How to Fall Back Asleep After Waking Up In Middle Of The Night

Updated Mar 10, 2025 | 03:00 AM IST

SummaryBut there are ways to help your body relax and drift off again without too much effort. Here are ten evidence-based strategies that could help you get the rest you need.
How to Fall Back Asleep After Waking Up In Middle Of The Night

Credit: Canva

Waking up in the middle of the night can be frustrating—especially when you struggle to fall back asleep. But there are ways to help your body relax and drift off again without too much effort. Here are ten evidence-based strategies that could help you get the rest you need.

1. Block out disruptive noises

If a disturbing sound outside your window wakes you, try shutting it to block it out. You might also try using earplugs, turning on a fan, or listening to white noise. A 2021 research review found that white noise may improve sleep in some individuals, though results were mixed and more studies are needed.

2. Leave your bed

Try moving into a different room if you haven’t fallen asleep in 15 minutes. Then do something relaxing to distract your mind for a few minutes. This may make it easier to fall asleep when you return to bed.

3. Avoid staring at the clock

Staring at the clock may make you feel anxious about not sleeping. You might even consider getting rid of your alarm clock completely. Research published in 2019 suggests that anxiety and trouble falling asleep are associated. People who manage anxiety often worry about falling asleep, and people who have difficulty falling asleep often feel anxious.

4. Avoid screens

Turn off all your devices. Notification sounds may awaken you. Smartphones and other electronics also emit blue light that may suppress your body’s melatonin production. Melatonin is a hormone that helps regulate your circadian rhythm and sleep cycles. Blue light-blocking glasses are an inexpensive option that may improve sleep, according to a 2021 research review, but research is mixed.

5. Meditate or try breathing exercises

A 2018 research review on the effect of mindfulness meditation indicates breathing exercises or meditating may help treat some aspects of sleep disturbance and improve sleep quality. One useful method is the 4-7-8 breathing technique: inhale through your nose for 4 seconds, hold your breath for 7 seconds, then exhale through your mouth for 8 seconds.

6. Relax your muscles

One technique that some people may find helps them relax and sleep is performing a full body scan. Close your eyes, breathe slowly, and move your attention from your face down to your feet, relaxing each area as you go.

7. Sleep with the lights off

Resist the temptation to turn on the lights, even if you get out of bed. Bright light may interfere with your body’s melatonin production and wake you up.

8. Focus on something boring

Research from 2018 found that many people report feeling sleepy when bored. The classic “counting sheep” technique — or any uninteresting task that occupies your mind — may help distract you and make falling asleep easier.

9. Listen to relaxing music

Relaxing music may help calm your mind and block sounds that may disrupt your sleep. Personal preference plays a large role in determining what type of music is best, so experiment with different styles.

10. Try sleep apps

Sleep apps offer relaxing stories, music, and sounds. Apps like Calm and Headspace offer free trials, allowing you to see what works best for you.

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The Silent Killer: Why More Indians Need To Pay Attention To Liver Cancer

Updated Aug 28, 2026 | 07:00 AM IST

SummaryIndia's shifting disease landscape, sedentary routines, poor dietary habits, and metabolic disorders like obesity and diabetes, means liver cancer is no longer just an infectious-disease concern. It's increasingly a lifestyle disease too.
The Silent Killer: Why More Indians Need To Pay Attention To Liver Cancer

Credit: iStock

Liver cancer rarely announces itself. It creeps in without warning, and by the time symptoms surface, the disease has often progressed to a stage where treatment options shrink, and outcomes worsen. That's why doctors have long called it a "silent killer."

In India, the threat is growing. Rising rates of hepatitis infection, fatty liver disease, and lifestyle-driven risk factors are pushing the numbers up.

Data from the World Health Organization's International Agency for Research on Cancer (IARC) shows more than 40,000 new liver cancer cases reported in India, a figure that underscores a mounting public health challenge. The disease also carries a high mortality rate, largely because most cases surface only once treatment options have narrowed.

This fits into a much larger global picture: WHO's newly released Global Status Report on Cancer 2026 warns that annual cancer cases worldwide could climb from 20.6 million today to nearly 35 million by 2050 without urgent intervention, with infections like hepatitis B and C among the preventable risk factors driving a significant share of the burden.

Why Does Liver Cancer Stay Hidden?

The liver is a workhorse organ, filtering toxins, storing nutrients, and keeping the body running, and it can keep functioning almost normally even after cancer takes hold. That resilience is precisely what makes early detection so difficult. When symptoms do appear, they're vague enough to be mistaken for something else entirely:

  • Unexplained weight loss
  • Persistent fatigue and weakness
  • Upper abdominal pain
  • Loss of appetite
  • Yellowing of the skin and eyes
  • Abdominal swelling

Because these signs surface late, patients often delay seeking care, which is exactly why regular health checkups matter most for high-risk groups, including people with chronic liver disease, hepatitis infection, or fatty liver.

What's Driving the Risk?

Liver cancer doesn't appear overnight; it's the result of years of accumulated damage. Key contributors include:

  • Chronic Hepatitis B and C infections, among the leading causes worldwide
  • Liver cirrhosis, where scar tissue replaces healthy liver tissue
  • Fatty liver disease, increasingly common in India amid rising obesity and diabetes
  • Excessive alcohol consumption, which steadily damages liver cells
  • Family history of liver disease or cancer
  • Exposure to toxins through contaminated food
  • Smoking, which raises overall cancer risk

India's shifting disease landscape, sedentary routines, poor dietary habits, and metabolic disorders like obesity and diabetes, means liver cancer is no longer just an infectious-disease concern. It's increasingly a lifestyle disease too.

Can It Be Prevented?

The good news: much of this risk is manageable.

  • Get vaccinated against Hepatitis B to block the long-term viral infection that often leads to cirrhosis
  • Maintain a healthy weight through diet and regular activity, as obesity is closely tied to fatty liver disease
  • Manage diabetes and metabolic health, since insulin resistance accelerates liver damage
  • Limit or avoid alcohol, a leading cause of cirrhosis
  • Avoid tobacco, which compounds cancer risk
  • Stay on top of routine screening if you're at risk; this is one of the most critical preventive steps and includes:
    • Liver function tests (LFTs) to catch early signs of inflammation or damage
    • Ultrasound scans every 6 months for those with cirrhosis, chronic hepatitis B or C, or advanced fatty liver disease
    • Alpha-fetoprotein (AFP) blood tests, used alongside imaging to flag early tumour changes
    • Advanced imaging (CT or MRI) for more detailed evaluation in high-risk cases

Paired with lifestyle changes and timely medical care, these steps can meaningfully lower the risk of developing liver cancer and support long-term liver health.

Know When to Seek Medical Help

Because liver cancer tends to progress silently, early detection is everything when it comes to improving outcomes. Doctors typically rely on a combination of diagnostic tools, ultrasound scans, AFP blood tests, CT or MRI imaging, and in some cases a liver biopsy, to catch the disease at a more treatable stage.

When caught early, treatment can significantly improve survival odds. The right approach depends on the stage of disease, liver function, and the patient's overall health:

  • Liver resection, surgically removing only the cancerous portion of the liver, when the disease is localized
  • Liver transplant, replacing the entire diseased liver with a healthy donor liver, in select cases
  • Ablation, using radiofrequency or microwave energy to destroy cancer cells with heat
  • Targeted therapy, drugs designed to attack specific cancer cells while sparing healthy ones
  • Immunotherapy, strengthening the body's own immune system to identify and fight cancer cells

Liver cancer is serious and life-threatening, but early diagnosis through screening, paired with timely medical intervention, can meaningfully improve treatment success and survival rates.

(By Dr. Kundan, Consultant - Surgical Oncology, Manipal Hospital, Ghaziabad_

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Hormone Replacement Therapy May Lower Dementia Risk In Women, Shows Study

Updated Aug 27, 2026 | 10:24 PM IST

SummaryWomen who used HRT had a 26% lower risk of dementia compared with non-users. Those who started menstruating later or experienced menopause earlier also had a 16% lower risk of dementia with HRT use.
Hormone Replacement Therapy May Lower Dementia Risk In Women, Shows Study

Credit: iStock

Women have a higher overall risk and prevalence of Alzheimer’s disease and certain other forms of dementia, partly because they tend to live longer than men and because of changes in estrogen levels after menopause.

A new study by researchers from the University of East Anglia (UEA) and the University of Exeter suggests that hormone replacement therapy (HRT) may be associated with a lower risk of dementia in some women.

“Dementia affects millions of people worldwide, with women making up almost two-thirds of Alzheimer’s disease cases, the main form of dementia. As populations age, understanding how sex-specific factors influence dementia risk is increasingly important,” said Prof Anne-Marie Minihane from UEA’s Norwich Medical School, who led the study.

HRT Linked To Lower Alzheimer’s Risk

The study, published in the journal Alzheimer’s & Dementia, analyzed health data from more than 180,000 postmenopausal women in the UK.

The findings showed:

  • 16% lower risk of Alzheimer’s disease among women who had used HRT compared with those who had never used it.
  • 10% lower risk of dementia overall was associated with HRT use.
  • 26% lower risk of any dementia among women who had undergone surgical menopause and used HRT.
  • 16% lower risk of any dementia among women with lower lifetime estrogen exposure due to later menstruation or earlier menopause.

Which Groups Benefited More From HRT?

The association between HRT use and lower dementia risk was stronger in certain groups. These include:

  • Women who underwent surgical menopause: Those who used HRT had a 26% lower risk of dementia compared with non-users.
  • Women with lower lifetime estrogen exposure: Those who started menstruating later or experienced menopause earlier had a 16% lower risk of dementia with HRT use.
  • APOE4 carriers: The association between HRT use and lower dementia risk was stronger among women carrying the APOE4 gene variant, a known risk factor for Alzheimer’s disease.
  • Women who started HRT between ages 46 and 56: This group experienced the greatest reduction in dementia risk.
  • Timing may matter: The findings support the “critical window” hypothesis, suggesting HRT may offer greater benefits when started closer to the menopausal transition rather than later in life.

