Why Can’t I Sleep?

Why Do I Keep Waking Up in the Middle of the Night?

Maybe you’re reading this at 3 am, frustrated and hoping for an easy solution. If this is a common occurrence for you, then you might have a deeper mental or physical health problem. Making lifestyle changes and adapting your sleep schedule can help, as can addressing the core issue. 

Here are five reasons you keep waking up in the middle of the night. 

You Have a Sleep Disorder

A sleep disorder is a condition that disrupts normal sleep. People with sleep disorders have trouble falling asleep, staying asleep, getting restful sleep, or all three. 

Some common sleep disorders include: 

• Insomnia: Difficulty falling asleep, staying asleep, or waking too early, leading to daytime fatigue. Insomnia can be a primary diagnosis or may be a sign of a different issue.
• Obstructive Sleep Apnea (OSA): Breathing repeatedly stops and starts during sleep due to airway blockage, often causing loud snoring, poor sleep quality, and waking up in the night.
• Central Sleep Apnea: Breathing interruptions occur because the brain fails to send proper signals to the muscles that control breathing. Results in poor sleep quality and waking in the night. 
• Narcolepsy: A neurological disorder causing excessive daytime sleepiness, sudden sleep attacks, and sometimes muscle weakness (cataplexy).
• Restless Legs Syndrome (RLS): An uncontrollable urge to move the legs—often described as uncomfortable sensations—primarily at night.
• Circadian Rhythm Sleep-Wake Disorders: Misalignment between a person’s internal clock and the external environment. Examples include delayed sleep phase, jet lag, and shift work disorder. Sometimes these are circumstantial (like just getting off a 12-hour flight) and will go away on their own; other times, they require professional help.

A sleep disorder can be treated by a doctor. 

You Have a Mental Health Disorder

Physical health disorders aren’t the only ones that can cause sleep disruptions. These mental health disorders are known for disrupting sleep:

• Anxiety: If you wake up with your mind racing or drenched in sweat from another panic attack or nightmare, then you might have an anxiety disorder. PTSD, generalized anxiety, and phobias are all common types of anxiety that make it difficult to fall and stay asleep.
• Depression: Studies have shown that people with depression are more likely to find it difficult to fall asleep and stay asleep. Changes in hormones and general feelings of hopelessness and sadness are considered to contribute to this. 
• Schizophrenia: This disorder is known to cause circadian rhythm disruptions. Delusions and hallucinations can also make it hard to fall asleep or fall back asleep once woken. 
• Bipolar Disorder: The manic stage of Bipolar Disorder is characterized by excessive energy and little need for sleep. 
• ADHD: People with ADHD are more likely to have trouble falling asleep, staying asleep, and getting a good quality of sleep. Restlessness, racing thoughts, and hyperactivity can make it difficult to go to sleep. And many people with ADHD have a delayed circadian rhythm, meaning their body wants to go to bed later than most people. Forcing your body to sleep when its circadian rhythm doesn’t want to can make it difficult to fall and stay asleep. 

In general, inefficient sleep is one major sign of a mental health issue. Sleep issues alone cannot diagnose a mental health condition, and they can point to many different types. Get assessed by a therapist to determine if you’re struggling with your mental health.

Biological Changes

Changes to your age and hormones can have a big impact on your sleep schedule and quality. For example, pregnancy commonly disrupts sleep schedules. Many expectant mothers have trouble falling asleep and staying asleep, and they may be prone to waking up in the middle of the night.

Bad Sleep Hygiene

Sleep hygiene is the habits that surround bedtime, going to bed, and sleeping. Examples of bad sleep hygiene routines include:

• Using phones, tablets, or screens right before bed
• Drinking caffeine or energy drinks late in the day
• Eating large meals close to bedtime
• Irregular sleep schedule (different bed/wake times every day)
• Napping too long or too late in the afternoon
• Exercising intensely right before bed
• Using the bed for activities other than sleep (like work or TV)
• Sleeping in a noisy, bright, or uncomfortable environment
• Consuming alcohol or nicotine before bedtime
• Going to bed stressed without winding down first

These are lifestyle changes that can be made to improve sleep quality. 

Circadian Rhythm is Off

We’ve mentioned circadian rhythm a few times— what is it? 

Circadian rhythm is our body’s natural 24-hour cycle. It is usually aligned with the sun. When the sun begins to set, the brain signals that it’s time to go to bed by releasing melatonin, slowing the heart rate, and decreasing body temperature. 

Sleep disorders can knock your circadian rhythm off. So can certain medications. Sometimes, artificial light or not getting enough natural sunlight can also confuse your body. 

Optimizing your circadian rhythm is one way to improve sleep and stop waking up in the middle of the night. Let’s explore how. 

How to Stop Waking Up in the Middle of the Night

Knowing why you keep waking up at 3 am is important. It’ll help you decide your next course of action. 

If you have a mental or physical health issue, getting a diagnosis and treatment is the first step. From there, you can optimize your sleep schedule by taking these steps: 

1. Sync Your Circadian Rhythm

If your circadian rhythm feels off (you stay up super late or wake up super early, you’re waking up in the middle of the night, or you’re exhausted in the middle of the day), you might need to reset it. Here are some tips to do so:

• Set a strict daily routine: Schedule when you work, eat, exercise, and wind down for the day. You can get more lax with it later on, but for a few weeks, try to be diligent about providing your body a healthy structure.
• Get outside when it’s sunny as much as possible. Take a meal outside, just sit outside, or even lounge in a window that has access to direct sunlight. 
• Get daily exercise. Even a 20-minute walk can help your body’s circadian rhythm.
• Avoid caffeine and nicotine, especially after noon. These can delay the circadian rhythm, making you stay up later. 
• Limit your screen time before bed. Blue light can also delay the circadian rhythm because it mimics sunlight in our brains.

