Why Am I Waking Up at 3am?

why am i waking up in the middle of the nightWhenever I write about sleep, I hear from a chorus of people who struggle to sleep through the night. Anecdotally, it seems a far more common complaint than difficulty falling asleep in the first place.

These complaints are one of three types:

  1. People who have trouble falling asleep
  2. People who sleep fitfully, waking multiple times throughout the night
  3. Those who reliably wake once, around the same time most nights

Understandably, this is a hugely vexing problem. Poor quality sleep is a serious health concern. Not to mention, sleeping badly feels simply awful. When the alarm goes off after a night of tossing and turning, the next day is sure to be a slog. String several days like that together, and it’s hard to function at all.

I’m going to go out on a limb, though, and assert that waking up in the middle of the night isn’t always the problem we make it out to be. For some people, nighttime wakings are actually something to embrace. As always, context is everything.

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What Causes You to Wake Up In the Middle of the Night?

One of the most frustrating things about nighttime waking is that there are so many possible causes. Sometimes the solution is as simple as practicing good sleep hygiene. Other times, medical help is in order. Still other times, the solution is something different entirely.

Transitioning to Lighter Sleep Stages

Sleep isn’t a uniform state of unconsciousness you slip into when it becomes dark and, theoretically, ride until morning. It’s a dynamic process that goes in waves—or more precisely, cyclesthroughout the night.

There are four (or five, depending on how you slice it) stages of sleep:

  • Stage 1: light sleep, occurs right after falling asleep
  • Stage 2: deeper sleep
  • Slow-wave sleep (SWS): deepest sleep, a.k.a. Stage 3 and Stage 4 sleep
  • REM: lighter sleep where our more interesting dreams occur (although we can also dream in non-REM phases1)

A single sleep cycle lasts about 90 minutes, during which you move from light sleep, through stage 2, into deep SWS, and back up to REM. Then down you go again, then back up, ideally at least four of five times per night.

Your sleep is also roughly broken into two phases over the course of a whole night. In the first half, you spend relatively more time in SWS. The second half is characterized by a higher proportion of REM sleep.

What does this have to do with nighttime waking?

One possible explanation is that as you transition into lighter sleep either within a single sleep cycle, or as you move from the first to the second phaseaches, pains, and small annoyances are more likely to wake you up. These can include medical issues like chronic pain, sleep apnea, restless leg syndrome, or GERD. Soreness from the day’s hard workout, noise or light from your environment, hunger, thirst, or being too hot or cold might rouse you from your slumber.

If you’re waking up multiple times at night, chances are that you’re experiencing physical discomfort that you’re not able to sleep through. Sometimes it’s obvious, but not always.

Was It Something You Ate Or Drank?

While individual studies have linked sleep quality to diet and macronutrient intake (high versus low carb, for example), they are mostly small and the results inconclusive.2 Still, you might be able to look at your diet and identify a likely culprit. For example, if your sleep problems started after going carnivore or adding intermittent fasting, that’s an obvious place to start.

A food log can help you spot patterns, such as whether eating certain foods at dinner tends to correlate with poorer sleep. Alcohol and caffeine are big sleep disruptors as well, though you surely know that.

If you’re frequently waking up to pee, you might be overhydrating, especially in the evening. More seriously, it can be a symptom of diabetes or bladder, prostate, kidney, adrenal, or heart problems. Getting up once or twice to pee probably isn’t cause for alarm. It’s worth seeing a doctor if you’re getting several times or urinating much more at night than during the day.

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What to Do About Nighttime Waking

First things first, pick the low-hanging fruit

I’m talking good sleep hygiene practices. Things like:

  • Sleep in a cool, dark, quiet room.
  • Minimize exposure to artificial lights after the sun sets. Use blue-light blocking glasses, and turn on night mode on your devices.
  • Watch your alcohol and caffeine consumption, especially later in the day.
  • Go to bed around the same time each night.

If applicable, experiment with your diet and food timing

Depending on your current diet, some experiments you might try include:

  1. If you’re ultra-low-carb, try increasing your carb intake for a few weeks.
  2. Try loading more of your carbs into your evening meal.
  3. Make sure your protein intake isn’t too low.3
  4. Try eating your last meal earlier if you’re waking up with indigestion, or later if you’re waking up hungry.

Try a teaspoon of raw honey before bed

One hypothesis is that you’re waking up in the middle of the night because your brain gets hungry for glucose eight hours after your last meal. The honey provides some carbs to get you through.

There’s no concrete evidence for honey as a sleep aid, but plenty of people swear by this remedy. I’m not sure it’s likely to be more effective than eating a serving of complex carbs at dinner. That said, even for low-carbers, I don’t think there’s any harm in trying.

