Here’s why you keep waking up at 3 a.m.

You know the scene. You wake up in the middle of the night and roll over to check your phone. But you don’t really need to. You already know it’s 3 a.m.

Most people wake up several times during the night. This is often accompanied by the body shifting position. These nightly awakenings usually coincide with transitions from one sleep stage to another. And are so brief, we often don’t remember them in the morning.

“The average adult awakens 7 to 15 times each night, and this is normal,” says Michael Perlis, director of the Behavioral Sleep Medicine Program at the University of Pennsylvania’s Perelman School of Medicine. But the 3 a.m. wake-up is one that can bring us out of deep sleep and make it hard to doze off again.

The most popular reasons why we wake up frequently at 3 a.m. are stress, anxiety, various sleep disorders, or even natural age-related circadian rhythm changes.

Change in sleep stages happens around 3 a.m.

Sleep is a complex process that consists of four distinct stages. And can be broadly categorized into two main types: Non-Rapid Eye Movement sleep (NREM or deep sleep) and Rapid Eye Movement sleep (REM or lighter sleep). The sleep cycle typically repeats throughout the night in a cyclical fashion. Here are the main sleep stages.

NREM Stage 1 (N1): the transition from wakefulness to sleep

• Light sleep stage that lasts for a few minutes.
• Muscle activity decreases, relaxation begins.
• Easy to be awakened from this stage.

NREM Stage 2 (N2): a slightly deeper stage of sleep compared to N1

• Constitutes a significant portion of total sleep time.
• Sleep spindles (short bursts of brain activity) and K-complexes (brief high-amplitude waves) may occur during this stage.
• Body continues to relax, heart rate slows.

NREM Stage 3 (N3): a slow-wave sleep (SWS) or deep sleep

• Characterized by slow delta brain waves.
• Most restorative stage of sleep, important for physical recovery, immune function, and memory consolidation.
• Waking someone up from this stage may lead to grogginess and disorientation.

REM (Rapid Eye Movement) Sleep: an active stage where dreaming occurs

• Characterized by rapid eye movements, increased brain activity, and muscle paralysis, except for the eyes and respiratory muscles.
• Heart rate and breathing become irregular, and vivid dreaming often occurs.
• REM sleep is thought to be important for emotional regulation and cognitive function.

You wake up at 3 a.m. because this is the time you shift from a deep sleep into a lighter sleep. If you go to bed at 11 p.m., by 3 a.m. you’re mostly out of deep sleep and shifting into longer periods of lighter sleep, known as REM. Your brain is more active in the REM stage, so it’s likely you’ll awaken.

Stress, depression, and anxiety

One significant factor that can disrupt sleep patterns and cause middle-of-the-night awakenings is the presence of stress, depression, or anxiety. Research shows that individuals experiencing high levels of stress or struggling with mental health conditions often report difficulty staying asleep or waking up during the night. Stress activates the body’s “fight-or-flight” response. Stress leads to increased cortisol levels and a heightened state of alertness, which can interrupt sleep cycles and wake you up around 3 a.m.

Depression can cause difficulty falling asleep, maintaining sleep, or waking up too early in the morning. Anxiety, on the other hand, often manifests as racing thoughts and worries that make it challenging to relax and fall asleep. The combination of stress, depression, and anxiety can create a vicious cycle, with disrupted sleep exacerbating these mental health conditions, and vice versa. Engaging in stress reduction techniques, such as mindfulness meditation, journaling, or seeking professional help through therapy, can be beneficial in managing these underlying causes of 3 a.m. awakenings.

Sleep disorders

Sleep disorders, such as insomnia, can significantly impact the quality of sleep. Insomnia is difficulty falling asleep, staying asleep, or both. Chronic insomnia is often associated with hyperarousal. A state of increased physiological and psychological arousal that hinders sleep initiation and maintenance. This hyperarousal can manifest as racing thoughts, worries, or an inability to relax. If you find yourself waking up at the same time every night (including around 3 a.m.) overwhelmed with thoughts, you might be suffering from a serious sleep disorder.

Other sleep disorders, such as sleep apnea or restless leg syndrome, can also cause frequent awakenings during the night. Sleep apnea is a condition where breathing repeatedly stops and starts during sleep. And often accompanied by loud snoring and gasps. These interruptions in breathing can cause brief awakenings, and individuals may find themselves waking up frequently during the night. Restless leg syndrome is uncomfortable sensations in the legs, compelling individuals to move them, which can disrupt sleep and lead to awakenings.

Addressing underlying sleep disorders typically involves a multifaceted approach. Cognitive-behavioral therapy for insomnia (CBT-I) is a highly effective treatment. It focuses on improving sleep habits, challenging negative thoughts about sleep, and implementing relaxation techniques. Consult a health care provider for diagnosis and appropriate treatment options for sleep apnea or restless leg syndrome. A breathing device, such as a continuous positive airway pressure (CPAP) machine is the most common treatment for sleep apnea. Certain medications initially developed for epilepsy have emerged as first-line treatment for RLS given their proven long-term effectiveness, safety, and lack of worrisome side effects. These treatment option may help alleviate symptoms and improve sleep quality.

Aging and circadian rhythm changes

As we age, our sleep patterns naturally undergo changes. Older adults often experience a shift in their circadian rhythm, which can lead to early morning awakenings. The circadian rhythm is our body’s internal clock that regulates sleep-wake cycles. Factors such as decreased melatonin production and increased sensitivity to external stimuli can contribute to waking up around 3 a.m. Additionally, women going through menopause may experience hormonal fluctuations that disrupt sleep in the middle of the night.

To manage circadian rhythm changes, it’s important to establish a consistent sleep schedule. Going to bed and waking up at the same time each day helps regulate the body’s internal clock. Creating a sleep-friendly environment, with a cool, dark, and quiet bedroom supports better sleep. Additionally, practicing relaxation techniques before bed, such as deep breathing or gentle stretching, can help prepare the mind and body for sleep.

Sleep disturbances: light and sound

It may seem trivial, but noises such as TV sounds, phone notifications, traffic sounds from a nearby road, or dogs barking can cause trouble falling asleep and unwanted nighttime awakenings. According to this study, nighttime environmental noise causes stress. As a result, sleep quality decreases.

The same can be said about light peeking through your bedroom door or window. This study found that light delivered through our eyelids when we sleep can suppress the production of melatonin by up to 60% closer to the end of the night.

The reason we become too sensitive towards lights and sounds, especially in the middle of the night, is that as we shift from a deep sleep into a lighter sleep, we become more aware of our surroundings. So even the slightest noise is able to wake us up.

Sleep restriction method for fighting 3 a.m. wake ups

If you are struggling with the 3 a.m. wake up, you may benefit from the sleep restriction method. It’s normal to experience this pattern of waking. So, try to acknowledge it and wait for sleep to come again. If it doesn’t, get up and read or listen to music and try again once you feel drowsy.

Sleep hygiene

Practicing what is known as good “sleep hygiene” can significantly increase your chances of having a good night’s sleep. Sleep hygiene practices include the following.

• Avoiding spicy or rich foods before bed. No more late-night curry or ice-cream parties. These can trigger indigestion and heartburn which is uncomfortable and can wake you up.
• Avoiding stimulants such as caffeine and nicotine in the afternoon and evening.
• Avoiding alcohol. Even though a glass of wine can help you fall asleep fast, it can disrupt your sleep in the second part of the night as the body begins to process the alcohol.
• Exercising. As little as 10 minutes of aerobic exercise a day can drastically improve your quality of sleep. Aim to hit the gym earlier in the day though, as exercise can increase energy post-workout.
• Making sure you sleep in a quiet dark space.