24-04-2025
Why You Keep Waking Up at 3 a.m.—And What Your Body's Trying to Tell You
According to a 2025 U.S. News and World Reports survey, a whopping 89% of adults in the U.S. wake up regularly during the night. This shows that falling asleep is only half the battle when it comes to getting adequate rest; staying asleep presents its own challenges.
According to sleep doctors we talked to, there are several different reasons why this happens; there isn't one universal cause. But in every instance, it can be frustrating and often hard to fall back asleep. Here, sleep doctors share the different reasons why people wake up in the middle of the night and their tips for what to do if you can't fall back asleep.
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If you like to wind down in the evening with an alcoholic drink, your relaxing habit may be sabotaging your sleep. 'Alcohol can disturb sleep,' says Dr. Richard Schwab, MD, the Chief of the Division of Sleep Medicine and a professor at the University of Pennsylvania Perelman School of Medicine. 'While alcohol can help someone fall asleep faster, it causes an increase in heart rate, which leads to sleep disturbances in the second half of the night."
He explains that this happens with every type of alcohol; it doesn't matter if it's whiskey, wine, beer or something else, saying, 'When alcohol is metabolized in the body, it increases body temperature. This causes the heart to beat faster, which is likely the reason why it can interrupt sleep."
Dr. William Lu, MD,the Medical Director at Dreem Health, also says drinking alcohol can lead to waking up in the middle of the night.
"Avoiding alcohol is always beneficial for your sleep," he explains. "You may be able to fall asleep easier with alcohol, but in the back half of the night, alcohol has a stimulating effect which in turn can cause earlier wakeups. It is also known that alcohol decreases the amount of deep sleep that you get causing you to feel more tired and less refreshed in the morning."
Scientific research backs up the connection between alcohol and sleep disturbances, showing that alcohol disrupts sleep in several ways, including interrupting circadian rhythm, increasing breathing-related sleep events such as snoring and triggering insomnia. Dr. Schwab explains that alcohol interferes with REM sleep, which is important for maintaining optimal brain health.
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Both doctors say that many common medications—both over-the-counter drugs and prescription medications—are associated with sleep disturbances. Dr. Schwab says this includes antidepressants, corticosteroids (which are used to treat arthritis, inflammatory bowel disease, asthma and allergies, among other health conditions), beta blockers for hypertension, antihistamines, decongestants and Alzheimer's medications.
Additionally, Dr. Schwab says that Benadryl can cause sleep disturbances. He explains taht some people with insomnia take Benadryl because it can help them fall asleep, but he emphasizes that this medication can lead to waking up in the second half of the night. This also happens with many other 'PM' medications, like Tylenol PM.
If a medication is causing you to have sleep disturbances, Dr. Schwab recommends taking it in the morning instead of at night. If the problem persists, talk to your healthcare provider.
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If you consistently wake up in the middle of the night, you could have sleep apnea, a sleep disorder that roughly 30 million Americans have. 'Sleep apnea causes a lot of sleep fragmentation and a lot of people don't know they have it, especially if they sleep alone,' Dr. Schwab explains.
Symptoms of sleep apnea include loud snoring, times when you stop breathing during sleep, gasping for air during sleep, waking up with dry mouth, morning headaches and feeling sleepy during the day. If you think you have sleep apnea, talk to your healthcare provider.
Sleep apnea isn't the only health condition that can lead to waking up in the middle of the night. Dr. Schwab says that chronic heartburn, chronic pain, COPD or lung disease and other chronic conditions can all cause sleep disturbances. Additionally, menopause symptoms such as night sweats can make it hard to stay asleep. If any of these health conditions are disrupting your sleep, talk to your doctor about possible solutions.
Dr. Schwab points out that there are all sorts of environmental reasons why you may wake up in the middle of the night too. Pets, kids, leaving the TV on at night and outdoor noises can all lead to waking up in the middle of the night.
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Waking up in the middle of the night is frustrating enough, but when you can't fall back asleep, it's even more annoying. If this happens, Dr. Schwab says reading a book in very low light until you get sleepy may be a better solution than lying in bed in frustration.
"I encourage people to get out of bed and to go somewhere different such as the couch or another room. Do some quiet activities until you begin feeling sleepy again and then go back to bed to try to sleep again," Dr. Lu adds.
If you wake up tired because you didn't sleep well the night before, Dr. Schwab says to resist the urge to nap, which could lead to yet another night of poor sleep. Having general good sleep hygiene tips in place can also help with sleep, he explains. With this in mind, avoid using electronics in the evening, don't sleep with the TV on and keep your bedroom dark and cool.
Not getting enough sleep greatly impacts both physical and mental health. If you are struggling to get good, consistent sleep, it's worth it to pinpoint the reason why and troubleshoot from there. That way, you can wake up each day truly well-rested and ready for anything the day brings.
Up Next: Dr. Richard Schwab, MD, Chief of the Division of Sleep Medicine and a professor at the University of Pennsylvania Perelman School of Medicine
Dr. William Lu, MD, sleep medician physician and Medical Director at Dreem Health
America's Sleepless Nights: Stress, Screens, and the Search for Rest in 2025 [Survey Report]. US News and World Reports
Alcohol and Sleep-Related Problems. Current Opinions in Psychology. 2020
REM Sleep: What Is It and Why It's Important. Sleep Foundation
Are your medications keeping you up at night? Harvard Health
What doctors wish patients knew about sleep apnea. American Medical Association.
Sleep apnea. Mayo Clinic