I’ll note, though, that fasting studies don’t show a link to sleep disturbances.4 That calls the “starving brain” hypothesis into question, but I suspect there’s an important nuance here. Individuals who can comfortably do longer fasts are almost certainly also fat-adapted and, at least during the fast, producing ketones to fuel their brains. Metabolically, they’re in a very different place from a carb-dependent person who struggles to make it through the night.

Consider napping

If you’re unable to get enough high-quality sleep at night, you might prefer to adjust your sleep schedule entirely. Instead, aim for a shorter nighttime sleep period, say five or six hours, paired with an afternoon nap. This is another variant of biphasic sleeping.

Years ago, I wrote a post on how to conduct just this type of experiment. Check it out and see if it might work for you. It’s unconventional in this day and age, but I know people who thrive on this schedule.

Finally, don’t hesitate to seek medical help

Sleep issues are a symptom of many diverse health issues, including hyperthyroidism, anxiety, depression, and, as previously mentioned, diabetes, heart disease, and others. Your doctor may want to test you for sleep apnea.

The Case of Hot Flashes

Hot flashes are a common cause of nighttime waking for women of a certain age. If you endure nighttime flashes, you’re probably familiar with the standard advice:

Unfortunately, as I’ve learned from my wife Carrie’s and many friends’ experiences, there is no one-size-fits-all solution. I do think acupuncture is a potentially helpful, underutilized tool. Mostly, though, it’s just a combo of trial-and-error plus time that seems to get most women through this phase.

Getting Back to Sleep

In the meantime, while you get to the root of the issue, here are some tips for getting back to sleep:

  • Take care of pressing needs. Get up and pee, get a drink of water, or adjust the thermostat. There’s no point in trying to power through the discomfort that woke you up in the first place. Just fix it.
  • Keep artificial lights and screens off. Use small nightlights to light your path to the bathroom if necessary, and wear your orange-tinted glasses.
  • Do a calm activity such as reading by candlelight, deep breathing exercises, or sketching or writing in your journal.
  • Most of all, don’t stress! Fretting is likely to keep you awake for much longer than simply accepting the fact that you are awake and lying peacefully in bed.

Are You Fighting Something You Should Be Embracing?

I’ve long believed that humans naturally tend to be biphasic sleepers. The idea that we should be passed out for a solid eight hours per night is a social construct not firmly rooted in our sleep biology.

Historian Roger Ekirch argues, rather convincingly I think, that before the advent of artificial light, humans across geographical locations and social strata slept in two chunks during the night. The first, usually just called “first sleep,” or sometimes “dead sleep,” comprised the first four or so hours. “Second sleep” went until dawn. In between, people would enjoy an hour, or perhaps two or three hours, of mid-night activities such as praying and meditating, reading and writing, having sex, and even visiting neighbors. This was seen as completely normal, even welcome.5

Anthropological evidence confirms that some modern-day hunter-gatherers around the world likewise engage in biphasic sleeping.6 Also, in one small experiment, seven adults lived in a controlled environment with 14 hours of darkness per night. Over the course of four weeks, their sleep and hormone secretions slowly and naturally became biphasic.7

Scholars argue that biphasic sleep confers an evolutionary advantage.8 If some individuals fall asleep earlier and some later, and most people are awake for an hour or two in the middle of the night, someone in the group is always up. That person can tend the fire and watch for danger. In fact, the waking hour was sometimes called the “sentinel” hour. According to Ekirch, it was often referred to as simply the “watch.”

Are You a Biphasic Sleeper, or Do You Have a Sleep Problem?

Waking up multiple times per night, such that you rarely feel truly rested, is a problem. However, we shouldn’t rush to pathologize a single nighttime waking. That might just be your natural sleep pattern. It doesn’t necessarily mean you’d be better off aiming for biphasic sleep either. Even if you wake reliably at the same time each night, sometimes a full bladder is just a full bladder.

The litmus test is how you feel. With a biphasic schedule, the intervening waking period should be pleasant. Your mind should feel calm and alert, if perhaps a bit dreamy. Anecdotally, many famous writers, artists, and sculptors have adhered to a biphasic schedule, believing that creativity and flow are enhanced during the mid-night hours.

Of course, you can’t tap into how you feel if waking is causing you a ton of angst. Remind yourself that waking can be normal, not dysfunctional. I know this can be easier said than done, especially if you’re sleep deprived. The thing about biphasic sleeping is that you’re still supposed to get the eight hours of nightly sleep you need, give or take. That means you have to spend nine or ten hours in bed. How many people do that nowadays?

