Why you wake up at 3am, and how to get back to sleep

Waking up in the middle of the night is normal, and around 3am sleep is at its lightest. In a sleep lab, healthy sleepers woke 20 to 40 times a night, more with age, and most of those wakings are forgotten by morning. The 3am waking that keeps you up is usually the one where your mind switches on.

Leave the clock alone and rest rather than trying to sleep. If lying there turns into a fight, get up for a while and come back when you're sleepy. The next morning, get up at your usual time.

Why do I wake up at 3am?

Go to bed around 11 and by 3am most of the night's deep sleep is behind you. Deep sleep comes early, so the rest of the night is lighter, and every 90 minutes or so a sleep cycle brings you close to the surface. It doesn't take much to wake you. A full bladder, a warm room, a partner turning over.

What you had the day before plays a part. Alcohol can make you drowsy at first, then tends to break up the second half of the night as it wears off. An afternoon coffee can do it too. In a review of 24 studies, caffeine added about 12 minutes awake in the night, which is why the caffeine cutoff is one of the habits.

You'll often read that cortisol is what wakes you at 3am. It does start rising a few hours after you fall asleep, in everyone, and keeps climbing toward morning. That's the body getting ready for the day, and on its own it isn't what keeps you awake.

Then your mind gets involved. At 3am problems look bigger and harder to solve. Mood tends to dip in the middle of the night, and one team of sleep researchers suggests that the thinking that keeps things in proportion isn't at its best then either. They call the idea "the mind after midnight."

Over time the wakings can start to feed on themselves. Bed becomes the place where you lie awake, and worry about the next waking is one more thing keeping you up.

It's also very common. In a survey of almost 9,000 adults in three US states, more than a third woke in the night at least three nights a week, and about one in seven had trouble getting back to sleep.

How do I get back to sleep?

Don't look at the time. One look and you start counting. "If I fall asleep now, I'll get four hours." The counting wakes you up even more. In one experiment, people with insomnia who could see a clock worried more and felt they took longer to fall asleep. Turn the clock to the wall and put your phone across the room.

Rest, and stop trying to sleep. Sleep is one of the few things that gets harder the more you try. Lying there calmly is fine, and sleep tends to come back once you stop chasing it.

When it does turn into a fight, get up. Go somewhere warm with just enough light to see your way, and do something quiet until you're drowsy. The usual advice is to get up after 15 or 20 minutes, but timing it means watching the clock, so go by how it feels. There's more on this in getting out of bed when you can't sleep.

If you're unsteady on your feet or you've taken something to help you sleep, sit up in bed with a low light and do the quiet thing there instead.

Worry is easier to leave on paper. Write one line on a notepad by the bed, then leave it for the morning. When it happens most nights, it can also help to give your worries ten minutes in the early evening. Write each one down, and next to it one small thing you could do about it.

The next day

Get up at your usual time, even after a bad night. Skip the lie-in, keep any nap short and before 3pm, and don't go to bed early to make up for it. You want to be sleepy by bedtime. If you're too sleepy to drive safely, though, don't drive. A short nap is the safer choice.

It also helps to know that many people with insomnia get more sleep than it feels like, which doesn't make the bad nights any less real. Light sleep can feel a lot like lying awake.

When to see a doctor

If you wake short of breath, with chest pain, or with your heart pounding and it won't settle, get help straight away. For chest pain, call 911 or your local emergency number.

A lot of 3am waking comes from the things above, but waking most nights can also go with health problems worth checking. See a doctor if:

• it's happened three or more nights a week for three months, or sooner if it's wearing you down. Ask about CBT-I, which guidelines recommend for long-term insomnia.
• you wake very early and feel low or flat most days. Early waking can be a sign of depression.
• you snore loudly, wake up choking or gasping, someone has seen you stop breathing in your sleep, or you nod off in the day however long you sleep. These can be signs of sleep apnea.
• you wake drenched in sweat when the room isn't hot. Hot flashes around perimenopause are a common cause, but night sweats can have other causes worth checking, especially with a fever or weight loss you can't explain.
• you're up to pee two or more times most nights.
• pain, heartburn or restless legs are what wake you.
• you wake from nightmares most weeks, or someone has seen you shout, punch or kick while you're dreaming.
• it started around when you began a new medicine. Your doctor or pharmacist can tell you if it might be the cause.

If you take something for sleep, take it only as prescribed, with no extra dose in the night unless your doctor has said so, and talk to your doctor before changing it. If it's ever had you walking, eating or driving without remembering it, call your doctor right away.

If you're having thoughts of suicide or harming yourself, at 3am or any time, call or text 988 in the US, or your local emergency number.

How Goodmorrow handles it

Goodmorrow coaches one habit at a time, and two of its habits help with waking at night, a steady get-up time and getting up when bed stops feeling like rest. For people who come to us with broken nights, the second one usually comes first. Mention the 3am waking in your morning note and it's tagged, so the lessons start to lean that way. With a ring or watch, we also look at whether your worst nights, as best it can tell, come after drinks, stressful days or late dinners.