Medically reviewed by: Aric Prather, PhD and Jared Meacham, PhD, RD, CSCS

“Why do I wake up in the middle of the night?” This is a common question, and the answer is complicated. It might just be a natural wakeup point for you. Or it could signal that you have an underlying condition, are experiencing hormonal changes, or that your sleep hygiene could use a revamp.

For many people, this is an all-too-common scenario. You fall asleep easily, but then 3 a.m.—or another arbitrary time—rolls around, and you wake up. Maybe you even feel wired and have difficulty falling back asleep. If this sounds like your own slumber pattern, you might be wondering: Why do I wake up at 3 a.m.?

Although we like to think of sleep as one long uninterrupted stretch of Z’s, all sleep is not the same. We have natural points in the night where we’re in lighter stages. You might also wake up from bladder cues telling you you’ve got to go. And other factors—from hormonal shifts to temperature changes to underlying conditions—could also be the culprit.

Middle-of-the-night wakeups are common, with some studies showing that more than 30% of people wake up at least three nights per week and have trouble falling back asleep. So you’re not alone in your frustration.

In this article, we explore waking up at 3 a.m. and other random times, how to stop waking up in the middle of the night, and more.

Why Do I Wake Up at 3 a.m.?

Whether you wake up at exactly 3 a.m. or you’re simply wondering: Why do I wake up in the middle of the night? We’ve got answers. We cover these topics more in-depth below, but some possibilities include:

• You’re waking up at a natural point in your sleep architecture.
• You’re experiencing natural shifts in temperature, hormones, and neurochemicals.
• You’re experiencing symptoms from the menopause transition—or andropause.
• You’re consuming too many liquids before bed and need to use the loo.
• Alcohol or caffeine intake or late-night eating habits are causing sleep disruptions.
• You have underlying conditions that disrupt your sleep.
• Your sleep hygiene is affecting your sleep patterns.

Sleep Cycles and the 3 a.m. Wakeup

You could be experiencing a natural waking up point as part of your sleep architecture. We go through four to six sleep cycles per night, with two phases in each.

• Sleep phases: The two sleep phases include non-rapid eye movement (NREM) and rapid eye movement (REM), with four stages across the two.
• Sleep stages: The four stages consist of three NREM and one REM, making up various percentages of your total sleep time.
• NREM 1: ~5%
• NREM 2: ~45%
• NREM 3: ~25%
• REM: ~25%

When you move through these sleep cycles and their individual phases, you shuffle through lighter and deeper stages of sleep. As you progress through your four to six sleep cycles, you naturally spend less time in NREM 3 (your deepest sleep stage) and more time in NREM 1 and 2 and REM.

You’re more likely to wake up from NREM 1 or 2 and REM sleep. Depending on when you fall asleep and start your sleep cycles, 3 a.m. might be a natural waking up point for you.

“The brain cycles between light sleep and deep sleep,” says Emma Lin, MD, a board-certified pulmonologist and sleep medicine specialist and the CEO and founder of Aimvein. “During the light sleep stage, various minor annoyances, such as a full bladder, coughing, or background noises, can rouse us. It is not a problem if you go back to sleep.”

Hopefully, all you need is a quick potty break or a shift in sleep position, and you’ll drift off again. But sometimes other factors might keep you awake. Read on for more insight.

Stress, Anxiety, and Cortisol: Why Am I Waking Up at 3 a.m. When I Feel Wired?

Your body undergoes trillions of chemical reactions per second, including when you’re sleeping. Some hormones, neurotransmitters, neurochemicals (those that act as both hormones and neurotransmitters), and more can promote wakefulness. They can do this naturally or if they become dysregulated.

Wake-promoting chemicals:

• Acetylcholine: This neurotransmitter is high during REM sleep, and it can naturally trigger an awakening.
• Cortisol: This stress hormone normally peaks in the early morning, but if you’re experiencing chronic stress, your levels may be dysregulated, leading to that 3 a.m. (or otherwise) wakeup.
• Dopamine: This neurotransmitter, related to motivation and reward, also increases during REM sleep. It may become dysregulated from various factors and might impact your sleep.
• Norepinephrine: This neurohormone, also called noradrenaline, is involved in your fight-or-flight response. By its nature, it promotes alertness. However, during certain sleep stages, norepinephrine is crucial for memory consolidation. As levels fluctuate, norepinephrine can lead to nighttime arousals.
• Serotonin: This neurohormone helps regulate mood and sleep. One of its functions is to inhibit REM at certain points, and it can therefore trigger an awakening if levels rise.
• Histamine: This neurotransmitter is involved in your immune system. Levels begin to rise in the middle of the night, peaking as you get closer to dawn. But if you are experiencing allergy symptoms, you may experience an earlier rise that wakes you up.

Many factors can contribute to the dysregulation of these bodily chemicals. Stress is a major one. Stress is a survival mechanism designed to keep us safe when experiencing a threat. But we typically aren’t running from predators as our ancient ancestors had to. Instead, multiple mini or large stressors can pile up in our lives, leading to what’s called chronic stress. This dysregulates cortisol and related stress hormones.

Additionally, several mental health conditions, including depression and anxiety, can affect levels of serotonin, dopamine, norepinephrine, and cortisol. Altered or dysregulated levels are related to disrupted sleep.

Temperature Changes and Waking Up

Your body undergoes slight cooling at night to promote sleep. Your body temperature then increases toward morning to help wake you up. But if your body heats up during the night unexpectedly, the temperature change can disrupt your sleep. Temperature changes can occur for several reasons, including your hormones.

Hormonal Shifts and Waking Up in the Middle of the Night

Midlife is packed with shifting hormones, whether you’re female (perimenopause/menopause) or male (andropause).

Perimenopause

Perimenopause, known as the menopause transition, can last anywhere from a few years to a decade or more. When you haven’t had a period for a full year, you’ve hit menopause. During the menopause transition, your hormones, such as estrogen and progesterone, can dramatically fluctuate before they eventually decline around the time of menopause.

These hormonal shifts can impact sleep, affecting up to 60% of people assigned female at birth. A few factors can contribute:

• Progesterone naturally promotes sleep and reduces anxiety, but it’s one of the first hormones to decline during the menopause transition.
• Gamma-aminobutyric acid (GABA), is a metabolite of progesterone. GABA, a neurotransmitter, also promotes sleep and reduces anxiety, so a loss of progesterone can reduce GABA and worsen sleep.
• Estrogen decline, which occurs closer to menopause but can fluctuate dramatically beforehand, also affects GABA activity.
• Vasomotor symptoms, aka hot flashes and night sweats, can increase as estrogen and progesterone decline or fluctuate, leading to nighttime arousals.

Andropause

Andropause is the natural decline in testosterone that people assigned male at birth experience starting around midlife and continuing as they age. It can also cause sleep disturbances through several processes:

• Testosterone helps maintain slow-wave sleep and sleep continuity, so you don’t wake up. A decline can lead to that middle-of-the-night wakeup.
• Less sleep can cause further declines in testosterone, creating a vicious cycle.
• Low testosterone is also associated with obstructive sleep apnea (OSA), a serious medical condition that causes nighttime waking. More research is needed to understand this connection.
• Testosterone indirectly boosts GABA, which promotes sleep. So low testosterone can reduce GABA or how well the neurotransmitter works.
• Low testosterone can also affect levels of neurohormones, such as dopamine, serotonin, and norepinephrine.
• Vasomotor symptoms can occur in males from testosterone decline or from prostate treatment.

Lifestyle and Environment: Habits That Trigger Waking Up at 3 a.m.

Sometimes lifestyle or sleep habits can also trigger waking up in the middle of the night. Here are a few of the most common contributors.

• Fluids: Staying hydrated is crucial to overall health, but consuming too much liquid before bedtime can increase the likelihood that you’ll need a middle-of-the-night trip to the bathroom for relief.
• Alcohol: Beer, wine, and spirits might also increase the likelihood you’ll need to hit the loo, but booze can also disrupt your sleep in multiple ways, especially if you imbibe close to bedtime.
• Caffeine: Caffeine is a diuretic and can also send you to the bathroom in the wee hours. In addition, it can disrupt sleep, since it blocks adenosine, a sleep promoting neurotransmitter. The risks of waking from your caffeine intake increase if you consume a large amount throughout the day or any amount at night.
• Meal or snack timing: Eating before bed can increase your risk for acid reflux, which can wake you. Late meals are also associated with disrupted sleep in general.
• Light pollution: While you sleep, light pollution can occur from porch or street lights, devices in your room, and other sources. This can disrupt your body’s release of melatonin, the sleep hormone.
• Noise pollution: Street sounds, noisy neighbors or roommates, the pitter patter of pets, and your bedmate’s snoring are all examples of noise pollution that can wake you.
• Irregular sleep schedule: Sleep quality goes down when your sleep and wake times differ significantly from one day to the next.

Health Conditions That Can Cause Middle-of-the-Night Wakeups

Several health conditions are associated with disrupted sleep and nighttime awakenings, including the following:

• Alzheimer’s disease and other forms of dementia
• Asthma
• Bruxism (teeth grinding)
• Cardiovascular disease (e.g., heart failure, arrhythmias)
• Chronic kidney disease (CKD)
• Chronic obstructive pulmonary disease (COPD)
• Chronic pain conditions (e.g., fibromyalgia, migraine and other headache disorders, neuropathy, arthritis)
• Gastroesophageal disease (GERD)
• Thyroid disease (e.g., hyperthyroidism, hypothyroidism)
• Mental health conditions (e.g., depression, anxiety, bipolar disorder, schizophrenia, attention-deficit/hyperactivity disorder, and post-traumatic stress disorder)
• Multiple sclerosis (MS)
• Obstructive sleep apnea (OSA)
• Parkinson’s disease
• Restless leg syndrome (RSL)
• Substance use disorders

Additionally, disrupted sleep could be a side effect of the medications you take for these conditions or others. If you have any of these conditions or suspect that medications you take might be leading to your waking up in the middle of the night, talk to your doctor.

Why Do I Wake Up at 3a.m.? Separating Myths From Sleep Science

If you’re searching for “Waking up at 3 a.m. meaning,” you’ll likely find several articles or influencers that try to link these wakeups to factors that lack evidence.

As an example, people following ancient medical philosophies might claim this is when your liver is detoxing. In fact, we know through modern science that your liver is doing its good work at all times. Your liver cells do have circadian clocks that are synced with your body’s master clock in your brain. In fact, nearly all cells in your body sync with your brain’s master timekeeper, but your liver is not the culprit of your 3 a.m. wakeups. Additionally, some myths perpetuated online have to do with the paranormal, including that belief that a 3 a.m. awakening is to receive spiritual messages from ghosts or deities.

Again, these claims aren’t rooted in science. In reality, you’re likely waking up for one or more of the scientifically based reasons mentioned in this article.

At-home strategies: How to stop waking up in the middle of the night and get back to sleep

If you’re struggling with middle-of-the night awakenings, a few strategies can help:

• Stop consuming liquids about two hours before going to sleep.
• Avoid caffeine within 6 to 8 hours of bedtime.
• Keep alcohol to a minimum and stop drinking several hours before sleep.
• Avoid meals or snacks within one hour of going to sleep, but you may need an even longer window, such as four hours, especially if you’re prone to acid reflux.
• Go to bed and wake up around the same time each night and day.
• Address noise pollution by wearing earplugs or using BetterSleep’s white or pink noise to block out disruptions.
• Wear an eye mask or use blackout curtains to nix light pollution.
• Keep your room temperature at 66 to 70 degrees Fahrenheit for sleep.
• Reduce stress during the day, and before bed by trying the BetterSleep breathwork, meditation, or deep sleep delta waves features.
• If you wake up and feel wired, try some of BetterSleep’s soothing sounds or use the cognitive shuffling technique.

“Consult a doctor if you wake up three or more nights per week [and] can’t go back to sleep within 15 to 20 minutes,” Dr. Lin says.

You should also consult a doctor if you’re tired, irritable, or have difficulty concentrating during the day, or snore loudly, gasp for air, choke, or have difficulty breathing when sleeping, she adds.

The Bottom Line

Waking up in the middle of night can be frustrating. You might worry that you won’t be able to fall back to sleep and feel rested by morning. The good news is that a middle-of-the night wakeup can be a normal function of sleep architecture, how your body cycles through different phases and stages of slumber.

In other cases, you might have an underlying medical issue that’s associated with disrupted sleep, your awake-time habits might be interfering, or your sleep hygiene might need some tweaks.

The good news is that solutions are in sight. Try some of the strategies in this article, but if you still have trouble with waking up and not getting back to sleep, talk to your doctor who can evaluate you and offer tailored solutions. We hope you sleep well!

Key Takeaways

• Middle-of-the night wakeups, including those at 3 a.m., can be a normal part of your sleep architecture.
• If you can go back to sleep, these awakenings aren’t a concern.
• If you have trouble falling back to sleep, try some of the tactics mentioned in this article, including some of the offerings from BetterSleep.
• If you continue to experience disrupted sleep, consult your doctor for solutions.

Frequently Asked Questions (FAQs)

What does it mean if you wake up at 3 a.m.?

Waking up at 3 a.m. does not have any specific meaning. Some myths suggest it’s an opportunity to receive a spiritual message, but no scientific evidence supports this claim. Instead, what might be happening is that you’re encountering a spot in your sleep where you naturally wake up as part of your sleep architecture.

What organ is cleansing at 3 a.m.?

Your liver is a key organ that detoxes your body. It is working all the time. Some articles and influencers state that you wake up at 3 a.m. because your liver is cleansing or detoxing then. However, your liver is always doing this work, and it has nothing to do with waking up in the middle of the night.

How do I stop my body from waking up at 3 a.m.?

Waking up during the night is completely normal. You might be experiencing a natural wakeup point at 3 a.m. as part of your sleep architecture. As long as you can easily go back to sleep, these awakenings aren’t a concern. However, if you wake up and find yourself unable to fall back to sleep, you might have an underlying condition contributing or you may need to revamp your sleep hygiene.