Why do I wake up at 3 a.m. every night?

A person's emotional reaction when waking up at night can affect sleep quality, according to neurologist Dr. Brandon Peters-Mathews of Virginia Mason Franciscan Health in Seattle. PHOTO/COURTESY: CNN
Now wide awake from a once
peaceful slumber, you roll over to check the clock and find it’s 3 a.m. That’s
the same time you woke up last night. And the night before.
If that sounds familiar, it’s because nocturnal awakenings happen to a lot of people.
Waking up several times
throughout the night is a natural occurrence often due to sleep architecture,
which are the stages of sleep that one cycles through every night.
These awakenings usually only last for
anywhere from a few seconds up to a few minutes — if they happen too frequently
in one night or there are disruptions to falling back asleep, that could be a
problem.
Here’s
what experts say could help.
Why you
might be waking up
Sleep architecture refers to the four stages
of sleep people cycle through during the night in about 90 to 120-minute
intervals, said Dr. Brandon Peters-Mathews, a neurologist with Virginia Mason
Franciscan Health in Seattle.
The cycle begins with a light sleep that
transitions into a deeper sleep, and then into the deepest sleep that occurs in
the third stage, often referred to as “slow-wave sleep,” Peters-Mathews said.
During
the fourth stage, known as rapid eye movement (REM) sleep, brain activity picks
up to levels that almost reach normal activity while awake — it’s after this
stage when people often wake up naturally, he said, and once they fall back
asleep the cycle begins again.
“Because
we tend to go to bed at roughly the same time on a nightly basis, and these
cycles are roughly the same length, we may wake at the same time in the night,”
Peters-Mathews said.
Most of these awakenings will be brief and
forgettable, but “there might be one or two cycles into the night that we wake
up and look at the clock and are aware of the time.”
Waking
up several times throughout the night is typically not disruptive to one’s
health, as long as falling back asleep occurs within about five to 10 minutes,
said Dr. Michelle Drerup, director of the Behavioral Sleep Medicine Program at
the Cleveland Clinic.
On
the other hand, when people find themselves waking up multiple times within the
hour, that could cause a sleep cycle to be fragmented and the individual might
not get any deep sleep, Drerup said.
These
frequent awakenings could be a sign of sleep disorders such as sleep apnea or
nocturia, she added.
When
people naturally wake up in the night, they are more likely to remember it
happening during the second half of the night.
That’s
when people typically have longer REM stage, light sleep, while the first half
of the night has longer stages of deep sleep instead.
“People
will say, ‘Oh, I sleep like really solidly for four hours. And then I feel like
I have more waking. And that’s also very normal based on our sleep
architecture,” Drerup said.
It’s
often a person’s emotional response to the awakening that can pose challenges,
Peters-Mathews said, and could result in someone developing secondary insomnia
if their reaction triggers prolonged wakefulness.
“If
somebody wakes in the night, and the first thing they do is look to their alarm
clock, and see what time it is, and that’s something that makes them feel
frustrated or upset or anxious as they anticipate the next day — it’s the
reaction that’s problematic,” he said.
A person’s circadian rhythm, or internal
biological 24-hour clock, could also be at play, said neurologist Dr. Cathy
Goldstein, a sleep medicine physician at the Michigan Medicine Sleep Disorders
Centers.
Your
circadian rhythm tells the body when it’s time to sleep and tends to line up
with your past sleep-wake cycles and the exposure to light throughout the day.
If
this rhythm is thrown off, or the sleep-wake cycle changes a lot, the body is
not going to have a great idea of when to have high-quality deep sleep, said
Goldstein, who is also a professor of neurology at the University of Michigan
in Ann Arbor.
“Circadian
rhythm is our internal biological clock, it times when we’re awake, it times
when we’re asleep — it times most of our physiological processes, so our body
does what it needs to do at the right time of day,” Goldstein said.
Circadian
rhythms and sleep architecture change with age, which might be why someone
could feel like they received more deep sleep when they were younger. As people
age, they tend to spend more time in light stages of sleep, she added.
These
cycles are inherent and might also establish someone as a night owl or an early
bird, Goldstein said, and could cause difficulty with keeping up with a work
schedule that does not align with an individual’s biological cycle, resulting
in daytime sleepiness.
Often,
even though someone wakes up early for work, falling asleep at a time that
allows them for enough sleep can be a challenge.
What’s
more, many night owls also tend to go to bed late on the weekend, which can
result in drowsiness known as “social jetlag” and will weaken the circadian
rhythm — possibly causing less deep sleep and resulting in more awakenings,
Goldstein said.
But
there are ways to move around your internal clock.
Falling asleep and waking up at the same time
every day, as well as getting natural light exposure throughout the day and
dimming artificial lights at night, will help strengthen your circadian
amplitude — the peaks and troughs of the cycle — Goldstein said, resulting in
more restful sleep.
It
could also be helpful to take a very low dosage of melatonin, no more than half
a milligram, a few hours before someone tends to naturally fall asleep, which
could help to move the body clock earlier, she added.
The
most important thing to do when waking up in the middle of the night is to
resist looking at the clock, Peters-Mathews said.
“If
the alarm is not going off, it’s not time to wake up. It doesn’t matter what
time it is. You get to roll over, get comfortable and go back to sleep.”
If
you don’t fall back asleep within 15 minutes, it’s best to get out of bed to
avoid developing an association with wakefulness with your bed, Drerup said.
She
recommends doing a quiet activity that will help one feel sleepy again, which
could be meditation or listening to music.
“Our
brains are highly associative, and they can get easily conditioned so that if
we stay in bed for a long time, and we’re awake, our brains start to associate
the bed with wakeful activities, like worrying and doing all kinds of things
besides sleep, so getting out of bed breaks that association,” Drerup said.
It’s
also important to ensure the awakenings are not happening from something
external, such as disturbances from your sleep partner, Peters-Mathews said.
“Optimizing
the sleep environment is important. … It sometimes means locking pets out of
the bedroom and optimizing noise, light and temperature within the bedroom
environment.”
But
if the awakening is naturally caused by your sleep architecture and does not
affect how you function the next day, there is nothing to worry about,
Goldstein said.
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