See if you can commit to at least a couple weeks of sufficient time in bed. Push away your previous (mis)conceptions about what a “good” night of sleep is “supposed” to look like. Try to welcome rather than fight the mid-night waking. Be open to what comes next.

TAGS:  sleep

About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

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25 thoughts on “Why Am I Waking Up at 3am?”

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  1. Thanks Mark.. For years I couldn’t understand why I was waking up for an multiple nights a week for hour or so at 2am. I discovered it occurred on nights I had wine with dinner! No wine, I sleep like a baby. The lower alcohol, lower sugar wines are better for sleep, but still a big difference versus no alcohol at all. I’m almost at the point where I feel like wine isn’t worth a bad nights sleep.

    1. Rich,

      My experience is the same. Alcohol affects my sleep. It sucks, as I love a good stout, but sleep is more important, especially as I am a shift worker.

      1. There are a growing number of craft brewers making alcohol free beer. These are not your grocery store near beer swill. I like Athletic Brewing Company (and they do have a stout).

        They are a good way to scratch the beer itch and skip the alcohol.

        There are also new alcohol free wines, but I haven’t tried any.

      2. Ditto. Alcohol absolutely wrecks my sleep. Increasingly so as I age.

        I enjoy having drinks with friends, and I feel like I am a much more engaging & entertaining person after a drink or two.

        But it’s no longer worth the trade-off of poor sleep.

    2. Wine does the same thing for me. Anything more than a glass or two, and I’m tossing and turning all night. But it’s only wine that does it, so I don’t think it’s the alcohol. Beer, Scotch, bourbon, gin (all with no mix), or whatever causes no problems for me.

      1. Have you tried the Dry Farmed Wines? No additives can make a big difference…

    3. Checkout my comment for why, seems you have the issue the Chinese have known about for millennia! Google TCM clock

  2. Maybe it is something outside. Note the day of the week and the time when you wake up. Set an alarm to a half hour (or more) that you wake up. It may be something happens in your neighborhood, and it takes your body a while to wake up. By the time you wake up, it is gone. In my neighborhood, I have neighbors that come home or leave for work in the middle of the night. Sometimes in the distance, I can hear the big trucks engine shifting. It might be enough to wake you briefly.

  3. Hi Mark, good morning. I write to you at 4:30 AM, I awake almost every day around 3- 330 in the morning. I usually go to bed around 10 at night or so, but I take a nap every day 20 minutes to 30 minutes or so and I’ll awake refreshed, reenergized, and ready to go. I have long embraced the sleep pattern, just came to understand that’s how it is for me. I don’t fight it anymore, I don’t have angst over this anymore, and I read your article and I nod and smile. I have long learned to embrace that I am most energetic and get the most done between 4 o’clock in the morning and 1000. That’s how I am wired, I really do get more done before 8 o’clock in the morning then many people do all day. Reading your article on sleep just re-emphasized to me that I am not abnormal. Although most people I know think my sleep patterns are strange, clearly I have adapted to something that just works for me. Thank you for your articles, keep up the good work, I very much enjoy the primal lifestyle and I definitely look forward to your columns. Thank you Mark.

  4. Many people have issues with things in food, like Histamine, Salicylates, and Oxalates. There are plenty of FB groups for those of us who do. These problems contribute to nocturnal awakening big time. I know. I’m one of those people. The reasons why people wind up with these issues is too long to go into here. I just wanted to add something that many people also have and can learn to deal with.

  5. I’ve only experienced biphasic sleep once in my life, for a two week period when I was road-tripping, and camping under the desert stars in Nevada/Arizona. After about the second day, I’d make camp shortly before sunset, read for a bit, then fall asleep once it started getting dark. Then in the middle of the night, I’d wake up for an hour or two, and watch the stars. With nearly zero light pollution, it was the most amazing night sky I’ve ever seen. As it started getting light outside, I’d wake up naturally, watch the stars again until the last star in the Big Dipper faded into the blue sky, and hit the highway again. Best sleep of my life. I’ve tried to replicate it at home, but have been unsuccessful so far.

  6. I have trouble falling and staying asleep except on days that I walk for 2 or more hours in the woods.

    When I run or lift weights or do nothing at all I don’t sleep well. After a long hike in the woods though I fall asleep easily and stay asleep.

  7. I’ve settled into a pattern. It usually goes something like:
    -dinner around 6pm
    -bed around 9:30-10pm
    -wake about 5am
    -gym 9am
    -first meal 11am
    -30-60 min nap about 2pm
    rinse and repeat

    seems odd, but that’s what I’m doing.

    kept nearly the opposite hours in college, but that was decades ago. LOL!

