Waking Up At 3 AM? A Sleep Disorder Might Be Waking You Up In The Middle Of The Night

Medically reviewed by April Justice, LICSW
Updated July 7, 2024by BetterHelp Editorial Team

Have you found that frequent waking is draining you of energy? The lack of sleep, combined with the frustration you may feel as a result, can impact both your physical and mental health.

If you are tired of having interrupted sleep at night, you’re not alone. According to the American Psychiatric Association (APA), around one-third of adults report at least some insomnia symptoms, whether it be trouble falling asleep or trouble staying asleep.

Below, we’ll explore the causes of insomnia and some strategies for improving your sleep.

Interrupted sleep can hinder your productivity

Do I have insomnia?

Therapists have discovered that the most common sleep concern is waking up in the middle of the night and not being able to fall back to sleep. Sometimes a sleep disorder is the cause, though there are health conditions such as sleep apnea that can prevent individuals from getting a night of quality, restful sleep. It may seem as if there may be a specific psychological reason behind waking up at 3 a.m. or similarly unhealthy hours. It’s estimated that 40% to 50% of all people with insomnia have a mental health condition.

According to the APA’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), insomnia disorder refers to a “predominant complaint of dissatisfaction with sleep quantity or quality, associated with one (or more) of the following symptoms:

  1. Difficulty initiating sleep.

  2. Difficulty maintaining sleep, characterized by frequent awakenings or problems returning to sleep after awakenings.

  3. Early-morning awakening with inability to return to sleep.”

To qualify as an insomnia disorder, this pattern must be present for at least three months.

Why can't I sleep? Different perspectives

There are various explanations for why you may have trouble falling or staying asleep.

Traditional Chinese medicine’s explanation

One of the main beliefs in traditional Chinese medicine is that the body’s internal organs work as a 24-hour clock, and each organ’s functions are heightened during certain parts of the day. For example, the stomach tends to carry out most of its functions between 7 and 9 a.m., and the bladder is usually most active between 3 and 5 p.m. Should there be consistent problems at a particular time of day, there may be something off with the associated organ.

The organ that tends to work the 1-3 a.m. shift is the liver. In most cases, the liver is acting up because it does not have enough glycogen to produce the energy your body needs to function, even while you are asleep because your body already spent most of its glycogen when creating adrenaline throughout the day. The body should not be generating adrenaline very often, but if it does, it is usually during times of stress, which can cause disruption in a person’s sleep patterns.


A lack of glycogen might be keeping you up, but the adrenaline that exhausted it may also be a contributing factor. Stress hormones don’t only cause challenges during the day; they also make it difficult for the body to fall asleep for people with high sleep reactivity. A lack of sleep also causes your body to produce more stress hormones, which in turn makes it harder to fall asleep.

Stress also makes it harder for you to sleep in other ways. Your body has ways of expressing stress that you might notice easily during the day, but they can be harder to catch at night. Nocturnal habits, such as clenching or grinding teeth, may be enough to wake you up in the middle of the night (and it’s terrible for your teeth).

Oftentimes, sleep maintenance insomnia and night sweats (or “trigger sweating”) are caused by stress and/or anxiety.

Alcohol and caffeine

Alcohol can cause drowsiness and it even makes it easier to fall asleep at night. However, it often doesn’t lead to a good night’s sleep. While it may put you out faster, alcohol can disturb the body’s natural sleep patterns in several ways, including messing with your internal body clock and making you need to get up and go to the bathroom more often. This could make it harder to fall back asleep overall.

Outside of alcohol, other drugs can interrupt sleep. Most of us know that caffeine can energize us, but many people don’t know how it works. Caffeine has a half-life of five hours. That means that if you drink two cups of coffee at two in the afternoon, you can still have quite a lot of it in your system even if you go to bed at 11 or 12. This could disrupt your nighttime sleep.


If it isn’t drinking that’s keeping you up, it could be eating. Eating late at night can cause your digestive system to work overtime, and that can lead to discomfort that wakes you up in the middle of the night—even out of a deep sleep. To avoid this, you might try to have your last meal around two to three hours before going to bed.


