Tired of Waking Up at 3 A.M.? We Have the Solution.

How often do you find yourself unwillingly jerked out of sleep around 3 AM? This annoying and unwanted nightly wake-up call plagues many people across all demographics.

Your 3 AM wakeup could be occurring for several different reasons, from hormonal imbalances to poor sleep hygiene. In this blog, we’ll break down why you’re waking up in the middle of the night and how you can prevent it.

Sleep cycles 101:

One of the reasons behind your 3 AM wakeup could simply be the natural cycle we go through as we sleep. During the 7 to 9 hours of sleep typically recommended for adults, the body cycles through four sleep stages. They are as follows:

1. Transition from wakefulness to sleep

2. Light sleep

3. Deep sleep

4. Rapid eye movement (REM) sleep

The length of each phase varies as you sleep throughout the night. You have longer deep sleep during the first 4 to 5 hours of sleep and longer REM sleep and lighter sleep as dreams occur and the morning approaches. Once you transition out of deep sleep and into lighter sleep, you are more easily awakened.

This means that if you go sleep around 10 PM every night, you’re transitioning into lighter sleep around 3 AM. Around 3 AM, your sleep will be much lighter and it will be much easier to wake up. This could be one explanation for your 3 AM wake-up calls.

Interestingly, the 3 AM wake-up can be traced back to the Industrial Revolution, when people in Western countries were to shift their sleep regiments from two segments into one. Prior to the Industrial Revolution, people broke their sleep time into two segments, called first sleep and second sleep. Two segment sleep cycles involved a shorter sleep at night and a midday nap. But after the Industrial Revolution, sleep was clumped into one longer interval to allow us to work throughout the day.

To stay asleep through your lighter REM sleep cycles, there are several steps you can take. Making sure your bedroom is dark and quiet is key. Without ambient noise or extra light, it will be easier to sleep throughout the night. Keeping your room cool is another potential solution to your 3 AM wake-up. Your core body temperature starts to drop and rise again around 2 or 3 AM, which also puts you in a lighter stage of sleep. A warm bedroom is sure to cause you to wake up sweating.

Stress:

Stress is another common culprit behind 3 AM wake-ups. Stress could especially be behind your 3 AM wake-ups if they started recently or happen around stressful life events. When you’re stressed, cortisol levels will already be heightened throughout the day, and will likely have a hard time going back down during the night.

Cortisol also plays a pivotal role in managing the ‘architecture’ of sleep. Researchers have discovered that the circadian rhythm causes a natural increase of cortisol levels around the hours of 2-3 AM. If you’re already feeling anxious or stressed, this extra bump in cortisol levels could cause you to wake up in a panic.

High levels of cortisol could also cause the sympathetic nervous system, commonly known as fight or flight mode, to kick in. Once this happens, your heart rate and blood pressure will increase, causing it to be even more difficult to fall back asleep.

To improve your sleep if you have heightened cortisol levels, the most important thing is to fall back asleep after waking up anxious. Instead of getting frustrated or worried about waking up in the middle of the night and potentially hurting your energy supply for the next day, try relaxation techniques. Deep breathing, meditation, and other relaxation techniques will help to calm your mind and allow you to fall back asleep.

Low blood sugar:

Another factor behind your dreaded 3 AM wake-up call could be low blood sugar. If you’ve eaten your last meal around 7 PM, your body will be out of fuel by 8 hours later at 3 AM. Your brain senses your body is nearly out of energy, so it causes a spike in cortisol to assist in jumpstarting the metabolic process. As described above, a spike in cortisol can cause you to jolt out of sleep.

If low blood sugar is behind the 3 AM wakeup, you can try eating a small meal around two hours before bed. But the meal should not be calorie-dense or especially fibrous, both could cause problems with sleep as your body digests. Some foods make better bedtime snacks than others and especially those that have a natural ability to raise serotonin or melatonin levels because of their tryptophan content. Such foods include:

• Oatmeal

• Cheese

• Yogurt

• Walnuts

• Almonds

• Hummus

• Tea - especially chamomile, ginger, and passionfruit

• Honey

• Berries

Be wary of eating before bedtime though, as some studies have found it can lead to overeating, weight gain, and further disrupted sleep if the wrong foods are eaten.

