I Need Sleep! Why Do I Wake Up At 3 Am Every Night?

Medically reviewed by April Justice, LICSW
Updated April 16, 2024by BetterHelp Editorial Team
Content warning: Please be advised, the below article might mention substance use-related topics that could be triggering to the reader. If you or someone you love is struggling with substance use, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357). Support is available 24/7. Please see our Get Help Now page for more immediate resources.

Most people experience nighttime wakefulness from time to time. However, if you’re waking up at 3 A.M. every night, you’re likely living with insomnia, which can involve difficulty staying asleep, as well as long periods of wakefulness each night. Stress, physical and mental health conditions, age, and lifestyle factors can all play a role in insomnia. You may find it helpful to exercise regularly, keep a regular sleep schedule, and do something relaxing before bed to manage insomnia. It can also be beneficial to see your doctor and speak with a therapist about your sleep-related challenges.

What is insomnia?

The American Psychological Association generally defines insomnia as “difficulty in initiating or maintaining a restorative sleep, which results in fatigue, the severity or persistence of which causes clinically significant distress or impairment in functioning. Such sleeplessness may be caused by a transient or chronic physical condition or psychological disturbance.

The CDC typically recommends that adults get an average of seven to nine hours of sleep at night. Adolescents usually need eight to 10, and school-aged children may need nine to 12 hours within a 24-hour period. As age increases, the recommended hourly numbers tend to decrease. 

Symptoms of insomnia can include the following:

  • Long periods of wakefulness at night
  • Difficulty falling asleep and staying asleep
  • Excessive feelings of grogginess or sluggishness upon waking
  • Irritability and difficulty concentrating during the day
  • Difficulty napping despite extreme fatigue

There can be several potential contributing factors to insomnia, such as stress, health conditions, substance use, poor sleeping environment, mental health conditions, and more. For some, insomnia may have no clear cause.

Sleep quality is often linked to mental health

Factors that may contribute to insomnia

Read more about several potential contributing factors below.


Stress may be one reason that some individuals have difficulty falling asleep, wake in the middle of the night, or are unable to return to sleep. Insomnia may emerge after a singular stressful event, like the loss of a loved one, a job, or a home. Continuous stress from financial, health, family, or work challenges can cause insomnia as well. 

One of the difficulties of experiencing insomnia due to stress can be that often, people worry over the fact that they can’t sleep because they’re stressed. This can then create another source of stress, potentially resulting in additional insomnia. 

Health conditions

Physical health problems, like heart and respiratory conditions, neurological conditions, and hormonal problems, can cause insomnia in some cases. People experiencing chronic pain and joint or muscle problems can be affected as well. 

There may be a bi-directional link between obesity and insomnia. Sleep studies generally show that adults who sleep five hours or less may be more likely to become obese, and conditions associated with obesity, like sleep apnea and acid reflux, can be common causes of insomnia. 

Mental health disorders

Post-traumatic stress disorder and other anxiety disorders can have an adverse impact on sleep, as can depression. Trouble sleeping can also be associated with a long list of other mental health conditions like bipolar disorder, schizophrenia, and more. 

If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.


People of different ages usually need varying hours of sleep to stay well-rested, and while older adults typically need far less sleep than school-aged children, it appears that aging can be a contributor to insomnia. Contributing factors may include a reduction in activity, changes in health associated with aging, and increased prescription medication use. Changes in our natural circadian rhythms as we age may also cause sleep disturbances. 

Lifestyle factors

Lifestyle factors like nicotine, alcohol and substance use, stimulating exercise, what and when you eat in the evening, work or travel schedules, and more may all be contributors to insomnia and poor sleep quality. Caffeinated beverages can disrupt sleep, as can medicines for blood pressure, asthma, and some antidepressants. Habits like using smartphones, tablets, laptops, and other electronics just before bed can adversely affect sleep, as can keeping an irregular bedtime schedule.


Tips for better sleep

There may be many things you can do to improve your sleep quality and increase the hours you stay asleep at night.

Get regular physical activity

As long as you exercise at least one to two hours before bedtime, regular physical activity can significantly improve sleep quality. This may be especially true if you exercise outdoors, as exposure to daylight during outdoor exercise can establish your body’s natural circadian rhythms. Physical movement may also relieve the stress and anxiety that may keep you awake at night. 

Keep a regular sleep schedule

Try to resist the temptation to stay up late and sleep in on weekends. Maintaining the same daily sleep schedule may help your body know when it’s time to go to sleep.

Do something relaxing before bed 

Creating a regular bedtime ritual can signal to the body that it’s time to wind down. It can also help to keep your bedroom cool, dark, and comfortable, and try to refrain from using your bed for anything but sleeping and sex. 

Avoid unhealthy consumption habits

Try to limit caffeine and alcohol or avoid them altogether before bed. It can also be beneficial to avoid large meals and smoking around bedtime.

Getting professional help

People often underestimate how vital it can be to get enough high-quality sleep, and the consequences of insomnia on physical and mental health can be far-reaching. But it isn’t always easy to uncover the causes of sleep disturbances, and if that’s the case for you, a visit to your primary care physician (PCP) may be recommended. 

Your PCP will likely conduct physical and lab tests, as well as review your medical history to isolate or rule out the causes of your insomnia. They may also review any medications you take and adjust them as needed. If necessary, your doctor may refer you to a sleep specialist who can conduct a sleep study

Sleep studies typically use technology to track the brain and body’s activity during sleep, including oxygen levels, arm and leg movements, and sleep stages. Through sleep studies, doctors can diagnose a host of sleep disorders beyond insomnia, such as sleep apnea and restless leg syndrome. 

Depending on the results of the study, your PCP can make recommendations and prescribe medications if needed. They may also refer you to a psychotherapist to manage stress, anxiety, depression, and any other underlying psychological causes for your sleep disturbances. 

Getty/MoMo Productions
Sleep quality is often linked to mental health

Benefits of online therapy

Online therapy can be an excellent choice for those living with insomnia as it usually allows for quite a bit of flexibility. You might choose to schedule your sessions close to bedtime so that you can work through relaxation exercises with your therapist before going to sleep for the night. In addition, if you’re feeling tired due to insomnia, attending therapy from home may be more convenient than traveling to a therapist’s office. 

Effectiveness of online therapy

Studies indicate that online therapy generally has a high rate of success in treating insomnia and depressive symptoms, as well as many other mental health conditions. If you believe you may benefit from working with a licensed mental health professional, online therapy may be a valid option.


Waking up at 3 A.M. each night can be an indicator of insomnia. You may be experiencing insomnia due to a variety of factors, such as your age, lifestyle, stress, and physical and mental health conditions. In many cases, keeping a regular sleep schedule, creating a relaxing nighttime routine, and exercising each day can improve your sleep. However, if you continue to wake up in the middle of the night, it’s generally recommended to speak with your doctor and a therapist.
Learn the impacts of sleep deprivation
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