Why Do I Keep Waking Up At 3 a.m.?
Expert Verified By: Dr. Shelby Harris 
The first time you wake up at 3 a.m., it doesn’t seem like a big deal. Maybe you’re too hot and need to throw off the covers. Or perhaps it’s time for a quick bathroom break. But what about those nights when every time your eyes open, you see the same digits glowing in the dark? What’s going on when you’re waking up at 3 a.m.(or at another odd hour) repeatedly?
Actually, there are numerous reasons for this behavior. You may be able to curb it with a few lifestyle adjustments, or it might be time to schedule an appointment with a health professional to provide more insight into the problem.
Why Do You Wake Up At 3 a.m.?
First things first — it’s not always a problem that you wake up in the middle of the night. Dr. Shelby Harris, Sleepopolis’ director of sleep health, says waking up in the middle of the night at the same time can just be a part of your natural sleep cycle.
“It’s totally normal to wake up in the middle of the night as long as you’re not up for a long time,” Harris says.
Of course, there may be other reasons you find yourself awake in the middle of the night. Dr. Kristen Casey, a licensed clinical psychologist and insomnia specialist, tells Sleepopolis that various underlying factors contribute to the habit of popping awake at 3 a.m. “A few include the effects of substances or medications, a misaligned desire for sleep and bed window, poor sleep hygiene, external stimuli such as noises or discomfort, the need to use the restroom, or a low sleep drive.” Let’s take a closer look.
Insomnia
Is waking up at 3 a.m. a form of insomnia? It depends. Harris says insomnia is characterized more by being awake for a bothersome amount of time — usually more than 30 minutes — than by the time someone is waking up.
Approximately 30 percent of American adults suffer from occasional sleeplessness, but there’s a difference between short-term and chronic insomnia. As you review more of the contributing factors to sleep disturbances, you might see a need to contact a healthcare professional about your regular pre-dawn awakenings.
Mental And Emotional Challenges
Without a doubt, stress throws a monkey wrench into our normal operating procedures — even though sleep is often exactly what we need to not feel so much pressure. Researchers at Baylor College of Medicine indicate that not only does stress affect how quickly we fall asleep, but also frequently causes “fragmented” sleep, which is defined by frequent awakenings throughout the sleep cycle. Further, the cycle worsens because “sleep loss triggers our body’s stress response system, leading to an elevation in stress hormones, namely cortisol, which further disrupts sleep,” according to Baylor’s sleep expert Dr. Annise Wilson.
Anxiety, whether clinically diagnosed or heightened by stress, can also interrupt your normal sleep cycle. Casey says people with anxiety might be in a state of “hyperarousal, which means they may experience intense worry or anticipation that wakes them up throughout the night.”
Stereotypically, it’s believed that people with depression sleep all the time, but that’s not always the case. Johns Hopkins Medicine reports that many individuals who feel stressed during a depressive episode might deal with “more nighttime wake-ups and [have] more trouble getting back to sleep than someone without depression would experience.”
Age
As we age, we spend more time in light sleep phases, creating more opportunities to wake up throughout the night. Our sleep needs change throughout our lives, too — here are the sleep requirements recommended by the Centers for Disease Control and Prevention (CDC):
- Teens: 8 to 10 hours
- Young Adults: 7 to 9 hours
- Adults: 7 hours or more
- Older Adults (65+): 7 to 9 hours
As you can see, planning for at least seven hours of sleep is ideal for living a well-rested and healthful life as an adult. There is some variation from person to person, so if you’re getting a bit more or less than is recommended for your age group and you feel well rested, there isn’t any need to worry.
Medications
Many types of medications and substances impact the quality of our rest. This includes but isn’t limited to:
- Alpha agonists
- Anticonvulsants
- Antidepressants and other selective serotonin reuptake inhibitors
- Appetite suppressants
- Beta agonists
- Beta blockers
- Cold medicines and decongestants
- Diuretics
- Dopamine agonists
- Niacin
- Steroids
- Theophylline
If you’ve experienced interrupted sleep as a side effect of these medications, ask your physician if there’s a more suitable alternative for your condition.
Other substances, such as alcohol, amphetamines, caffeine, and psychostimulants are known to interfere with sleep cycles as well, especially close to bedtime.
Health Conditions
Various medical illnesses compound sleep issues, and there are many reasons why. Have you noticed a connection to waking up at 3 a.m. with any of the following?
