Sleep is a basic human need that is important for maintaining physical and mental health. However, not everyone can sleep soundly and with quality. There are some people who experience sleep disorders, one of which is often waking up at 3 or 4 in the morning and having difficulty falling back asleep.
Frequently waking up at 3 or 4 a.m. can be caused by various factors, both related to sleep cycles, psychological conditions, and medical conditions. Here are some common causes and their explanations based on journals and research.
A. Sleep Cycle
The sleep cycle is the stages experienced by the body during sleep, which consists of four phases, namely:
Phase 1
The transition from wakefulness to sleep, which lasts about 5-10 minutes. In this phase, the body begins to relax, heart rate and breathing slow down, and muscles tense.
Phase 2
Light sleep, which lasts about 20-30 minutes. In this phase, brain activity decreases, body temperature drops, and eye movements stop.
Phase 3
Deep sleep, which lasts about 30-40 minutes. In this phase, the body enters the recovery stage, blood pressure and heart rate decrease, and the immune system is strengthened.
Phase 4
Rapid eye movement (REM), which lasts about 10-20 minutes. In this phase, the brain becomes active, dreams occur, the eyes move quickly, and the body’s muscles become limp.
This sleep cycle repeats throughout the night, with each phase varying in length. Typically, deep and REM sleep phases become longer and more intense as the morning progresses. This means that if someone wakes up at 3 or 4 a.m., they may have been disturbed while in deep or REM sleep, which is the most important phase of sleep for health and well-being. (sehatq.com)
Research conducted by Murray et al. (2023) shows that the body’s neurobiological system reaches a turning point around 3 or 4 am, which is called the circadian clock2. The circadian clock is the body’s biological rhythm that regulates the sleep and wake cycle, which is influenced by light and dark.
At this turning point, the body begins to prepare itself to wake up, by increasing levels of the hormone cortisol, which functions as a stress hormone. (secan.id)
If someone has high levels of stress, their cortisol levels can rise faster and higher than normal, causing them to wake up earlier and have difficulty falling back asleep.2 Additionally, if someone has an irregular sleep cycle, such as due to shift work, jet lag, or insomnia, their circadian clock can be disrupted, causing them to wake up at inappropriate times. (detik.com)
B. Psychological Conditions
Psychological conditions related to emotions, moods, and thoughts can also be the cause of frequent waking up at 3 or 4 am. Some common psychological conditions are:
1. Stres
Stress is the body’s response to pressure or challenges that are perceived as threatening or beyond one’s capabilities. Stress can be caused by a variety of things, such as work, relationships, school, health, or finances. Stress can trigger a fight-or-flight response, which causes the body to release the hormones adrenaline and cortisol, which increase heart rate, blood pressure, and alertness.
If stress persists, the body can develop chronic stress, which can disrupt sleep cycles and cause someone to wake up at 3 or 4 a.m.
2. Emergency
Anxiety is an excessive and irrational feeling of fear, worry, or nervousness about something uncertain or dangerous. Anxiety can be caused by various things, such as trauma, phobias, panic disorders, or obsessive-compulsive disorders. Anxiety can make it difficult for someone to relax, calm down, and fall asleep.
Anxiety can also cause someone to overthink, which is thinking about negative things repeatedly, which can disrupt sleep and cause someone to wake up at 3 or 4 in the morning.
3. Depression
Depression is a mood disorder characterized by feelings of sadness, hopelessness, or worthlessness that persist and interfere with daily activities. Depression can be caused by a variety of things, such as genetics, environment, hormones, or painful life events.
Depression can change the balance of brain chemistry, which affects the sleep cycle. Depression can cause someone to experience insomnia, which is difficulty falling asleep or staying asleep, or hypersomnia, which is excessive sleeping.
Depression can also cause someone to wake up at 3 or 4 in the morning and feel unenergetic or unmotivated.
C. Medical Conditions
Medical conditions related to the body’s physical, organ, or system can also be the cause of frequent waking at 3 or 4 a.m. Some common medical conditions are:
1. Restless leg syndrome
Restless legs syndrome is a neurological disorder characterized by an irresistible urge to move the legs, usually while resting or sleeping. Restless legs syndrome can be caused by a variety of things, such as iron deficiency, pregnancy, kidney problems, or certain medications.
Restless legs syndrome can make a person feel uncomfortable, restless, or painful in the legs, which disrupts sleep and causes a person to wake up at 3 or 4 in the morning.
