this light exposure will depend on the distance traveled, and whether preparation was made prior to departing on the trip.

Hearing impaired

Finally, those with a hearing impairment may benefit from using a light to wake, rather than an audible alarm. The deaf may otherwise need to rely on others to wake on time. The use of a sunrise alarm clock may provide a new degree of independence.

Alternatives to Sunrise Alarm Clocks

Many people will be attracted to the possibility of easing insomnia and waking and getting up easier. Not everyone may want to use a sunrise alarm clock, however. There may be a handful of alternatives to consider. Consider how these additional options may make it easier to wake in the morning:

Natural sunlight

Throw the window shades open in your bedroom before retiring for the evening. This will let in natural light. After sunrise, the light will be able to stream through the windows and promote wakefulness. Unfortunately, this may not be ideally timed certain times of the year.

Light box

Consider a light box with 10,000 lux of intensity. It is powerful enough to shift the circadian rhythm, benefiting seasonal affective disorder as well.

Light therapy glasses

For those with a little extra buying power, light therapy glasses are a convenient and effective option. With a lower amount of light, shone directly into the eyes, these glasses can make it easier to wake.

Caffeine

A cup of coffee or tea can make it easier to get the morning started. Caffeine blocks adenosine, a signal for sleep, within the brain. With a half-life of 4 to 6 hours, it can get you through the morning.

Get motivated

Consider ways to motivate yourself out of bed. Morning exercise, quickly hopping in the shower, a special breakfast, or stepping outside to enjoy the early light may be helpful. In some cases, scheduling something you really enjoy for first thing in the morning may do the trick. 

Conclusion

There are many effective ways to wake and feel refreshed. A sunrise alarm clock may help to ease the transition to wakefulness. If you consistently struggle to wake, or have sleep of poor quality, consider getting evaluate by a board-certified sleep physician. Sleep disorders can be effectively resolved to the benefit of your health and well-being.

Sources:

Follum JD, Catchpole JM. “Sunrise alarm clock for the hearing impaired.” Biomed Sci Instrum. 2011;47:18-23.

Viola AU et al. “Dawn simulation light: a potential cardiac events protector.” Sleep Med. 2015 Apr;16(4):457-61. doi: 10.1016/j.sleep.2014.12.016. Epub 2015 Feb 26.

Gabel V et al. “Dawn simulation light impacts on different cognitive domains under sleep restriction.” Behav Brain Res. 2015 Mar 15;281:258-66. doi: 10.1016/j.bbr.2014.12.043. Epub 2014 Dec 27.

Thompson A et al. “Effects of dawn simulation on markers of sleep inertia and post-waking performance in humans.” Eur J Appl Physiol. 2014 May;114(5):1049-56. doi: 10.1007/s00421-014.2831-z. Epub 2014 Feb 11.

How to Wake and Get Up Early

By Brandon Peters, MD

It can be downright painful to drag yourself out of bed at an hour earlier than you are used to waking. Sometimes it is simply necessary to wake and get up early, however. What are the best ways to wake and get up early? Discover how to accomplish this with simple changes—such as alarm clocks, morning sunlight, and caffeine—that you can implement immediately that may have lasting benefits.

Changing Your Wake Time May Depend on the Purpose

Consider whether you need to wake up early once, such as to catch an early flight, or if you are adapting to a new schedule that shall persist. This will help determine what solutions or techniques should be considered to help you get up early. It may also be helpful to reflect on what your relationship to your alarm clock says about your personality. Difficulty waking may suggest underlying problems with the amount or quality of sleep.

Making Long-Term Changes to the Timing of Sleep

If possible, especially if this is a long-term adjustment to your sleep schedule, try to make changes gradually. For children or adolescents getting ready to resume school as the summer draws to a close, it is much easier to plan ahead and start waking earlier in the week or two before the first day back.

Begin by setting an alarm in the morning that is close to your current, natural wake time. Then, day by day, move the wake time earlier by 15 minutes. This could be adjusted as quickly as necessary or as slowly as comfortable. As a general rule, it takes 1 day to adjust to every 1-hour change in the timing of sleep (such as with jet lag). The wake time may be comfortably moved earlier every few days, for example.

