Ever find yourself wide awake in the early hours, unable to re-enter the land of nod? Many women struggle with 3am wake-ups. Here’s what might be causing them and how to take action.
For Lucy Clark, it’s thoughts of work that often keep her from slumber.
“I may mull over things I'm stressed about and on some occasions I won't go back to sleep at all,” says the 33-year-old publicist, who has “struggled” with sleep on and off since her early 20s.
“[I] will go through stints of the classic 3 or 4am wake up,” she says.
The state of women’s shut-eye isn't great, with results of our 2021 national sleep survey showing 41% of women rated their sleep quality as poor, compared to 32% of men.
Psychologist and CEO of the Sleep Health Foundation Moira Junge says that waking in the very early morning hours is not only common, “it can be considered normal”.
“Sleep studies show us that people can wake during the night often [and for healthy sleepers, it’s a non-event].” These people, she explains, generally go back to sleep effortlessly with no memory of the wakening. They don’t check the time or consider themselves a poor sleeper.
According to Dr Junge, the problem occurs when there is a difficulty returning to sleep, in other words, insomnia.
There are plenty of reasons for early morning insomnia, such as chronic pain and other underlying health concerns. However, in Dr Junge’s experience, “anxiety is the most common [reason]”.
When we are overly stressed, we are too “wired” and “alert” for sleep, says Dr Junge. If the heightened stress and disrupted sleep persist, she says “what generally happens is the primary problem becomes the worry of not sleeping”.
As difficult as it may be, “it’s important not to stress about not sleeping or associate sleeping with stress”, she adds.
With its power to send us to sleep quickly, alcohol appears the perfect sleep aid. But according to Steve Allsop, professor at Curtin University’s National Drug Research Institute, “we do not get quality sleep under alcohol’s influence”.
Alcohol can “increase the speed of falling asleep, [but] it suppresses or reduces rapid eye movement (REM) sleep, which is essential to sleep health and waking refreshed”, he says. The drink also increases urine production, meaning night-time trips to the loo, plus large amounts can affect the respiratory system, promoting snoring and poor sleep, adds Prof Allsop.
As for how many drinks it takes to disrupt sleep, Prof Allsop says “even modest amounts of alcohol can have an impact”. Ultimately, he recommends factoring your alcohol consumption into your sleep plan, having a few alcohol-free days each week and observing the drinking guidelines.
Research shows that around 56% of women report ongoing insomnia in the lead-up to their final menstrual period (perimenopause).
Disrupted sleep around the time of menopause makes sense. Many women experience hot flushes, night sweats, migraines, mood changes and other symptoms that can affect their daily lives.
Studies also show that cases of obstructive sleep apnoea increase around this time, with weight gain and hormonal changes at menopause a possible reason. Obstructive sleep apnoea occurs when the muscles in the throat relax during sleep, stopping the person from breathing. Snoring is one of the signs of the condition.
In addition, Dr Junge says this stage of life can be demanding, with many women juggling ageing parents, dependent children and work. She recommends keeping active and being mindful that once menopause symptoms settle, sleep problems and any sleep-related anxiety can linger if we’re not careful.
Listen to a podcast on menopause and sleep, featuring Jean Hailes endocrinologist Dr Sonia Davison.
In some cases, early morning sleep troubles are driven by a bedtime schedule that is out of sync with the body’s circadian rhythm, or internal ‘clock’. Dr Junge points to shift workers who may experience this problem.
To promote a healthy circadian rhythm, she says we should ideally expose ourselves to light during the waking period and darkness as the sun sets. To do the latter, she recommends using dim lighting and avoiding screen time before bed.
Unsurprisingly, poor sleep can affect almost every aspect of our lives. “When sleep-deprived, the part of the brain that ties emotions to memories, the amygdala, doesn’t function properly, which means reactions will be more intense in some situations,” says Alisha Guyett, PhD candidate in Flinders University’s sleep health division.
She says that insufficient shut-eye affects memory, mood regulation and judgment. “From a physical perspective, sleep allows the body to restore its immune system. If we reduce the amount of sleep, our bodies can be more susceptible to illness.”
So how do you address those 3am wake-ups?
It’s important to identify the cause of the insomnia, of which there are many. If your sleep issues are persistent or concerning, seek medical advice.
If medication or a medical condition isn’t driving the problem, these tips from Dr Junge might help: