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I've started to wonder whether or not my bouts of insomnia are truly detrimental or just "the way I am." Last night for instance, I woke up after four hours of sleep feeling very excited and stimulated about a project I am working on. At first, I assumed this was another case of increased cortisol, but felt also conflicted since my state of mind was quite positive and eager.

I have for quite some time held, what now appears to be, an unhealthy attitude that I absolutely need X hours of sleep or else my performance and mood will suffer. Now, however, I am considering that when nights like last night come, that I should just surrender to the restlessness and go about reading or working on project.

Would I only be encouraging future episodes by not lying in bed? Or is my body trying to tell me something, like "Now would be a great time to work!"

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The Mayo Clinic says, among other things:

If you wake up and can't fall back to sleep within 20 minutes or so, get out of bed. Go to another room and read or do other quiet activities until you feel sleepy.

Super thrilling and exciting work may not be the best choice. That said, I've been waking in the night lately and I found that doing a small nugget of work (most recently I changed a demo in an upcoming presentation, which took about half an hour) gives me a sense that I did something and earned a chance to relax. That was a better result than reading for an hour. I went back to sleep afterwards quite easily.

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Suppose that you also want to sleep better on the long term. Then that may require some lifestyle changes like exercising more. If waking up much earlier than usual and feeling that you just can't sleep more happens quite frequently, then you need to weigh your options such that sticking to your new routine is going to work the best. The problem with getting more exercise is that while sleep is known to be affected by exercise, it's not easy to get to sleep better by exercising more. You need to continue to exercise for a while to reap the benefits for sleep:

But people with insomnia and other sleep disturbances tend to be “neurologically different,” Dr. Baron said. “They have what we characterize as a hyper-arousal of the stress system,” she said. A single bout of exercise on any given day “is probably not enough to overcome that arousal,” she explained. It could potentially even exacerbate it, since exercise is itself a physical stressor.

Eventually, however, if the exercise program is maintained, Dr. Baron said, the workouts seem to start muting a person’s stress response. Her or his underlying physiological arousal is dialed down enough for sleep to arrive more readily, as it did in the 2010 experiment.

We may get a better insight into insomnia by looking at populations were insomnia is rare. It turns out that many indigenous populations don't get the amount of sleep that is conventionally recommended, but they don't suffer from insomnia anywhere near the levels that's considered to be normal in Western societies. As pointed out here:

Though the San, Tsimane, and Hadza often average less than seven hours of sleep, they seem to be getting enough sleep. They seldom nap, and they don’t have trouble dozing off. The San and Tsimane languages have no word for insomnia, and when researchers tried to explain it to them, “they still don’t seem to quite understand,” Siegel says.

The Tsimane get far more exercise than most Westerners do. We can read here:

The Tsimane get a ton of exercise, Gurven says, but it's not really intense exercise. "I think there's a general stereotype that if you're a hunter-gatherer and farmer, that you're exercising vigorously every day, like the equivalent of running a marathon, and that's not the case," Gurven says. "It's really just that they're not sedentary."

Instead the Tsimanes do a lot of walking — about 7 1/2 miles each day. And they're active for more than 90 percent of daylight hours. In contrast, Americans spend about half their waking hours sitting down.

And they eat far less fat than we do:

When you hear "hunter-gatherer," people often think of the meat-packed paleodiet. But the Tsimane diet couldn't be further from that. More than 70 percent of their calories come from carbohydrates — ones that are packed with fiber, such as corn, cassava and plantains. The other 30 percent of the calories are split evenly between protein and fat.

So, by changing your lifestyle by getting more exercise, eating healthier and getting a larger fraction of your calories from whole grain carbs, and by not focusing too much on getting 8 hours of sleep (6.5 hours may be enough), you'll likely end up sleeping better.

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    while this is interesting "how to have less insomnia" material, that wasn't the question. The question was "should I get up and do stuff when I wake up?" and there is nothing in this answer aimed at that. It's a great answer to an entirely different question asking about diet and exercise and their effect on insomnia. – Kate Gregory Jun 4 '17 at 0:14
  • @KateGregory I've made some changes in the text to make clear that a long term goals aimed at sleeping better could be used to decide what to do when an incident where you don't get enough sleep happens. That's a personal matter, so I can't say you have to do this or that. A morning person who doesn't get enough sleep may want to exercise in the morning while an evening person like me will prefer to do it later in the day. Thing is that with lifestyle change involving exercise this is something you need to think about while previously you could just coast along with a few hours sleep. – Count Iblis Jun 4 '17 at 1:03

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