Why Can’t I Sleep Through the Night?

You fall asleep the moment your head touches the pillow. Then at ten past three your eyes open, your mind switches on, and you lie there doing arithmetic about how many hours are left.

This is one of the most common things women describe to me, and one of the most misunderstood. Falling asleep and staying asleep are two different problems with two different sets of causes.

What’s actually happening at 3am

Your sleep isn’t one long block. It moves in cycles of roughly ninety minutes, and you surface briefly between them. Normally you don’t notice. Waking fully means something is nudging you awake at that moment — and there are a handful of usual suspects.

Blood sugar. If dinner was carbohydrate-heavy or early, your blood sugar can dip in the small hours. Your body responds by releasing adrenaline and cortisol^° to bring it back up — and those are alerting hormones. You wake.

Cortisol timing. Cortisol naturally begins rising in the early hours to prepare you for waking. If your baseline is already high from chronic stress, that rise starts sooner and hits harder.

Hormonal shifts. In perimenopause, falling progesterone removes some of its natural calming effect, and night sweats fragment sleep even when you don’t fully register them.

Alcohol. It helps you fall asleep and then wrecks the second half of the night as it metabolises. A glass of wine at nine is often the 3am alarm clock.

What it isn’t

It probably isn’t “just getting older” — age changes sleep architecture, but reliably waking at the same time most nights is a pattern, and patterns have causes.

It isn’t necessarily anxiety, either. Plenty of women wake first and then find things to worry about, rather than the other way round. The racing mind can be a consequence of the cortisol spike, not the cause of the waking.

And it isn’t fixed by more sleeping pills over the long term. They can help short term, but if the driver is blood sugar or hormones, sedation treats the symptom and leaves the cause.

What actually helps

• Eat enough at dinner, and include protein and fat. Undereating in the evening is a common and overlooked cause of night waking.
• Consider a small bedtime snack if you consistently wake at the same hour — a spoonful of nut butter, a few walnuts, a little Greek yoghurt.
• Stop alcohol earlier, or take a fortnight off entirely and see what happens. This one is often dramatic.
• Cool the room. Your core temperature needs to fall for deep sleep. Aim cooler than feels intuitive.
• Consistent wake time, even at weekends. Regularity matters as much as duration.
• Wind down ninety minutes before bed. Screens down, lights low, no work email. Treat it as the start of sleep, not the end of the day.
• Magnesium glycinate^° helps some women. It’s gentle and worth a trial, though not a substitute for the above.
• If you wake, don’t fight it. After twenty minutes, get up, keep the lights low, read something dull. Lying there building an association between your bed and frustration makes it worse.

Start here

For one week, note what time you wake and what you ate and drank that evening. Most women find the pattern themselves within a few days — and a pattern you can see is a pattern you can change.