The night never looks darker or lonelier than at 3 a.m. Everything is worse at night -- anxiety and worries are bigger, pain is stronger, fevers are higher, moods are darker. We toss and we turn. We count sheep, we measure breaths, we relax muscles, yet, there we are, still awake! Anxious rumination keep gnawing at us as we recount the day’s events. Imagination is in hyperdrive, constructing the most far-fetched, worst case scenarios about all kinds of things. We toss and we turn some more, to no avail; even the sheep we tried to count have scattered, leaving us alone in the dark doldrums of the night.

Prevalence rates indicate that 1 in 3 people worldwide suffers from sleep disturbances (Cleveland Clinic report) - that’s about 2.6 billion people who are tossing and turning as well. Somehow I don’t find it reassuring to know that at 3:00 a.m.

But why is this happening?

For starters, we are diurnal, or daytime creatures, not nocturnal, and this affects all our body functions, including our moods and behavior. We are awake during the day and asleep during the night, a cycle that repeats daily as part of the body’s circadian rhythm. The circadian rhythm is the body’s internal clock that controls and organizes the ebb and flow of all biological processes necessary for life: body temperature, heart rate, blood pressure, hormone production and release, immune functions, energy levels, reproductive functions, digestive processes. Psychological and cognitive processes are also affected by the circadian rhythms. Executive functions, such as working-memory, concentration, problem-solving, decision-making, goal-setting are all at peak levels during morning hours. Emotions tend to be affected similarly, with participants in one study, for example, reporting more positive feelings in the morning and negative mood in the evening. 1

This short video is an excellent explanation of the basic workings of the circadian rhythm.

So what does this have to do with the middle of the night worries?

As we saw above, we function at optimum levels during the daytime when all physical, cognitive, and psychological systems work in synchronicity to enable us to navigate the demands of daily life. The converse follows that we don’t do so well at night. Studies show that as part of the circadian rhythm, a whole string of events takes place around 3 a.m.: melatonin levels start to drop and there is a shift in the sleep pattern from deep sleep to light sleep; body temperature starts to increase; stress hormones begin to rise. These are normal shifts directed by your body clock, but if you are already having residual stress from events of the previous day, these normal fluctuations will surely wake you. And, once awake, the sky is the limit when it comes to finding things to worry about -- anything is fair game. In the middle of the night, there is not much to distract us. During the day we have various and sundry activities to occupy our minds, so that worries are less likely to have as strong a hold on us. At 3:00 a.m., however, we are alone, adrift in the sea of worries.

The view in Chinese medicine is that energy, or Qi, moves through the various organs of the body in a 24 hour cycle - note the circadian rhythm pattern. At 3:00 a.m, the energy is highest in the liver. If you wake up at that time, you are experiencing Liver Qi stagnation, which is affected by poor diet, excessive alcohol consumption, unresolved anger, and high levels of stress.

I can definitely relate to the whole “unresolved anger and high levels of stress” idea with an experience I had just the other night. I have a 4 month old puppy, and as part of getting her ready for bed, I take her out to pee one last time at about 9:30. She usually goes within a couple minutes, and all is good. This particular night, the second night in a row, she seemed to have no interest in going. An hour into the whole ordeal we were still doing the “Go potty, Maya” thing. By 10:30, though, I was pretty much out of patience, and completely exasperated (recall the findings showing that people experience more negative emotions as the evening goes on). I am sure she could tell that I was frustrated, which made everything worse, since it probably made her more anxious. At 10:30 a.m. I would have had a whole different attitude. I would have practiced my breathing exercises (click here for a quick and easy 60 second breathing exercise), we would have gone in the house, and I would have kept her tethered to me on the leash so I could keep a close eye on any peeing signs. But at 10:30 p.m., I was tired after a long day of work and just wanted to be done with it so I could go to bed. In that frame of mind, it seemed to me that she was just being stubbornly perverse in refusing to pee. Although I knew I was being irrational, I couldn’t help myself. By that time of night, rational thinking is at a low point and coping strategies are spent. So, I finally gave up and we went inside. I put Maya in her crate, where she promptly peed. Ugh! And at 3:00 o’clock sharp I woke up and found myself adrift in a sea of unpleasant emotions.