Age-related sleep disturbances:

If your sleep only became disrupted when you got older, unfortunately aging and menopause could be the culprits. As we age, we spend less time in deep sleep, causing us to be more prone to awakenings from factors like noise or light. Typically, as we get older, we tend to go to bed earlier and wake up earlier as well. There are also many age-related medical conditions, like osteoarthritis and urinary problems, that can cause an overall decrease in sleep quality.

Menopause can also cause a disruption of sleep. Many women also experience sleep problems throughout the stages of menopause. The most common problem is an insomnia-type pattern, which throughout menopause means difficulty staying asleep. Over 50% of women going through menopause report some level of difficulty sleeping. An additional 25-30% of menopausal women report insomnia, which is defined as over 3 months of trouble staying or falling asleep that affects daytime functioning in response. Sleep apnea is also common during menopause.

The primary culprit behind sleep issues during menopause are symptoms like hot flashes. Hot flashes can hit you any time of day, and when they occur at night, many women have difficulty falling back asleep and then feel lethargic or fatigued throughout the following day. Researchers also report that sleep disruption feeds into mood disturbance in women with falling estrogen levels during menopause.

Talking to your medical practitioner about hormone replacement therapy and stress management while also working on sleep hygiene can help to alleviate these sleep disturbances.

Hormonal imbalances:

Another common culprit behind the 3 AM wake-up is hormonal imbalances. Three hormones, in particular, are known to cause disturbances in sleep:

• Low progesterone: Women going through the early stages of menopause frequently have sleep disruptions like the 3 AM wakeup. This is because progesterone directly impacts one of our important relaxation neurotransmitters, GABA. GABA plays a key role in helping your mind disengage from the alert, wakeful state of the day and transition into relaxation and sleep. The neurotransmitter can help ease feelings of anxiousness, decrease muscle tension, and reduce physical and mental stress. In perimenopause, the ovaries create less progesterone, resulting in a lack of GABA to calm your mind.

• Dysregulated cortisol: As described above in the section about stress, cortisol often plays a role in disrupted sleep. Normally, at night time, levels of melatonin will increase and cortisol will decrease. But if you are under acute or chronic stress, you will have frequent wake-ups between 2-4 AM and have trouble falling back asleep. This is because high levels of cortisol will trigger your fight or flight mode and prevent sleep.

• Thyroid imbalances: People with both overactive (hyperthyroidism) and underactive (hypothyroidism) thyroid function report common problems with sleep. An overactive thyroid can cause nervousness or irritability which will cause difficulty sleeping. Hyperthyroidism can also lead to frequent urges to urinate and night sweats. An underactive thyroid has been linked to poor sleep quality in multiple studies. It often causes people to take longer to fall asleep and a shorter sleep duration through the night.

If hormonal imbalances are the root of your 3 AM wake-ups, try these steps to naturally support hormone balance:

• Avoid inflammatory foods

• Eat a diet rich in antioxidants

• Increase fiber in your diet

• Avoid non-nutritive sweeteners

• Limit exposure to endocrine disruptors

You should also be frequently testing your hormone levels to make the necessary lifestyle and dietary adjustments to ensure good sleep and optimal health.

Sleep hygiene 101:

Not having good sleep hygiene is another common root of the 3 AM wake-up or poor overall sleep. Causes of poor sleep hygiene include:

• Drinking caffeine or alcohol before bedtime

• Using computer or cell-phone screens close to bedtime

• Not getting enough natural light during the daytime

• Smoking

• Eating spicy or rich foods close to bedtime

• Napping too late in the day

• Not getting enough exercise

• Eating too close to bedtime

Our top recommendations for your best night of sleep include:

• Increase bright light during the day- Bright light in the daytime will bolster your body’s circadian rhythm. One study found that for people with insomnia, bright light in the day reduced the time it took to fall asleep by 83%.