Our bodies have a sort of internal clock called the circadian rhythm that can be affected by our sleep environment. Before electricity, our bodies naturally set this rhythm-based on night-and-day cycles, among other factors. Although humans have had artificial light for quite some time, lighting can confuse our bodies as we set sleep schedules. If you stay up late or work after dark, all of the natural light may be confusing your body, altering your REM stage, and leading to sleep trouble.

If you need to stay up, you might try to use dimmer lights. You can also utilize light therapy if this is a concern for you. Sleep experts and therapists can explain more about this technique and how it can be useful for your sleep.


There’s a specific kind of light, called blue light, that might be doing even more damage. This kind of light comes from electronic devices like televisions, computers, and mobile phones. If you like to scroll through social media or watch videos in bed, cutting that habit may help you sleep better. If you sometimes need to check your phone at night, consider installing a blue light filter. Some phones come with this feature in the settings. If your phone doesn’t, you might look for an app that will do the job.

Getting your sleep back on track

To regain balance in the body’s system, it’s important to focus on the body functions involved in glycogen production.

  • Eat healthier meals and reduce the consumption of alcohol, junk food, and drugs like painkillers. This can help the liver better produce glycogen. 

  • Keep adrenaline at a low level throughout the day. This might mean cutting out sugar and caffeine from your diet and reducing the use of technology around bedtime. You can instead use that time to perform meditation breathing exercises or take a warm bath. This may reduce your stress, which can help keep adrenaline levels to a minimum and leave enough glycogen for the liver.

  • Balance blood sugar levels. To balance your blood sugar levels, you can try to eat meals regularly, but avoid foods with refined sugar and carbohydrates. Ideal foods to eat are foods with protein, such as nuts and oats.

  • Finally, if you’re having problems with waking up in the middle of the night and you recently changed your schedule, it could just be your body adjusting to your new routine. To address this, you can try to go to bed and get up at the same time every day and give your body a little more time to catch up.

If you’re still finding it difficult to get enough sleep, it may be a good idea to work with a therapist or consult your doctor. Doctors can assess whether underlying health conditions like high blood pressure or restless leg syndrome may be causing your difficulty falling asleep, and in some cases, they may prescribe sleep medicine.

How therapy can help you lead a healthier lifestyle

If it feels like there is something more pressing that is preventing a good night’s sleep, it may be helpful to consult a therapist. Frequent waking is a common complaint for many adults. You may experience feelings of solitude and loneliness, especially at 3 a.m., but you are not alone. There is relief to be found.

Many adults have found success in using therapy as an option to fight their lack of sleep at night. One of the most popular forms of psychotherapy is cognitive behavioral therapy (CBT), or CBT-I when it’s used for treating insomnia. In many situations, CBT has been found to be effective for treating sleep issues—often without the need for sleeping pills—by teaching individuals how to identify thoughts and behaviors that may contribute to sleep problems and replace them with healthier ones.

Getty/Vadym Pastukh
Interrupted sleep can hinder your productivity

A licensed counselor or therapist may be able to lead you to more restful night of sleep and a happier life. If you don’t like the idea of going to a therapist’s office, you can seek therapy online at BetterHelp. Online therapy has been found to be just as effective as in-person therapy in many situations, and it tends to be more flexible. You can connect with a licensed therapist via audio or video chat, and you can write to them in between sessions via in-app messaging at any time—even during the night. They’ll respond as soon as they can to any questions or concerns. 

Read below for some reviews of BetterHelp counselors.

Counselor reviews

“Really helpful and positive! Being able to type out what's bothering me when I can't sleep at night is very helpful to me, and usually, there's a reply by the morning!”

"I tried a few counselors and almost gave up until I found Colleen. I love her! She's easy to talk to, really gets me and best of all she makes me feel like I'm talking to a friend. She's given me some great tips and I'm sleeping better already most nights."


If you find yourself waking frequently, it could be due to stress, lack of exercise, a sleeping disorder, or another underlying problem. While there may be physical causes, mental health concerns can play a role too. With BetterHelp, you can be matched with a licensed therapist with experience helping people overcome insomnia. Take the first step to better sleep and reach out to BetterHelp.
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