Don’t be surprised if your circadian rhythm changes as the seasons change, too. Many people find they need more sleep during the winter. That’s because your body is adjusting to the lower amounts of daylight. 

2. Practice Good Sleep Hygiene

Some habits you can practice for good sleep hygiene include:

• Keep a consistent sleep schedule, even on weekends
• Create a relaxing pre-bed routine (reading, stretching, dim lights)
• Limit screens at least 30–60 minutes before bed
• Keep your bedroom cool, dark, and quiet
• Avoid caffeine, heavy meals, and alcohol close to bedtime
• Use your bed only for sleep and relaxation
• Get regular daytime exercise and natural light exposure
• Limit naps to short, early-day sessions if needed

Try to treat your bedroom like a sanctuary for sleep, and sleep only. Make it comfortable and relaxing, whatever that means to you. Some people like using a lavender spray on their pillow. Others enjoy sleep music. Some people like big, comfy beds with lots of pillows. Others find a minimalist approach to be best. 

When it comes to creating your sleep routine, don’t be afraid to experiment. There are a lot of suggestions out there, but it might take some trial and error to understand what your body needs. 

Click here for a complete guide to Good Sleep Hygiene.

3. Try Sleep Medicine

Sometimes, sleep medicine can help you get the sleep you need to even begin implementing some of these strategies. Extreme sleep deprivation can eventually kill you, so using medication to assist in getting enough sleep is a good idea if you’re chronically sleep-deprived. 

Some sleep medicine to talk to your doctor about includes:

• Silenor
• Restoril (short-term use)
• Halcion (short-term use)
• Rozerem
• Desyrel

Many of these medications can cause addiction and dependence, so it’s important to always take them under the supervision and guidance of a medical professional. 

4. Time Your Sleep Cycle

Did you know your body sleeps in cycles, too? Throughout the night, the body will go to 4 stages of sleep. 

• Stage 1 (N1 – Light Sleep): This is the transition from being awake to sleeping. Muscles relax and breathing slows down. You can easily wake up during this stage.
• Stage 2 (N2 – Light/Moderate Sleep): Your heart rate and body temperature drop. This stage makes up most of your total sleep and helps with memory and overall rest.
• Stage 3 (N3 – Deep Sleep / Slow-Wave Sleep): This is the deepest, most restorative non-REM sleep. It's hard to wake up from this stage. The body repairs tissues, builds bone and muscle, and strengthens the immune system.
• Stage 4 (REM Sleep – Dream Sleep): Brain activity increases, vivid dreaming happens, and muscles are temporarily paralyzed. REM sleep supports learning, memory, and emotional processing.

These stages repeat in cycles throughout the night, usually four to six times. Every cycle takes around an hour and a half to complete. Therefore, it can be useful to plan your morning alarm for when you’re coming out of REM sleep. 

Calculate about when you’ll go to bed. Most doctors recommend around 8 hours of sleep, so aim for either 7.5 hours or 9 hours of sleep to wake up on your sleep cycle. 

You can also set an alarm an hour and a half before you wake up. This is just to reset your sleep cycle, so you get 1 more complete sleep cycle before you wake up. This is only recommended if you are confident you can fall back asleep. 

5. Practice Progressive Muscle Relaxation

Progressive Muscle Relaxation is a great mindfulness way to calm your body and promote feelings of sleepiness and relaxation. 

It’s easy to do, too, and can be done lying down. 

Get comfortable in bed. Close your eyes. Start at the top of your head and clench every facial muscle as tight as you can. Hold it for a second and then slowly release it. Notice the tension melting away. Do the same down your arms, in your core, your legs, and finally your feet. 

Click here for a complete Progress Muscle Relaxation for Sleep Script.

6. Address Underlying Anxieties

Stress is one of the biggest disruptors of sleep. When your body is releasing cortisol well into the night, it’s going to want to stay up, and may even wake you up at 3 am to tell you about that super-urgent to-do list item. 

If you wake up in the middle of the night anxious, write down what you are stressed about. Putting it on pen and paper tells your mind, “I hear you. This is an issue. I will deal with it in the morning. I won’t forget.” 

Then, in the morning, deal with the things that are stressing you out. Setting boundaries and taking steps to promote relaxation are good ideas if you are facing something out of your control, too.

Too anxious to sleep? Read our blog on the 5 best anxiety-beating strategies. 

What To Do When You Can’t Sleep

Waking up at 3 am? Or maybe you’re waking up drenched in sweat in the middle of the night and feeling unable to fall back asleep? 

These are common experiences, but that doesn’t mean they’re not frustrating! As the time to your alarm creeps closer and your eyes remain wide open, you start getting desperate. What can you do? 

Here are some things you can do when you’re awake at 3 am and can’t sleep:

• Get out of bed and do something relaxing. (Some people find getting work done to also be a helpful strategy, but try to avoid screens. If you have to use screens, put a blue light filter on it.) Head back to bed when you’re feeling sleepy again.
• Write down what you’re worried about.
• Read a book.
• Do a body scan meditation.
• Do some gentle stretching.
• Drink some tea, but avoid caffeine.

Remember that everybody is different! People have different circadian rhythms and sleep needs. Some people thrive late at night. Others want to be in bed by 9 at the latest. 

There is no right or wrong answer when it comes to sleep. As long as you’re getting enough of it, it’s restful and restorative, and you’re finding it via healthy means, then you’re well on your way to good sleep. 

Need some help finding the right sleep routine for you? Contact Lifebulb Counseling. We have therapists who can diagnose and treat mental health disorders, work with doctors to treat sleep disorders, and help you optimize your sleep schedule for the highest quality of restful sleep. 

We accept most major insurances and have little to no wait time. 

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