Why Do I Shake When I Wake Up?

Waking up shaking can stem from various causes, including low blood sugar, medication side effects, anxiety, or alcohol and caffeine consumption. Parkinson's disease can also contribute. Managing stress, reviewing medications, and avoiding caffeine/alcohol before bed can help. Consult a doctor if the shaking persists.

Waking up shaking can be an unnerving experience—especially when you don’t know what’s causing the shaking.

This can lead to asking yourself questions like, “Why do my hands shake when I wake up?” or, “What do I shake when I wake up suddenly?” (Or, in the case of post-nap shaking, “Why do I shake when I wake up from naps?”)

There are a variety of reasons why you might experience shaking after waking up, whether that’s after a full night of sleep or following a quick nap.

Understanding those reasons can not only make the experience less scary but can also give you helpful insights into how to deal with—and, ideally, stop—the shaking.

Let’s take a look at what might be behind your post-sleep shaking episodes—and what you can do to manage the condition.

Why do I shake when I wake up?

There are a number of conditions and behaviors that could make you shake while waking up, including:

Low blood sugar

Low blood sugar, also known as hypoglycemia, can manifest a wide range of symptoms—and one of the more common symptoms is shakiness. [1] As such, “low blood sugar can contribute to shaking upon waking,” says Ila Dayananda, MD, chief medical officer at Oula Health.

While hypoglycemia is most often associated with diabetes, other conditions and/or medications could also cause blood sugar to drop. [1] And if blood sugar drops while you’re sleeping, it may cause you to experience side effects when you wake up—including shaking.

Medications

Medications can often bring side effects—and, depending on the medication, the person, and how their body tolerates it, in certain situations, one of those side effects could be shaking in the morning. [2]

Anxiety

Feeling anxious could also contribute to shaking after you wake up.

“Shaking upon waking can also be a stress response to high anxiety or stress, where our bodies are nervously activated either while we are sleeping or upon waking,” says Dayananda.

Any sort of anxiety could make you feel shaky. But when it comes to serious shaking upon waking, extreme anxiety or panic attacks are often to blame. [3]

Drinking coffee or alcohol

What you’re putting into your body can also cause shaking upon waking—and, more specifically, what you’re drinking.

“Drinking excessive caffeine or alcohol can both cause tremors upon waking,” says Dayananda. [4, 5]

Parkinson’s disease

If you’re suffering from Parkinson’s disease, your post-wake-up shaking could be a symptom of the disorder. [6]

“In the advanced stages of Parkinson’s disease, some individuals may experience morning tremors, known as morning akinesia, which can occur upon waking,” says Dayananda. [7]

How to prevent morning shakes

Clearly, there are a number of things that could be making you shake in the morning. But what steps can you take to minimize your chances of waking up with AM shakes?

Some ways to prevent morning shakes include:

Find healthy ways to manage stress and anxiety

If you suspect that anxiety is playing a role in your morning shakes, then the best thing you can do is find healthy ways to manage stress and anxiety. For example, you might:

  • Practice deep breathing, which can shift your nervous system from “fight or flight” to “rest and digest.” [8]
  • Get into a regular exercise routine as exercise releases endorphins, feel-good hormones that can help to manage anxiety symptoms. [9]
  • Seek treatment for your anxiety (for example, seeing a therapist who specializes in anxiety disorders). [10]

The more you do to manage your anxiety, the more you lower your chances of waking up with anxiety-induced shakiness.

Review your medication regimen

As mentioned, shaking can sometimes be a side effect of a medication. If you suspect that it’s one of your meds that’s causing your morning shakiness, then it may be helpful to discuss your medication regimen with your doctor.

“Review any medications you are taking with a healthcare provider to identify potential side effects contributing to shaking upon waking, as adjusting medication timing or dosage may help alleviate symptoms,” says Dayananda.

Avoid drinking caffeine or alcohol too close to bedtime

Both alcohol and caffeine can play a major role in the morning shakes. So, if you want to avoid shaking in the morning, you’ll want to “limit how close to bedtime you are taking in any caffeine or alcohol,” says Dayananda.

Dayananda recommends avoiding alcohol at least four hours before bedtime. [11] And when it comes to coffee or other caffeinated beverages, “earlier is better,” she says. [12]

Talk to your doctor

If you’re taking steps to deal with post-sleep shakiness—but you’re still waking up with significant shaking—then it’s important to talk to your doctor.

They can help you determine what’s causing your shaking symptoms—and what you need to do to stop the shaking.

FAQs

Why are my hands shaky in the morning?

There’s no universal answer to the question, “Why do my hands shake when I wake up?” Shaky hands in the morning could have a number of causes, both temporary (like drinking too much caffeine before bed) and more ongoing (for example, a chronic condition like Parkinson’s disease).

What underlying medical conditions could cause me to shake when I wake up?

There are a number of underlying medical conditions that could cause shaking after waking up, including hypoglycemia, Parkinson’s disease, or an anxiety disorder.

Next, find out why your hands go numb when you sleep and what to do about it.

References

  1. Mayo Clinic. Hypoglycemia. https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-20373685
  2. Medline Plus. Drug-induced tremor. https://medlineplus.gov/ency/article/000765.htm
  3. Mayo Clinic. Panic attacks and panic disorder. https://www.mayoclinic.org/diseases-conditions/panic-attacks/symptoms-causes/syc-20376021
  4. American Medical Association. What doctors wish patients knew about the impact of caffeine. https://www.ama-assn.org/delivering-care/public-health/what-doctors-wish-patients-knew-about-impact-caffeine
  5. Cleveland Clinic. Alcohol Withdrawal. https://my.clevelandclinic.org/health/diseases/alcohol-withdrawal
  6. American Parkinson Disease Association. Tremor in Parkinson’s. https://www.apdaparkinson.org/what-is-parkinsons/symptoms/tremor/
  7. Tambasco N, Simoni S, Nigro P, Paolini Paoletti F, Marsili E, Calabresi P. Morning akinesia in Parkinson’s disease: challenges and solutions. Research and Reviews in Parkinsonism. 2016;6:57-63. https://doi.org/10.2147/JPRLS.S83276
  8. Harvard Health. Relaxation techniques: Breath control helps quell errant stress response. https://www.health.harvard.edu/mind-and-mood/relaxation-techniques-breath-control-helps-quell-errant-stress-response
  9. Mayo Clinic. Depression and anxiety: Exercise eases symptoms. https://www.mayoclinic.org/diseases-conditions/depression/in-depth/depression-and-exercise/art-20046495
  10. Mayo Clinic. Anxiety disorders. https://www.mayoclinic.org/diseases-conditions/anxiety/diagnosis-treatment/drc-20350967
  11. Spadola, C. E., Guo, N., Johnson, D. A., Sofer, T., Bertisch, S. M., Jackson, C. L., Rueschman, M., Mittleman, M. A., Wilson, J. G., & Redline, S. (2019). Evening intake of alcohol, caffeine, and nicotine: night-to-night associations with sleep duration and continuity among African Americans in the Jackson Heart Sleep Study. Sleep, 42(11), zsz136. https://doi.org/10.1093/sleep/zsz136
  12. Food and Drug Administration. Spilling the Beans: How Much Caffeine is Too Much? https://www.fda.gov/consumers/consumer-updates/spilling-beans-how-much-caffeine-too-much

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