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-When it comes to sleep, I'm not sure there a topic that frustrates more than waking up at night (sometimes referred to as sleep maintenance insomnia). The struggle to make it from bedtime to wake can be a long and tortuous journey for some. In this episode we will: -explore the history of sleep and nocturnal awakenings -define the prevalence of nocturnal awakenings in the adult population -understand both the definition of arousal and its relationship to awakenings -investigate the concept of sleep efficiency, how it relates to sleep expectation versus sleep need, and how this itself can lead to increased awakenings at night -determine how the presence or absence of excessive sleepiness can help to understand the cause and seriousness of nocturnal awakenings -learn the risk factors and predictors that often lead to nocturnal awakenings find out that an individual's determination of the cause of their awakenings can be unreliable -discuss the role of sleep studies in determining if there are pathological causes for nocturnal awakenings -explore the role of anxiety and worry in nocturnal awakenings -summarize the numerous studies that have shown the role of exercise in reducing both frequency and duration of nocturnal awakenings