Why You May Wake Up Shaking: Causes and Treatment

Why You Might Wake Up Shaking or Trembling

Waking up shaking or trembling can be startling and concerning. However, in most cases, it is not a cause for alarm. There are several potential reasons why someone might wake up shaking or trembling, most of which are treatable and not life-threatening.

Anxiety or Panic Attacks

One of the most common reasons for waking up shaking is anxiety or panic attacks. Anxiety disorders are very prevalent, affecting over 40 million adults in the United States alone. Panic attacks often happen at night or upon waking.

When you have a panic attack, your body goes into fight-or-flight mode even when there is no real danger. Your breathing and heart rate increase, you may sweat or feel flushed, and you could experience trembling or shaking as your muscles tense up. These physical symptoms are your body's natural reaction to stress hormones like adrenaline. While panic attacks can be extremely distressing, they are not dangerous and will pass within a few minutes.

If you experience recurrent panic attacks or chronic anxiety, there are very effective treatments available, including therapy and medication. Relaxation techniques like deep breathing, meditation, and guided imagery can also help reduce shaking from anxiety.

Hypoglycemia

Another potential cause of waking up shaking is hypoglycemia, or low blood sugar. This happens when your blood sugar levels drop during the night and your body releases adrenaline and other hormones to rapidly raise them back up.

Symptoms of nighttime hypoglycemia include sweating, racing heart, confusion, and trembling. It is most common in people with diabetes who take insulin, as incorrect dosage or irregular eating can lead to low blood sugar while sleeping.

Preventing nighttime hypoglycemia involves carefully monitoring blood sugar and coordinating your insulin, food, and activity. Consuming a snack before bedtime can also help stabilize your blood sugar levels overnight.

Fever and Chills

Trembling or shivering can also accompany fevers. When your body temperature is elevated, your muscles might shake as a means of generating heat through muscle contractions. Fevers lead to chills and shivering as your body tries to raise its temperature up to a new set point.

Infections, inflammatory conditions, and some cancers can all cause fevers. So if waking up shaking is accompanied by sweating, body aches, cough, or other symptoms, it may be wise to visit your doctor to check for an underlying illness. Treating the source of the fever will resolve the chills and shaking.

Alcohol Withdrawal

Someone who is physically dependent on alcohol may experience tremors and shaking during alcohol withdrawal. This typically begins 6 to 24 hours after the last drink, once the alcohol has left their system.

Alcohol affects the neurotransmitters in your brain that govern muscle movements. In response to suddenly stopping alcohol consumption, your brain goes into overdrive, causing your muscles to shake uncontrollably. This symptom of withdrawal is where the term "the shakes" originates from.

The treatment for alcohol withdrawal tremor is to safely reintroduce alcohol and gradually taper it off under medical supervision. This prevents dangerous complications like seizures. Medications may also be used to control withdrawal symptoms.

Medication Side Effects

Some medications can also list shaking or tremor as a potential side effect. Drugs that affect the central nervous system, like antidepressants, stimulants, and certain pain medications are most likely to cause tremor. However, any medication has the potential to cause tremor in some people.

If you have started a new medication and then begin waking up with trembling or shaking, talk to your doctor. They may adjust your dosage or switch you to an alternative drug to alleviate the side effect. Don't stop taking medications on your own without medical guidance.

When Should I See a Doctor?

Occasional shaking upon waking up is not necessarily a cause for concern on its own. However, if the tremors are severe, happen frequently, or are accompanied by other symptoms, you should make an appointment with your doctor to identify the cause.

See a doctor promptly if shaking is accompanied by:

• Fever
• Confusion
• Chest pain
• Trouble breathing
• Loss of consciousness

Also see your doctor if shaking:

• Happens without any identifiable cause like anxiety or fever
• Gets progressively worse over time
• Spreads to other parts of your body like your arms or legs
• Is brought on or worsened by certain medications
• Interferes with your daily activities

Diagnostic tests like bloodwork, imaging, and referral to a neurologist may be needed to get to the bottom of chronic or unexplained shaking episodes.

When to Seek Emergency Care

In some cases, waking up shaking or trembling can be a sign of a life-threatening emergency that requires immediate medical attention. Seek emergency care if shaking is accompanied by:

• Difficulty breathing - This could indicate a severe allergic reaction that is blocking the airways or a condition like heart failure that makes breathing difficult.
• Chest pain - Along with tremors, chest pain may be a sign of a heart attack.
• Severe headache - Shaking with a sudden, severe headache could mean a stroke or hemorrhage in the brain.
• Unresponsiveness - If the person shaking is difficult to rouse or non-responsive, it could signal a medical emergency like seizure, stroke, or diabetic emergency.

If in doubt, it is better to be safe and call emergency services right away. Rapid treatment can be crucial for preventing permanent injury or disability in events like stroke or heart attack.

Tips for Managing Waking Up Shaking

If your doctor has ruled out any serious conditions, there are things you can do at home to manage troublesome tremors upon waking:

• Practice stress management and relaxation techniques like deep breathing, meditation, yoga, or gratitude journaling.
• Avoid stimulants like caffeine, energy drinks, and nicotine before bed.
• Cut back on alcohol, especially right before bedtime.
• Get regular aerobic exercise to reduce anxiety symptoms.
• Try over-the-counter supplements like magnesium, valerian root, or chamomile.
• Use weighted blankets or try progressive muscle relaxation before bed.
• Go to sleep and wake up at consistent times to regulate your circadian rhythm.
• Reduce nighttime hypoglycemia by eating a bedtime snack.

Talk to your doctor if lifestyle measures are not effective at reducing tremors. They may be able to prescribe anti-anxiety medication or beta blockers to control shaking episodes.

Conclusion

Waking up with tremors or shaking can be alarming, but is rarely life-threatening on its own. Anxiety, low blood sugar, fever, alcohol withdrawal, and medication side effects are some potential causes. See a doctor if the shaking does not have a clear cause, worsens over time, or interferes with your daily life. With treatment of any underlying condition and some lifestyle changes, tremors can often be reduced or eliminated.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.