6 Strategies for Better Sleep

1. Establish a bedtime routine.

Remember that the circadian rhythm controls the fluctuations of body processes, which means that if one process is out of rhythm, it affects the functioning of the entire organism (click here for some examples of how things in our body are connected). This is especially true for sleep, because sleep deficit increases the activity of the amygdala, the brain structure responsible for processing of emotions, especially fear and anxiety. If your amygdala is more vigilant, so to speak, your stress response is more easily triggered during the day, and the 3:00a.m waking. is more likely to occur.

2. Turn off the electronics.

It probably sounds like an impossible recommendation to follow, but read why turning off electronics 1-2 hours before sleep would benefit you immensely. Electronics have a double impact on sleep. The blue light emitted by screens suppresses the release of melatonin, so sleep is delayed, while the flickering of the pixels on the screen activates the amygdala and the release of stress hormones. As a result 3a.m. is more likely to occur.

3. Avoid exercising close to bedtime.

Although exercise is beneficial for reducing overall stress, it also temporarily increases the release of adrenaline, which increases your heart rate and breathing rate to supply more oxygen to your working muscles. For that reason, physical activity close to bed will actually disrupt your sleep because adrenaline and sleep do no mix. Choose instead slow, stretching yoga that releases the tension accumulated in your muscles in the course of your day.

4. Eat a light snack if you are hungry.

The foods you eat have to be digested, which means that the muscles of your digestive system are activated and digestive fluids and hormones are released. If you eat close to bedtime, all this activity happens exactly at a time when your body is starting to wind down for the night and prepare for descent into deep sleep, a time when body functions slow down and muscles relax. What your body does with these conflicting demands is sacrifice sleep in order to deal with the meal.

If you are in fact hungry, choose a light snack that will not put undue demands on your body. A handful of almonds and raisins, a banana with almond butter, a couple of kiwis, a small bowl of oatmeal, a slice of toast with fruit are all reasonable bedtime snacks.

5. Give your mind something to think about.

If, in spite of these steps you still find yourself adrift at 3a.m., it is important to recognize that lying there in the dark, hoping that sleep will come back is a recipe for trouble. When you have nothing to do, your mind will find its own occupation, which will be dwelling on all those things that bugged you or worried you during the day. Nobody ever thinks about how much fun they had on their last vacation! And from there, it’’s off to the races. There is no end to the things that we worry about at 3 a.m.

Many of my clients have had positive experiences with apps such as CALM. They find that, indeed, it calms them down and helps them fall asleep within a few minutes. For myself, I prefer an app called TAPPING SOLUTIONS. It is a combination of mediation, visualization, and tapping of acupressure points. I know, it sounds like a lot of work at 3 a.m., but it helps shift the focus away from worries while at the same time activating the parasympathetic nervous system, the part of the nervous system that controls rest and relaxation.

6. Seek the help of a mental health professional.

If you suffer from severe insomnia, ask your primary care doctor for a referral to a sleep specialist who will evaluate whether a sleep study would be beneficial to diagnose the nature of your sleep difficulties. And, if you experience chronic stress, ask for a referral to a mental health professional who can address your sleep problems through CBT (Cognitive Behavior Therapy - Insomnia) as well as help you explore the sources of stress in your life in order to develop effective stress management strategies.

Though it is dark -- find the light.

Though you are worried - find your peace.

Though you are restless - find your relaxation..

Dr. Dana Watts

Clinical Psychologist

Helping Clients in the Greater Cleveland Area

440-895-1100

1.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3944144/

2.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3475279/#:~:text=In%2033%20normal%20individuals%20who,the%20cycle%20over%2024%20h.

3. http://www.turningpointeacu.com/blog/2017/2/19/waking-up-at-the-same-time-each-night-the-chinese-medicine-body-clock-explains-why