- GERD, or gastroesophageal reflux disease, often plagues people more often during sleep. Some studies indicate people can actually be affected by acid reflux and wake up as a result, even if they don’t have obvious symptoms such as heartburn or upset stomach.
- Menstrual syndrome, premenstrual dysphoric disorder, and pregnancy cause women to experience a range of issues due to hormonal shifts, and sleep interruption might be one of them.
- Perimenopause and menopause are time periods where good rest is merely a suggestion for many women suffering with hot flashes, night sweats, and yes, more extreme hormonal fluctuations.
- Nocturia, also known as nocturnal urinary frequency, is caused by various health and lifestyle issues. Individuals with this condition have disrupted sleep cycles because they have to wake up more than once before the alarm goes off to relieve themselves.
- When someone has arthritis, fibromyalgia, neuropathy, and other chronic pain conditions, a full night’s rest is challenging. For example, they can’t always settle into a position and stay asleep due to escalating joint and muscle pain. Experts also point to chronic pain’s interference with a person’s ability to move through all stages of sleep. What’s worse, because of sleep deprivation, our bodies produce an excessive amount of cytokines, which accelerates inflammation and causes more pain.
Sleep Disorders and Circadian Rhythm/Sleep Drive Issues
The American Sleep Association indicates that approximately 50–70 million adults in America suffer from different sleep disorders. Some of the most common conditions include:
Additionally, circadian rhythm issues can also cause middle of the night sleep problems. If you have advanced sleep phase syndrome (meaning you go to bed very early and wake up very early) it’s possible that your body clock is a bit off kilter — advanced more than you’d like, in this case. You may need to talk with a sleep specialist to help recalibrate and push your mid-night awakening to a more reasonable time.
It’s also possible that you simply haven’t built up your sleep drive enough. When we wake up in the morning after a good night’s sleep, our body’s need for sleep starts at zero because we’ve just woken up. Every minute that you’re awake throughout the day slowly builds up your sleep drive (kind of like your “appetite for sleep”) to the point where you’re super-hungry for sleep at bedtime. This then leads to a nice, full “meal” of sleep at night.
If you wake up later in the morning, go to bed too early at night, or take naps during the day (even short dozes), it is essentially snacking on sleep!
Lifestyle Choices
Do you wake up more often after weeks of indulgence during the fall and winter holiday season? Is it difficult to sleep all night when your beloved pet hogs the bed? These and other behaviors all play a part in how well we rest.
“A lack of exercise, smoking cigarettes, and consuming substances may affect the quality of our sleep,” Casey says. “We’ve also seen that alcohol can cause frequent awakenings throughout the night.” She adds that not only might a lack of exercise contribute to having a poor sleep drive, but too much can have an impact, too. “If we exercise quite a bit we may need more sleep compared to when we’re sedentary.”
Other habits contributing to earlier-than-desired awakenings include too much napping (here’s how to do it properly), overeating and/or eating too close to bedtime, or a less-than-ideal sleeping environment (follow these tips for designing a snooze sanctuary).
When To Talk To Your Doctor
“I always suggest that someone see their healthcare provider if they experience consistent awakenings overnight around the same time,” Casey says. “It gives me a reason to believe that they may be engaging in a behavior that contributes to the awakenings, or they may need assistance in shifting their sleep window.”
Tips For Sleeping Through The Night
If you receive a good bill of health but still need to break the habit of waking up repeatedly when you don’t want to, we have resources that can help.
- Follow this 30-day sleep hygiene plan.
- Use a sleep calculator to gain a better understanding of how much rest you really need.
- Create a consistent soothing bedtime routine with features such as a warm bath, music, meditation, prayer or quiet reflection, and other relaxing techniques.
- Cool the bedroom to 60–67 degrees.
- Reduce your exposure to blue light screens at least an hour before calling it a night.
Casey weighs in with her top three recommendations, too:
- Maintain consistency with your daily wake time.
- Limit substances, such as alcohol and nicotine, close to bedtime.
- Try various ways to manage stress and anxiety more effectively, especially when certain uncontrollable stressors don’t have solutions. Her advice? Try cognitive behavioral therapy for insomnia.
The Last Word From Sleepopolis
Whether you’re managing a health condition, taking a certain type of medication, or simply can’t get on a good sleep schedule because of stress and responsibilities, take heart: You won’t wake up at 3 a.m. forever. Hopefully with what you know now, you can understand the reasons for this peculiarity and how to remedy it.
