Dr Amir Khan shares 3 simple ways to fall back asleep when 3am wake-ups strike

Waking up at 3 am is common for millions of women. So much so, it happens almost regardless of age or sleep setup. Stress is the main reason, but don't worry, no one is going to tell you to 'just be less stressed before bed' to improve your sleep. We all know it's not that easy.

Dr Amir Khan is an NHS GP and woman&home's resident doctor. He's shared plenty of sleep tips with us over the years. Recently, he spoke about this particular problem and said there's a "biological reason" for early wake-ups.

"Around 2 to 4 am, your body is in a very particular phase of sleep. Cortisol, your natural stress hormone, starts to rise in preparation for waking up. It's completely normal, but if you're already stressed, anxious, or running on empty, that small hormonal shift can be enough to tip you into wakefulness," he said.

"At the same time, your brain is more vulnerable. During the night, especially in the early hours, blood sugar levels can dip slightly. If they drop too low, which is more likely if you've had alcohol, eaten very late, or are under chronic stress, your body releases adrenaline to compensate," he said.

"That surge can wake you up suddenly with a racing heart or a sense of alertness," he explained.

At 3 am, there are also fewer distractions. "It's just you and your thoughts, and your brain's threat system becomes louder. The amygdala, part of the brain that processes fear, is more reactive when we're sleep-deprived, so worries that feel manageable at 3 pm can feel catastrophic at 3 am."

Hormones also play a role, the doctor says, especially during perimenopause when they fluctuate, and changes in oestrogen levels affect temperature regulation, cortisol levels, and sleep.

"That's why so many women report early morning awakenings and poor sleep [during menopause]," he added.

When you've woken up at 3 am a few times, you'll probably worry about it happening again and disrupting your rest. That's when it becomes a vicious cycle, the doctor explained. "The more you worry about waking up, the more likely you are to wake up."

Dr Khan says it's a very normal problem. "We all cycle through lighter sleep every 90 minutes. The problem isn't waking up. It's the anxiety about being awake," he said.

How to stop waking up at 3am

• Relax: "The problem isn't waking up. It's the anxiety about being awake. The more you worry about waking up, the more likely you are to wake up," says the doctor.
• Gentle breathing: Once you're awake, don't panic and start clock-watching. Start some gentle breathing exercises to lower your cortisol levels and gently lull yourself back to sleep.
• Avoid looking at your phone: If you normally look at your phone before bed, it might be tempting to scroll until you feel tired again. Blue light from your phone may stop you from falling asleep again, as it inhibits the production of melatonin, the hormone we need for sleep.

Research and experts suggest that HRT and some alternatives to HRT can be helpful ways to manage difficult menopause symptoms, like night sweats, that could be playing havoc with your sleep.

It's important to know that your body isn't "broken" if you wake up every night and struggle to sleep, the doctor says. "It just means your biology is doing what biology does, and we just need to help it along a little bit."