2. Sleep apnea
Sleep apnea is a respiratory disorder characterized by repeated cessation of breathing during sleep, usually accompanied by loud snoring. Sleep apnea can be caused by a variety of things, such as obesity, large jaw, tonsils, or tongue, or narrowing of the airway.
Sleep apnea can cause a person to experience hypoxia, a lack of oxygen in the blood, which can trigger the body’s stress response and cause a person to wake up at 3 or 4 in the morning.
3. Acid reflux
Acid reflux is a condition characterized by stomach acid rising into the esophagus, which can cause a burning sensation, pain, or nausea in the chest or throat. Acid reflux can be caused by a variety of things, such as overeating, eating spicy, acidic, or fatty foods, drinking alcohol or coffee, smoking, or stress.
Acid reflux can disrupt sleep and cause someone to wake up at 3 or 4 a.m., especially if they sleep in a flat position or on their right side, which makes it easier for stomach acid to rise into the esophagus.
D. How to Overcome Frequently Waking Up at 3 or 4 in the Morning
Frequently waking up at 3 or 4 in the morning can disrupt a person’s sleep quality and health. Therefore, it is important to know how to overcome this problem. Here are some ways that can be done, namely:
1. Maintain sleep hygiene
Sleep hygiene is a collection of good habits and practices to improve sleep quality. Some examples of sleep hygiene are:
- Establish a regular and consistent sleep and wake schedule that aligns with your body’s circadian clock.
- Avoid naps, especially in the afternoon or evening, which can disrupt the nighttime sleep cycle.
- Avoiding caffeine, alcohol, nicotine, or stimulant drugs, especially in the afternoon or evening, which can make it difficult to fall asleep or wake you up in the middle of the night.
- Avoid overeating, especially spicy, sour, or fatty foods, especially at night, which can cause acid reflux or indigestion.
- Create a comfortable, dark, cool, and quiet sleeping environment, which can help the body relax and fall asleep.
- Avoid using gadgets, television, or activities that stimulate the brain, especially before bed, which can interfere with the production of the hormone melatonin, which functions as a sleep hormone.
- Doing calming activities, such as reading a book, listening to music, meditation, or yoga, before bed, can help reduce stress and anxiety.
2. Overcoming psychological conditions
If someone is experiencing severe or chronic stress, anxiety, or depression that interferes with their sleep and daily activities, they should seek professional help, such as a psychologist, psychiatrist, or counselor. They can help a person identify and address the causes and effects of their psychological condition, through therapy, counseling, or medication, depending on their individual needs and circumstances.
3. Treating medical conditions
If someone is experiencing restless legs syndrome, sleep apnea, acid reflux, or another medical condition that is interfering with sleep, they should consult a doctor. A doctor can help diagnose and treat the medical condition, through a physical examination, lab tests, or sleep tests, depending on the individual’s symptoms and cause.
A doctor can also recommend or prescribe medications, breathing aids, or lifestyle changes, which may help manage the medical condition.
E. Conclusion
Frequently waking up at 3 or 4 am is a problem that can be caused by various factors, both related to the sleep cycle, psychological conditions, and medical conditions. This problem can interfere with a person’s sleep quality and health, so it is important to know how to overcome it.
Some ways that can be done are maintaining sleep hygiene, overcoming psychological conditions, and overcoming medical conditions, according to the causes and conditions of each.
F. Bibliography
- National Sleep Foundation. (2020). What Happens When You Sleep? Retrieved from https://www.sleepfoundation.org/how-sleep-works/what-happens-when-you-sleep
- Murray, G., Nicholas, C. L., Kleiman, J., Dwyer, R., Carrington, M. J., Allen, N. B., & Trinder, J. (2023). Nature’s clock and human mood: The circadian system modulates reward brain regions. Emotion, 13(5), 976-984. https://doi.org/10.1037/a0033833
- National Institute of General Medical Sciences. (2020). Circadian Rhythms. Retrieved from https://www.nigms.nih.gov/education/fact-sheets/Pages/circadian-rhythms.aspx
- American Psychological Association. (2020). Stress effects on the body. Retrieved from https://www.apa.org/topics/stress/body
- Anxiety and Depression Association of America. (2020). Sleep Disorders. Retrieved from https://adaa.org/understanding-anxiety/related-illnesses/sleep-disorders
- Mayo Clinic. (2020). GERD. Retrieved from https://www.mayoclinic.org/diseases-conditions/gerd/symptoms-causes/syc-20361940
