Sleep-Maintenance Support
The ‘can’t stay asleep’ pattern
Sleep-maintenance insomnia is the pattern where you fall asleep, but you don’t stay there. You wake repeatedly, or you wake after a few hours and struggle to drift off again. The hours between 1am and 4am can feel agonising — tired enough to want sleep, but your body keeps surfacing.
This pattern can be driven by stress, alcohol, pain, reflux, medication, blood-sugar dips, hormonal changes, breathing-related sleep issues, or simply a lighter sleep architecture. Repeated waking fragments your deep and REM sleep even if the total hours look reasonable on paper.
This collection is for you if you
- fall asleep fine but wake multiple times a night
- wake after 3 or 4 hours and can’t drift off again
- feel unrefreshed in the morning despite enough time in bed
- find that night waking is your main sleep complaint
When to consult a clinician
If your awakenings are linked to loud snoring, choking or gasping, witnessed breathing pauses, severe reflux, chronic pain, or alcohol/medication use, book a specialist consultation. These need medical assessment, not sleep support alone.
Sleep-Maintenance Support is non-prescription, Schedule 0. It complements clinical care; it does not replace it.
Prescription options for sleep maintenance — after consultation
For sleep that won’t stay, the prescription target is coverage duration across the second half of the night, not onset speed. The following classes may be considered after a specialist sleep consultation.
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Compounded low-dose H1-selective agent — Slumbr’s flagship maintenance therapy; selective H1 antagonism, no dependence
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Dual orexin receptor antagonist (DORA) — removes the wakefulness drive across the full night
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Prolonged-release melatonin — first-line for adults 55 and over
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Low-dose sedating antidepressant — for sleep-maintenance with comorbid low mood, anxiety, low appetite, or weight loss
Prescription medication is dispensed by Slumbr Sleep Clinic’s in-house pharmacy after a specialist physician consultation. Every script is a clinical decision made per patient.
Patterns often overlap. You may also benefit from:
Insomnia rarely presents as one clean pattern. Other Slumbr collections you may want to look at: