Why We Wake Up at 3 A.M.

A Conversation with Lindsay Scola, Sleep Advocate and Writer

Guest: Lindsay Scola — Writer, Speaker & Sleep Advocate

Host: Natalie Walton — GM, BetterSleep

Topic: Middle-of-the-night wakeups: what's normal, what's a signal, and what to do in the moment

Introduction

Natalie: Welcome back, sleepers, to our ongoing series of conversations with sleep experts — from doctors to writers to the people who spend their lives helping us understand what's going on in our minds at night. I'm your host, Natalie Walton, GM of BetterSleep. And I'm so pleased to have Lindsay Scola with us today. Lindsay is a writer, speaker, and sleep advocate who helps people understand their sleep without shame, pressure, or impossible routines. She blends science, lived experience, and humor to make sleep your biggest power move. Hello, Lindsay — welcome. It is so great to have you here today.

Lindsay: I am thrilled to be here. Thank you so much for having me.

Natalie: Today we're going to talk about something so many of us experience but rarely understand: waking up in the middle of the night. Why it happens, why it's often completely normal, and how to tell when it might be a signal worth paying attention to. Let's begin with a reality check, because the numbers are fascinating. Waking up in the middle of the night is incredibly common — one U.S. study found that about 35% of people wake up at least three times a week, and a similar study across several European countries found nearly one-third of people report the same thing. Lindsay, why is this such a recurring phenomenon for so many of us?

Why Middle-of-the-Night Wakeups Are Normal

Lindsay: Waking up in the middle of the night is completely normal — we were actually biologically programmed for it. If you think back thousands of years when we were living in caves, we needed to know when the lions were coming in so we could grab our people and get out. Very heroic. Fast-forward to now, we still have lions — they just look a little different. They're work stress, or things with family. Even good stress can manifest the same way in our sleep. Our brain doesn't really know the difference between being excited about an upcoming wedding or a memo that's due next Thursday that you have no idea how to write.

Lindsay: What's happening overnight is a temperature shift. Our bodies really like cold to sleep, so our temperature drops in the evening to help us fall asleep more easily, and we reach our coldest point between about 2 and 4 in the morning. Around that time, our cortisol also starts to naturally rise so we can wake up later. So there's a bit of a temperature rise and a bit of a cortisol rise, which makes our sleep lighter at this time. If we already have cortisol in our system from stress, we're going to wake up. The wake-up isn't the problem — it's the spiral that comes after that keeps us awake in the middle of the night.

Segmented Sleep: How People Used to Rest

Natalie: What's even more interesting is that before the Industrial Revolution, people didn't even try to sleep straight through the night. They followed what's called segmented sleep. Can you tell us more about that pattern and why it used to be considered normal?

Lindsay: We used to have a kind of cosmic playlist when it came to our sleep. We rose with the sun and rested with the dark. Then Thomas Edison came along and gave us — thankfully — electricity, so that you and I could be on our computers talking to each other right now across the continent. But along with that came some sacrifices.

Lindsay: Before we had electricity in the house, people went to bed as soon as it got dark. They'd wake up in the middle of the night and be up for a couple of hours — they'd spend time with family, they'd read, they'd pray, they'd have sex, whatever people did before the internet. Then they'd go back to sleep and wake up again with the sun. This was the concept of "two sleeps," and it was completely normal. Then came the Industrial Revolution and electricity in the home, and we started getting a condensed work schedule — and with that, our sleep got condensed into a single time period as well. But just because we've evolved doesn't mean our body doesn't have a memory of what used to happen.

Where the Misconception Comes From

Natalie: If waking up in the night is part of our history and biology, where did the misconception come from that it's not normal?

Lindsay: We kind of never learned about sleep — this thing we spend a third of our life doing. No one ever taught us about it. Think back to elementary school: we learned about the food pyramid. Depending on how old you are, some of us learned how to balance a checkbook. But we never learned what sleep should feel like or what's going on. And we don't really talk about it.

Lindsay: So we tend to make it feel like it's our fault when it happens — especially with middle-of-the-night wakeups. What usually happens is we're in our amygdala, our fight-or-flight place. That's really great for getting you out of a burning car or saving the family from lions. It's not great for rational decision-making. This tends to be the place where we tell ourselves that we did this — we messed something up, we woke up in the middle of the night, we're never going to sleep again. Next thing you know, it's been two hours, we're wide awake, the alarm is going to go off in 45 minutes, and what do we do?

Lindsay: We have to do some education for ourselves that, one, this is totally normal. And then there are some really helpful tools we'll get into about what to do as soon as you wake up, so you can roll back over and go to sleep versus spending hours awake and revving yourself up.

When Nighttime Wakeups Become Something to Investigate

Natalie: When do nighttime wakeups move from normal sleep stuff into something worth looking at more closely?

Lindsay: If you're occasionally waking up in the middle of the night, remind yourself that's normal. But if you're constantly waking up — say, needing to pee multiple times a night — this could actually be a symptom of sleep apnea. We've all heard about snoring and gasping, but that isn't always the case. For a lot of women especially, needing to use the restroom multiple times at night is actually a symptom of sleep apnea.

Lindsay: Think about it: right now, you and I are talking, our airways are open, our brain is telling us we're awake. When you have sleep apnea and the airway closes, your body sends a signal — "oh my god, I can't breathe" — and it opens the airway back up. Sometimes this wakes us up, sometimes it doesn't. But think about the first thing you do in the morning: your system relieves itself. If you're continually waking up throughout the night, your system wants to relieve itself. That's one red flag.

Lindsay: Another red flag: some sleep disorders cause fractured sleep. You can fall asleep fine, but you can't stay asleep. If you're constantly waking up and nothing is necessarily going on — you're not spinning about anything, you just find yourself wide awake and feel like you have very little control over when you sleep — those are times when it's good to see a sleep specialist.

Lindsay: A sleep specialist is a doctor specifically trained on diagnosing and treating sleep disorders, which are actually pretty common. About one in five of us has a sleep disorder, and only about 18% get diagnosed. That's millions of people worldwide in need of medical attention who have no idea.

Sleep Quirk or Sleep Alert?

Natalie: Now we're going to play a quick round of a game we're calling "Sleep Quirk or Sleep Alert." I'm going to read some 3 a.m. scenarios, and you'll tell us whether they're normal sleep quirks or whether someone should raise an eyebrow and take notice. Let's jump in.

Lindsay: Yes!

Scenario 1: "I wake up once or twice a week but fall back asleep within 20 minutes."

Lindsay: Totally normal — and that's our goal. When you wake up in the middle of the night, if you've been awake for more than 20 minutes, you'll want to get out of bed to give yourself a reset. But if you're just waking up and rolling over and going back to sleep, nothing to worry about.

Scenario 2: "I wake up every single night and I'm up for an hour or more."

Lindsay: We'll talk about this in a minute with some tools. If you try the tools and the long wakeups start fading, nothing to worry about. If it's happening for a long period of time, it's worth seeing a sleep specialist to check if something else is going on.

Scenario 3: "I wake up at 3 a.m. drenched in sweat."

Lindsay: This can be a sign of perimenopause and menopause affecting sleep — absolutely normal, not pleasant, but nothing to worry about. And if someone tells you there's nothing you can do to improve sleep during perimenopause and menopause, that's absolutely wrong. There are lots of things you can do.

Lindsay: I really recommend having a toolkit ready. If you're starting to have hot flashes, look into moisture-wicking sheets and pajamas — because if you're waking up drenched and you're keeping your room cool (which gives us the best sleep), you can get really cold later and that affects your sleep. Wicking moisture away makes you more comfortable. I also suggest having separate blankets from your bed partner, so you can throw off a blanket and go back to sleep. Have a fan ready to kick on, or even keep a chemical ice pack in your nightstand so you can shake it up and use it. That should calm your system down enough to go back to sleep.

Scenario 4: "I wake up at 3 a.m. starving."

Lindsay: A lot of people can have a blood sugar dip in the middle of the night. If this is happening, try a high-protein snack about an hour before you go to sleep — something like a scoop of almond butter or some Greek yogurt. Something that gets you through the night so you don't have that blood sugar dip that makes you think, "Oh my god, I'm so hungry, I can't even think."

Scenario 5: "I wake up and need to pee multiple times a night."

Lindsay: This is definitely a signal to go see a sleep specialist — even if you don't think you're a loud snorer or that you gasp in your sleep. It can be a sign of sleep apnea, especially for women. Also look out for waking up with a headache, dry or cotton mouth in the morning, or really bad dips in the afternoon where you just can't keep your eyes open.

Natalie: This is so helpful. What I'm taking from this conversation is that we should be gentle with ourselves when it comes to these nighttime wakeups — we shouldn't feel guilty for waking up in the middle of the night. It's all extremely normal.

Lindsay: Yeah, absolutely.

What to Do the Moment You Wake Up

Natalie: If someone wants to improve this pattern, what's the first thing they can do tonight to make it easier to fall back asleep?

Lindsay: We talk about 3 a.m. wakeups because it's the magic middle-of-the-night number, but this works if you wake up at midnight, 1, 1:45, or 4:15 — it doesn't matter. The first thing I want you to do when you wake up is absolutely not look at the clock. Remember, we're in our amygdala, our fight-or-flight. The goal is to bring in our prefrontal cortex, our rational decision-making. So we want to do something gentle with ourselves to distract us from the fact that we woke up.

Lindsay: I love to do a body scan. You start down at your toes and feel if there's anything going on — not judging anything, just noting. Then work up your legs, thighs, stomach, chest, shoulders, and head. What you're doing is distracting your brain to come out of that fight-or-flight place and trigger your parasympathetic nervous system — your rest and digest. If you do that and feel sleepy and roll over and go back to sleep: fantastic.

Lindsay: Here's another one to try: cognitive shuffling. You pick a letter and say a word. A — apple. B — bear. C — cat. It does not have to be fancy. There don't have to be any rules. We actually want this to be easy on our brain, because the goal isn't to entertain us; the goal is to distract us.

Lindsay: Now, we never want to stay in bed for more than 20 minutes — and I don't want you to look at the clock, so this is a guess. "I've been lying here 15 minutes, maybe 20." Get out of bed and go do something else. Don't worry about staying in the dark — when we stay in the dark and we're up in the middle of the night, all that does is tell our brain we can't sleep and give us more stress. We're taking all the stress out of this moment.

Lindsay: Go do something low-activity where you don't have to think a lot — fold laundry, clean the kitchen. I really hate cleaning. It's absolutely my worst thing, I loathe it. Sometimes my brain is like, "No thank you, I'll go back to bed." But the goal is to distract ourselves, and then when we feel sleepy, go get back in bed.

Why It Has to Be the Bed (Not the Couch)

Natalie: Why is it that we want to feel sleepy before going back?

Lindsay: For a lot of us, this has been happening for a long time, and we've trained our brain to think that the bed is a battlefield. If we get up, go do something else, feel sleepy, go back to bed, and fall asleep, we start retraining our brain to associate the bed with sleep.

Lindsay: The last thing I want you to do is go lie down on the couch and fall asleep. If this is all about retraining and we fall asleep on the couch, we've told our brain that the couch is safe and the bed is dangerous. So as soon as you feel sleepy — even if you're sitting on the couch organizing recipes or going through magazines — go get back in bed.

Lindsay: All of this is about training our brain. Have something ready to go. I really love a sound reset at this moment. I sleep with a sound sleep mask — it has flat Bluetooth panels and it's a blackout mask. You're giving your brain something else to think about, but because it's blackout in front of you, it feels really safe to go back to sleep.

How the BetterSleep App Supports the Moment

Natalie: How can tools like BetterSleep support someone in these moments — either before bed, or when they wake up at 3 a.m. and can't fall back asleep?

Lindsay: This is where the sound reset really comes into play. BetterSleep is filled with fantastic tools that can take your brain off what it might be ruminating on, because effort is the enemy of sleep. Anytime we start putting effort into "why am I awake?," we're turning our brain on so much that it's not going to fall back asleep.

Lindsay: This is also why I said don't look at the clock. Once we look at the clock, we start doing math. "It's 3:17 a.m. My alarm goes off at 6. I have this many minutes to go back to sleep." Next thing you know, you're wide awake. When you have something like BetterSleep — an easy tool where you can just hit what you need, close your eyes, and go back to bed — you've taken the stress out of the situation.

When to Seek Professional Guidance

Natalie: If these wakeups persist or become disruptive, is that when you recommend seeing someone medical or getting professional guidance?

Lindsay: Absolutely. If you have a hard time falling asleep, or you're staying asleep only for a while and then lying awake for a long stretch in the middle of the night, and you think you're dealing with insomnia — there's something called cognitive behavioral therapy for insomnia (CBT-I), and there are great specialists in this.

Lindsay: If you can fall asleep fine but can't stay asleep, I really want you to go see a sleep specialist. And if any of the sleep apnea symptoms we talked about are happening, please go see a sleep specialist. Sometimes our general practitioners don't know exactly what to look for, and a sleep specialist will ask you the right questions and help you come up with a plan together.

Lindsay: I really want you to trust your gut. If something feels off about how you're waking up, it is always okay to seek help. That's the only way we get better. That's the only way we get information. That's why sleep specialists are there.

A Final Message for Anyone Feeling Discouraged

Natalie: To wrap up, Lindsay — what's the one message you want people who feel discouraged about their nighttime wakeups to walk away with?

Lindsay: I want you to remember that waking up in the middle of the night is completely normal. You have not done anything wrong. There is nothing to feel guilty about, and you are retraining your body.

Lindsay: Take the pressure off yourself when you wake up. Remind yourself: this is nothing I did. Go out and try a bunch of different things to figure out what your thing is. My favorite is a sound reset. You might find you like going into the living room and doing 20 minutes of a puzzle, and that makes you feel better and lets you come back to sleep.

Lindsay: It is okay to play. Sleep is so uniquely personal to each of us, and we never learned that it's okay to figure out what's going to work best with your brain. If you think about eating, you know you're supposed to experiment — you might do really well with a Mediterranean diet, and I do really well with a high-protein diet, but not vice versa. It's the same with what makes you comfortable at night and what makes you get back to sleep easier.

Lindsay: The last thing I want you to do is get on your phone and doom scroll, or anything that will wake you up more. Remember: this is nothing I did. I've got tools ready to go. And I'm happy to try everything until I figure out what my thing is.

Closing

Natalie: Lindsay, thank you so much. Your story and dedication to helping people sleep better is truly inspiring and deeply appreciated. You can learn more about Lindsay's work at her website, lindsayscola.com. Please be sure to download BetterSleep to explore soothing content designed to help you gently fall back asleep during nighttime wakeups. Until the next episode — be patient with your nights and yourself. Better sleep is something you can build one night at a time. Thank you so much, Lindsay.

Lindsay: Thank you for having me.

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