Try to keep a regular bedtime and go to bed when feeling sleepy to avoid insomnia. It will not be helpful to crawl into bed early without feeling sleepy: it will just take longer to fall asleep. This desire for sleep will gradually shift earlier in increments, too. Listen to your body, spend time relaxing in the hour before your bedtime, and go to bed when you naturally feel sleepy. These incremental adjustments may help you to wake up more easily.

To optimize your sleep, maintain a regular sleep schedule (with consistent bedtimes and wake times) even on weekends or days off. To reinforce the wake time, get 15 to 30 minutes of morning sunlight upon awakening. If possible, roll out of bed, throw on clothes, and immediately go outside. Do not wear sunglasses or a hat; let the light hit you in the face (especially your eyes). The fresh air will wake you and the light will help to align your circadian rhythm and sleep pattern. If necessary due to where you live, consider the use of a specialized light box. Getting morning light exposure can be especially helpful for night owls with delayed sleep phase syndrome.

Reinforcing the Wake Time with Solutions and Determination

Beyond making gradual adjustments and reinforcing the circadian rhythm with light exposure, there can be other solutions that may prove helpful to wake and get up early. Consider these potential options and solutions:

• Set a loud, obnoxious alarm that is disruptive to your sleep.

• Put the alarm clock across the room so that you physically have to get up to turn it off. Don’t go back to bed once you are up.

• Consider setting multiple alarms on different devices (alarm clock, phone, etc.).

• Set the alarm as late as possible so that you don’t have an option to hit snooze, but have to get up immediately—or be late.

• Recruit others to help you wake up, such as members of the household who may already be awake or someone who can call you until you are up.

• Once out of bed, immediately go to the shower.

• Morning exercise or getting outside may also help to keep you awake.

• Consuming caffeine may clear morning sleepiness until you naturally start to wake.

• Avoid the use of sleeping pills as these may cause morning hangover effects.

Once you are awake and out of bed, you may still have a desire to return to sleep due to sleep inertia. This may be profound if you are waking significantly earlier than your usual wake time. It may feel like the middle of the night, and you may just want to crawl right back into bed. If this persists, you may consider reasons that your sleep is not as restful as it should be.

Make certain that you get enough hours of sleep to feel rested. Sleep needs vary, but most adults need 7 to 9 hours of sleep. As we get older, beyond the age of 65, the average sleep need may decrease slightly to 7 to 8 hours. If you don’t get enough sleep at night, it will be more difficult to wake up.

Treating sleep disorders may also be necessary to make it possible to wake and get up early feeling rested. Insomnia may insidiously undermine sleep, reducing the total amount and compromising the quality. Restless legs syndrome (RLS) may make it hard to fall asleep. Obstructive sleep apnea may also fragment sleep, leading to excessive daytime sleepiness and other symptoms. If one of these conditions is present, testing and treatment may be necessary to resolve the difficult waking.

In some cases, morning sleepiness may require further treatment. When it is due to a sleep disorder (sleep apnea, narcolepsy, or shift work sleep disorder) and interferes with daytime function, prescription stimulant medications may be used. These medicines may include modafinil (Provigil), armodafanil (Nugivil), or others such as methyphyenidate (Ritalin). Speak with a board-certified sleep medicine physician if you feel like you are struggling more than you should be.

As you adopt these changes to wake and get up early, initially have a fallback plan. Don’t just start by setting one alarm 2 hours before you naturally wake up and expect to jump out of bed refreshed; it may not go well. Consider ways to adjust gradually and use the recommendations above to help reinforce this change. Get help from others, including a sleep doctor if needed, to keep you on the right path. It can also be helpful to acknowledge that with determination and grit you can do it. Don’t allow yourself to go back to bed. The first few days will be the most difficult, but it will get easier.

Brandon Peters, MD, is the author of Sleep Through Insomnia, a neurology-trained sleep medicine specialist at Virginia Mason Medical Center in Seattle, and former adjunct lecturer at the Stanford Center for Sleep Sciences and Medicine.