  8. Throwing my vote in for the raw honey before bed! It’s the craziest thing. Late last year I was waking up between 3-3:30am every night, without fail. It started out of nowhere and lasted for several months; this was especially frustrating because historically I sleep like a frickin baby. My sleep hygiene was great; blue light blocking glasses, consistent bedtime, a mix of stretching/hot baths/cold showers before bed, diffusing lavender. None of these things were working so I even tried things like sleep aids and cannabis. Then while in the google rabbit hole I saw someone mention the raw honey and the logic behind it made sense to me since I typically eat my last meal of the day by 6pm, plus I just so happened to have a jar in the back of my spice cabinet. IT WORKED. It frickin worked!! Immediately. I’ve been taking it every night since and I’m back to rock solid sleep. One other benefit that I experienced was cognitive. I noticed around the same time that I was getting more forgetful, which was really bothering me because I typically have a great memory. It wasn’t anything major, just things like forgetting an actress’s name or how to spell a seldom used word. Once I started the raw honey that completely reversed and my memory is back to normal. I don’t know why, and that wasn’t an outcome that I was expecting or looking for, but I think it’s pretty darn interesting. Definitely give it a try if you’re on the fence!

  9. I wake up almost nightly at the same time. I lie awake and feel frustrated because I’m awake and can’t go back to sleep and I berate myself for not being able to quiet my mind. Thank you for writing about biphasic sleep! I’m going to look at my nightly waking in a different way to see if maybe this is how I’m supposed to sleep!

  10. There are actually links to why people wakeup at the times they do in tradition medicine such as TCM. 3am (Assuming dst) is Liver time and people will often wakeup around then after drinking alcohol due to the Liver being stressed. Happens to me like clockwork if I drink.

    1. I found this out the hard way when my kung fu teacher showed me a kick-blocks-kick technique.

      The next lesson when I told him about my sleep problems, he asked if I woke up about 3 am (I did). Then he showed me the point on top of my foot where he kicked me, and told me pretty much what you said.

      I haven’t thought about that for years, thanks for the reminder, and trip down memory lane.

  11. Mark, I can always rely on your thoroughness for solutions to my problems. They never leave anything out, which is why I find your topics so useful. I find solutions to my own problems by trial and error through your complete research and explanation on topics. You never leave anything out, no stone unturned and so medically knowledgeable, I only come to your content for medical research help for common problems. I can’t say enough how you’ve helped me.

  12. Would you be willing to discuss how to find a decent mattress! My wife likes soft mattresses I like firm – this is a constant problem. For me the soft mattress causes lower back pain….

    1. Buy two Twin extra long mattresses (38×80) set them tight side by side on a king box spring and bed frame. Lock them together with a clamp set up. Use King sheets to make one bed.

  13. My personal take and experience is this: I wake up at just about every light sleep phase (every 1 1/2 hrs) I roll over opposite to the side I wake up on (71 years old and don’t turn in my sleep). I usually urinate in a jug on my night stand and go right back to sleep. I want to be disturbed by this wakening as little as possible thus the urinating without having to walk to the bathroom. If I have a if I’m up longer than a few minutes, I start to meditate. If that doesn’t work, I take GABA (any time) or a corydalis supplement (if I have 4 or more hours before I wake. I don’t ascribe to the biphasic sleep Idea or at least to getting up and doing something. Just lay there and meditate. The more you do the more awake you become. The most important thing is not to worry about it. I may wake up 6 times a night but usually feel fully rested in the morning.

  14. I often wake up after four hours of sleep and feel alert. My solution to this for some time has been to get up and meditate for 40 minutes. When I return to bed, I sleep soundly.

    I find it easier to go into a deep meditation in the middle of the night. And I dream more vividly after meditating.

  15. One of the advantages of nose breathing, as explained by James Nestor (author of Breath), is less need to get up in the middle of the night to pee. Apparently mouth breathing generates more liquid than nose breathing. I’ve tried mouth taping and found I can indeed go all night without getting up to pee!

  16. WOW! Thank you so much for this amazing, encouraging response to our sleep issues. There are days I sleep for 4 hrs and feel great and there are days that I don’t with the same amount of sleep. BUT to understand that is can be more complex helps a lot. Thanks again for helping all of us learn.

  17. Since menopause, I always wake up at least once in the wee hours. Since going on HRT, I can go back to sleep. But not always, and not always easily. What I find works is a routine, and a temperature change. I get up, go to the bathroom, and run my hands and wrists under cold water. I go back to bed, and lie down with no covers on. Once I begin to get uncomfortably chilly, I pull the covers back on, and, as I warm up, I usually go to sleep. Sometimes it takes more than one cycle.