Could HRT Support Personalized Care?

The researchers said the findings add to growing evidence that the effects of hormone therapy on brain health are complex and may vary between women.

“While HRT has long been prescribed primarily to relieve menopausal symptoms such as hot flushes and night sweats, this work suggests it may also play a role in long-term cognitive health for some women,” Prof Minihane said.

The latest findings build on previous research from UEA, which found that HRT use was associated with better memory, cognition and larger brain volumes later in life among women carrying the APOE4 variant.

The team said the findings could help support more personalized approaches to HRT prescribing, taking into account factors such as menopause type, genetic risk, lifetime hormone exposure and age at HRT initiation.

Prof David Llewellyn of the University of Exeter Medical School said the findings help identify which women may be more likely to benefit from HRT and when treatment may have the greatest effect.

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Can Stress Trigger Psoriasis Flare-Ups? Understanding The Mind-Skin Connection

Updated Aug 27, 2026 | 01:00 PM IST

SummaryStress can trigger or worsen psoriasis flare-ups by influencing immune and inflammatory responses, highlighting the connection between psychological stress and skin health.
Can Stress Trigger Psoriasis Flare-Ups? Understanding The Mind-Skin Connection

Credit: AI

The association between stress and psoriasis is one of the better-documented cases of the mind and skin connection within dermatology. Consistent across studies, at least in most case series, there is a sizable proportion of patients who experience an important stressful event within the weeks prior to onset or flare-up.

The mechanism is quite clear cut. While the skin is often seen as being passive, it is far from it. Skin itself is immunologically active, having a stress response system of its own, able to produce corticotropin-releasing hormone and cortisol independently from adrenals.

The Mind-Skin Connection

Under prolonged stress, the shift happens in the hypothalamic-pituitary-adrenal axis, leading to a reconfiguration of the immune response towards inflammatory pathways, specifically IL-17 and IL-23 pathway which was targeted by most biologics developed up to now.

Neuro-endocrine innervations lead to the release of neuropeptides such as substance P, attracting inflammatory cells while lowering the threshold of itching. Chronic stress also impairs barrier recovery process, relevant for a disease where the slightest skin damage leads to a plaque formation.

So whenever a patient claims stress caused her flare-up, she is describing an actual immunological phenomenon.

And the cycle, which is the part that entraps people.

And here lies the complexity, the place where I believe most of the articles end prematurely.

Also read: ‘Sunscreen Is A Health Essential’: UK Skin Cancer Survivor Urges Govt To Scrap Tax

Stress Aggravates Psoriasis

Then the psoriasis becomes the source of stress. Highly visible plaques on hands, scalp or face are hard to hide within a culture where we greet, eat and worship with our hands. Patients start dressing in ways that conceal their plaques. They avoid public showers, salons, wedding events. Itch affects their sleeping habits, causing higher inflammation levels.

Then come the questions patients do not usually disclose unless specifically asked. The shame. Some patients have experienced people wondering whether they could catch the condition. Some of them have been asked to leave the salon where they went. This is not just an annoyance, but also a hurt, directly feeding back into the loop.

The prevalence of depression and anxiety in psoriasis is much higher than among healthy people. Moreover, these problems cannot be explained only by a reaction to one's appearance. The same inflammatory mediators, which cause psoriasis, are now associated with depression. Therefore, psoriasis and depression can be two symptoms of one inflammatory condition.

Also read: Mpox Spreads in Guinea-Bissau, Half Of Suspected Cases Are Children

What Really Helps?

Here I need to be very careful, since the idea that stress provokes psoriasis can be twisted into the belief that the patient has caused his/her own illness. But it is not true and is insulting to people suffering from the condition. It should be said again that psoriasis is a genetically based immune disorder. It is stress that exacerbates the disease.

Within this framework, stress management techniques are useful and there is the trial evidence for their efficiency. In one study, mindfulness-based intervention helped to improve the outcome and even accelerated clearance with phototherapy.

Physical exercise has an independent anti-inflammatory effect and treats metabolic syndrome associated with psoriasis. Sleeping is an obligatory factor because sleep deprivation increases the level of cytokines that we need to suppress. Cognitive behavioral therapy helps people to cope with itching-scratching cycle.

There is no doubt that alcohol and smoking make psoriasis worse, although they are usually used as a coping strategy in response to stress. They serve as an additional burden on health.

All of this is important but not an alternative to treatment. Topicals, phototherapy, systemic medications, and biological agents still remain the core of the treatment regimen. Stress management is only an adjunct, and I always remind my patients about it so that they never feel guilty for taking medicine.

Treat The Whole Person

Now I ask two questions at each review of psoriasis. How much of the body surface area is affected and how much of the person's life does it occupy. The answer to these questions often does not coincide.

I saw patients with rather small involvement of the skin surface, whose psoriasis completely ruined their self-esteem. And I met patients with large involvement who coped with the disease perfectly.

Body surface area does not measure suffering. If we treat only what we can see, we will treat half of the disease.

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