Why Do I Keep Waking up at 3 AM and Can’t Get Back to Sleep?

It keeps happening—you wake up at 3:00 in the morning. While sleep experts recommend waking up at the same time each day, surely this is not what they had in mind. As the rest of the world slumbers through their golden hours of rest, the Sandman keeps calling a midgame time-out on you.

If this is an unwanted part of your nightly ritual, you probably wonder “Why me?” and “Why 3 AM, known as ‘the witching hour’ according to urban legend?” And you’re not alone. In spite of following sleep hygiene basics: limiting blue light, caffeine, eating, and exercise before bed; creating a cool and dark sleep environment; stress management; etc., this happens with recurrence to many people. Welcome to the 3 AM Club.

Your body’s repeat 3 AM wake-up call is a more than a nuisance. It is a sleep maintenance misfortune, creating a major challenge to meeting the recommended seven to nine hours of sleep per night for adults 24-64 (slightly more for younger adults and a bit less for those older).1 Further, insufficient sleep is considered a serious concern for public health, productivity, and safety.2 And due to disrupted “hunger hormones,” being a member of the 3 AM Club can take a toll on your waistline.3,4

So what is behind this sleep maintenance misfortune? First, make sure your healthcare practitioner rules out any possible medical contributing factors. Examples include arthritis, asthma, chronic pain, endocrine or gastrointestinal problems, or sleep apnea. Once these have been ruled out, you’re likely left pondering the many theories of what provokes the 3 AM phenomenon. Here are just a few ideas to consider:

  • It’s an ancestral thing. Our preindustrial ancestors slept much differently from how we do today. Without artificial light, they would sleep more in sync with the rising and setting of the sun. Further, according to historian and sleep expert Roger Ekirch, PhD, their natural sleep patterns were segmented or biphasic. They slept twice, following their body’s rhythm of what was called a “first sleep” and a “second sleep.”5 So is the 3 AM break related to sleep cycles?
  • Sleep cycles. A normal sleep pattern begins with about 4 to 4 ½ hours of a deep-sleep stage. Then the body shifts into the light sleep stage. During this stage, also known as the rapid eye movement (REM) stage, the brain is more active.6 So while it is normal to wake up several times every night, most awakenings are too brief to remember the next morning. That is unless they happen during the lighter sleep stage. But that still leaves the question: Why 3 AM?

  • The TCM body clock. The traditional Chinese medicine (TCM) “body clock” concept elucidates how energy moves through the body’s meridians and organs over a 24-hour cycle. Because of the mind-body-emotion interconnectedness central to Chinese medicine, these patterns reflect not only the health of each organ but also the emotions tied to a given organ. 7 In that model, every two hours energy is strongest within a particular organ and its functionality. The period between 1-3 AM is “showtime” for the liver and its metabolic activities.7

    Given that the liver is a major organ for detoxification, an episode of excess alcohol or a general toxic overload on the liver could be triggering the 3 AM wake-up call. Perhaps this is why so many individuals report sleeping better during and after cleansing protocols. Likewise, in TCM the liver is linked to emotional imbalance, such as explosive anger, bottled up emotions, frustration, and resentment. If these sound familiar, talk with your healthcare practitioner about meditation or counseling.
  • Hormones (of course). If you’re a menopausal woman waking up with hot flashes, the cause isn’t exactly a mystery. But hormonal imbalances, in general, may cause sleep disturbances.8 Because the liver metabolizes hormones, an overloaded, sluggish liver could thereby indirectly contribute to hormone-related sleep disturbances.9
  • Blood sugar. Workhorse that it is, the liver is our body’s blood sugar “warehouse manager,” converting glucose in the bloodstream into glycogen for storage.10 The liver breaks down the glycogen, releasing it into circulation during fasting periods, such as sleep.10 But even during sleep, the brain is still the body’s primary consumer of glucose.10 And if, in the wee hours of the morning, the liver’s glycogen supplies run low, the displeased brain sends cortisol as a messenger to get production back on track.10 And voilà, just like that, you’re awake. Often, a small amount of carbohydrate, such as some honey, is a simple remedy to hunger pangs, but reliance on a 3 AM snack is a bandage, rather than a solution. Consult your healthcare practitioner or a dietitian if your sleep disturbances appear to be blood-sugar related.

You may never know precisely why your body is waking at 3 AM. But if it is more than an occasional occurrence, blood sugar or hormonal imbalances or toxic load may be factors to consider, so you should discuss the issue(s) with your healthcare practitioner.

This information is for educational purposes only. This content is not intended as a substitute for professional medical advice, diagnosis, or treatment. Individuals should always consult with their healthcare professional for advice on medical issues.


  1. National Sleep Foundation. https://sleepfoundation.org/press-release/national-sleep-foundation-recommends-new-sleep-times. Accessed July 19, 2017.
  2. Center for Disease Control. https://www.cdc.gov/features/dssleep/index.html#References. Accessed July 19, 2017.
  3. Spaeth AM et al. Sleep. 2013;36(7):981-990.
  4. Patel SR et al. Am J Epidemiology. 2006;164(10):947-954.
  5. Kraft S. https://www.coveyclub.com/waking-up-3am-why/. Accessed December 24, 2018.
  6. State of Consciousness. http://facweb.furman.edu/~einstein/general/sleepdemo/sleep.htm. Accessed January 15, 2019.
  7. Turning Point Acupuncture. http://www.turningpointeacu.com/blog/2017/2/19/waking-up-at-the-same-time-each-night-the-chinese-medicine-body-clock-explains-why. Accessed December 24, 2018.
  8. Kravitz HM et al. Obstet Gynecol Clin North Am. 2018;45(4):679-694.
  9. Encyclopedia of Natural Medicine, 2nd Edition, by Michael Murray, ND, and Joseph Pizzorno; Prima Publishing; Rocklin, CA; 1998.
  10. Mahan KL et al. Food, Nutrition & Diet Therapy. Philadelphia, PA. Saunders. 2004.
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About Maribeth Evezich

Maribeth Evezich, MS, RD is a functional nutrition and therapeutic lifestyle consultant. Maribeth is also a graduate of Bastyr University and the Natural Gourmet Institute. Whether she is in her kitchen experimenting, at her computer researching, or behind the lens of her camera, she is on a mission to inspire others to love whole foods as much as she does. She lives in Seattle, is on the faculty of Bastyr University, and is the founder of Lifestyle Medicine Consulting, LLC and the culinary nutrition blog, Whole Foods Explorer. Maribeth Evezich is a paid consultant and guest writer for Metagenics.

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