April 4, 2023

Up at 3 a.m.? Here Are Possible Reasons Why

This common phenomenon is usually harmless, but a consistent sleep-wake schedule can help

Illustration of an alarm clock at three o'clock AM

Next time you wake from a sound sleep and roll over to see those familiar numbers on the bedside clock, know that you’re not alone.

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Whether your time is 3 a.m. or 1 a.m. or any other time, you’re one of many people who experience regular nighttime awakenings.

The time — while it may be surprisingly predictable, down to the minute — really isn’t significant, says psychologist and sleep expert Alexa Kane, PsyD.

“At one point, you may have had a reason to wake up at that time, maybe in response to sleep apnea or a crying baby,” she says. “Your body may have become conditioned to it.”

Regardless, nighttime awakenings are a common phenomenon and are usually harmless, especially if you easily doze off again. They don’t mean you’re a bad sleeper. And they may not necessarily mean you have insomnia.

What’s causing your 3 a.m. wake-up call?

Waking up at night — at any ungodly hour — isn’t a problem on its own. However, waking up and staying awake can be.

According to Dr. Kane, the real worry comes when those wake-up calls keep you up until the birds are chirping.

Your late-night awakenings can stem from a variety of different reasons — whether it be a sleep disorder or a temporary distraction — but here are some reasons you may be waking up hours before the sun is even up:

Trips to the bathroom

Even while you’re asleep, your body is still hard at work breaking down what you ate and drank that day. That’s why it’s natural to wake up needing to go to the bathroom once in a while, but when it becomes too common, this could be a sign of nocturia.

Your environment

Maybe it’s a siren blaring from an ambulance, a neighbor’s radio blasting next door or a pesky street light shining right onto your side of the bed. These kinds of external sleep disturbances can cause you to wake in the middle of the night. But this is more likely to happen in the wee hours of the morning, as you’re coming out of REM sleep.

Stress, anxiety or depression

Sometimes, our minds can keep us awake more than any outside distractions. A particularly stressful day can lead to intrusive thoughts in the middle of the night — maybe they come in the form of a nightmare that jolts you up at 3 a.m. In more serious cases, some people even experience sleep paralysis.

Anxiety can also make it difficult to sleep through the night. If you’re consumed by what happened earlier that day or constantly thinking about the to-do list that’s awaiting you in the morning, this could trigger your waking up at night.

Similarly, it’s common for people with depression to experience poor sleep patterns, too. This can lead to oversleeping and feeling drowsy during the day.

Sleep disorders

So, how do we know if these late-night awakenings are tied to a specific sleep disorder? While factors like anxiety and depression can be a temporary distraction causing you to lose valuable sleep, over time (if untreated) they could lead to something else.

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“If you wake up and begin to experience worry, anxiety or frustration, you likely have activated your sympathetic nervous system, your ‘fight-or-flight’ system,” explains Dr. Kane. “When this happens, your brain switches from sleep mode to wake mode. Your mind may start to race, and your heart rate and blood pressure may go up. That makes it much harder to get back to sleep.”

This kind of stress response can lead to insomnia, a full-blown sleep disorder.

Regularly waking up at night also can be a symptom of sleep apnea. If you have this disorder, you occasionally stop breathing during sleep. Besides waking you up, sleep apnea can disrupt your heart rhythm and reduce the flow of oxygen to your body.

Other symptoms of sleep apnea include:

  • Snoring.
  • Being jolted awake while choking or gasping for air.
  • Daytime sleepiness or fatigue.

“If you have these symptoms, see a physician or sleep expert,” stresses Dr. Kane. “Untreated sleep apnea can cause heart disease, diabetes, obesity and other health problems.”

What should you do when you wake up in the middle of the night?

The next time you wake up at 3 a.m. (or whatever time), give yourself 15 to 20 minutes to doze back into dreamland. It’s OK.

If you’re awake longer than that, it’s best to get out of bed, advises Dr. Kane.

“Our brains are highly associative,” she says. “That means if we stay in bed for a long time when not sleeping, our brains can associate the bed with wakeful activities like worrying and planning, instead of sleep. Getting out of bed breaks that association.”

When you get out of bed, do something that promotes sleep:

  • Practice deep breathing.
  • Meditate.
  • Read something boring.
  • Listen to some calming music.

“Relaxation exercises can help you shut off your body’s fight-or-flight response and activate a rest-and-digest response,” explains Dr. Kane. “When your body calms down and you feel sleepy again, head back to bed.”

But whatever you do, don’t use your cell phone, check email or use any electronic devices as blue light signals to your brain that it’s time to wake up.

Tips to prevent you from waking up in the middle of the night

Even if you do everything right before bed, one good night of sleep isn’t going to magically put you back on a good snooze schedule. The best way to put an end to late-night awakenings is to keep a consistent sleep-wake schedule. That means getting up at the same time each day (yes, even on weekends).

Committing yourself to a proper bedtime is only half the battle to improve your sleep hygiene. Having other good sleep habits is just as important.

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“Give yourself 30 to 60 minutes before bed to wind down and prepare your body and mind for sleep,” Dr. Kane recommends. “Use this time to plan for the next day, writing down your worries, concerns and frustrations so you don’t need to perform those mental gymnastics while in bed at 3 a.m.”

Here are some tips that Dr. Kane suggests to help avoid those annoying late-night awakenings:

Limit fluids before bed

Try cutting down on how much water you drink before bed and see if that puts your late-night pee breaks to rest. If not, talk to a healthcare provider to see if there could be other underlying issues affecting this.

Avoid eating before bed

When those late-night cravings hit, it can be hard to resist. But you should try and avoid eating right before bed for the same reason you should limit fluids — because it’s going against your body’s circadian rhythm. You should be in the clear if your last meal is about three hours before you hit the hay.

Try over-the-counter sleep aids

While supplements like melatonin can help put you to sleep (maybe on a night when you’ve had too much coffee or are struggling with pain), some studies have suggested magnesium as helping your quality of sleep. You should be getting enough magnesium from your diet as it is, but it won’t hurt to try taking around 200 milligrams and see if it helps you stay asleep.

Make your bedroom as dark and quiet as possible

If noise is what’s waking you up at night, try a white or pink noise machine. Or invest in a good set of earplugs that you can actually sleep comfortably in. If you live in the city or suburbs and there are tons of street lights, see if blackout curtains or a sleep mask can help.

Seek help for stress, anxiety or depression

While it’s common for us all to feel overwhelmed, anxious or sad once in a while, chronic stress, anxiety or depression can have a profound effect on our health. It’s important to identify and note these emotions ─ and know when it’s time to seek help. If self-care and a mindfulness routine aren’t helping (or helping enough), reach out to a healthcare provider to see what care they recommend.

When to call a doctor or sleep expert

When your lack of sleep starts to mess with your work performance, and concentration or is causing you distress, it’s time to see a sleep expert. Your primary care provider can help you find one. Not sure if it’s that bad? There are a number of wearable devices and apps that can help you track your shut-eye time.

“We often see chronic insomnia develop in people with ineffective sleep routines — such as waking at 3 a.m. and staying in bed for hours trying to fall back to sleep,” notes Dr. Kane. “This behavior leads to the association that bed does not mean sleep and reinforces insomnia.”

Plus, sleep disorders can also put you at higher risk for heart disease, diabetes and having overweight or obesity.

All in all, waking up at 3 a.m. may just be a symptom of stress, one too many glasses of water before bed or loud noises outside. But if these wake-up calls become frequent and you can’t pinpoint a reason, it may be worth investigating why that invisible alarm is going off in your head.

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