• Reduce blue light in the evenings- Too much light in the evenings can trick your circadian rhythm into thinking it’s still daytime. Blue light especially has a reputation for disrupting sleep patterns.

• Avoid caffeine in the afternoon- When you drink caffeine, you stimulate your nervous system. This can stop your body from entering relaxation mode at night. One study found that consuming caffeine 6 hours before bed significantly negatively impacted sleep quality.

• Don’t take long or irregular daytime naps- While short, “power” naps have proven to be beneficial, irregular or long naps can worsen your sleep at night. Daytime naps can confuse your body’s internal clock, leading to insomnia or frequent wake-ups at night. One study found that daytime naps can cause people to feel sleepier.

• Avoid alcohol at night- Alcohol can cause or increase symptoms of snoring, disrupted sleep, and sleep apnea. Alcohol also alters your circadian rhythm by disrupting melatonin production. One study found that nighttime alcohol consumption decreases natural elevations in human growth hormone, which impacts your circadian rhythm and helps to build muscle, burn fat, and build healthy tissues.

• Keep your bedroom cool- A high bedroom temperature has been found to disrupt sleep more than external noises. Studies have found that when you and your bedroom are hot, sleep quality will decrease and wakefulness will increase.

• Keep your exercise during the day- Studies have found that exercise can enhance all sleep aspects and reduce symptoms of insomnia. For those with severe insomnia, exercise works better than most sleeping aids. One study demonstrated that daytime exercise reduced time to fall asleep by 55%, anxiety by 15%, and total sleep time by 18%.

The importance of good sleep:

Over the past decades, sleep quality has continued to decline; now, in 2021, the majority of people are getting what is considered to be poor sleep. This wreaks havoc on a person’s overall health. Bad sleep can lead to hormone imbalances, decreased athletic performance and brain function, weight gain, and increased risk of disease.

While we are sleeping, the body is actually going through several activities necessary for life.

• Sleep is vital for brain health. As we sleep, our brain is processing what we have learned throughout the day while also removing waste products from brain cells. Sleep also impacts brain functions like learning, memory, problem-solving skills, focus, concentration, and creativity.

• Nerve cells communicate and reorganize as we sleep.

• Cells undergo repair. As you sleep, your muscles repair, proteins synthesize, tissues grow, and hormones are released.

• Energy is restored and stored for use the next day. 8 hours of sleep produces daily energy savings 35% higher than when awake.

• Activity increases in the amygdala, striatum, hippocampus, insula, and prefrontal cortex. These regions all heavily regulate emotion, causing emotional health to be heavily dependant on sleep. If you are sleep-deprived, you’re more likely to have emotional overreactions. A lack of sleep can also lead to worsened mental health issues.

• Sleep supports a healthy heart. While scientists aren’t certain of the connection between the heart and brain, multiple studies have demonstrated poor sleep can lead to worsened heart conditions. Sleep deprivation is associated with high blood pressure, increased inflammation, elevated cortisol, weight gain, and insulin resistance- all factors that lead to heart disease.

Continued poor sleep quality can lead to or exacerbate conditions like:

• Anxiety

• Depression

• Poor memory

• Poor concentration and focus

• Fatigue

• Poor motor skills

• Weakened immune system

• Insulin resistance

• High blood pressure

• Chronic diseases like heart disease and diabetes

• Risk of early death

Essentially, you need to get a good night’s sleep to ensure a long and healthy life.

Waking up at 3 AM is not only annoying, but it can also cause serious impacts on your overall health. We need sleep to survive and function optimally.

For more information on sleeping through the night, or to ask about how you can quiet your 3 AM wake-up call, click here to contact us or call 276-235-3205 to schedule your complimentary discovery call.

The Johnson Center for Health services patients in-person in our Blacksburg and Virginia Beach / Norfolk locations. We also offer telemedicine for residents of Virginia and North Carolina!