No, you do not need to take ‘three half minute pauses’ to avoid ‘sudden unexpected death’ when waking up at night

“Sudden unexpected death at night – how to avoid it,” starts several posts doing the rounds on Facebook in South Africa. 

The posts warn that those who get up in the middle of the night or early morning to urinate need to “take note of the 3 half minute pauses”, which will “greatly reduce the risk of sudden unexpected death”.

According to the posts, standing up too quickly from a lying position causes “lack of sufficient blood flow to the brain”. The posts say that when waking up, you should lie in bed for the first half a minute, then sit in bed for the next half, and then sit on the edge of the bed while lowering the legs for another thirty seconds.

“After that series of half minute pauses, you won't likely suffer from insufficient blood circulation to your brain, reducing the possibility of sudden unexpected death.” 

We traced the same claim back as far as 2016 and found it did the rounds again in 2019. Versions of it are posted as a graphic with a picture of a doctor and text. The graphic was also sent to Africa Check on our WhatsApp line.

So should you really adhere to the three “half minute pauses” rule in order to “avoid death” when waking up during the night? We checked.

Night-time waking is common 

Waking up in the middle of the night is normal for human beings, says Johns Hopkins School of Medicine, a private research university in the US.

Most people experience mini awakenings, which are not noticeable, and some have observable wake-ups, two to three times per night.

Some common causes for waking up during the night include needing to pee, overheating, indigestion, or stress, anxiety and depression.

One problem with observable wake-ups is that humans can develop sleep maintenance insomnia, or difficulty getting back to sleep, causing frustration and sleep deprivation.

Sleep deprivation is associated with excessive sleepiness, impaired memory, depression and obesity, and is also linked to some chronic health problems, including kidney and heart disease, high blood pressure and diabetes.

Patients with orthostatic hypotension should always get up slowly 

Although waking up frequently at night can cause problems, there is no evidence that getting up too quickly could lead to “sudden unexpected death at night”, as these Facebook posts claim. 

Dr Bernard Gitura, a cardiologist in Nairobi, Kenya, told AFP Fact Check that the claim has no scientific basis.

“The heart cannot become weakened or the supply of blood in the brain cut short simply from waking up suddenly,” Gitura told AFP Fact Check. 

“This is because the body has a complex mechanism which it uses to regulate blood pressure and flow when one is rising from a sleeping position.”

If you have orthostatic hypotension, also known as postural hypotension, you may feel lightheaded or even faint when getting up, as a result of low blood pressure.

Orthostatic hypotension can be caused by dehydration, heart and nervous system conditions, and can be treated by treating these conditions. But it doesn’t lead to “sudden unexpected death”, day or night. 

There is no evidence for the claim in these fear-mongering social media posts and no need to get up slowly in thirty-second increments for most healthy people.