Waking up at 3 a.m.?

I hear this all the time from patients. 46% of adults can’t sleep through the night. They fall asleep just fine, but then wake up in the middle of the night and can’t get back to sleep. 

This is one of the most frustrating sleep patterns because it feels like you're doing everything right. You're not wired at bedtime. You nod off quickly. And then? Bam—you're up, alert, and staring at the ceiling.

There’s a popular theory floating around that we evolved to wake up at 3 a.m. to tend fires or keep watch. It’s a nice story, and it gets a lot of airtime online. But unless you’re jet-lagged or actually guarding a fire…that’s not what’s waking you. 

Waking up in the middle of the night is almost never random—and it’s one of the most fixable sleep problems I see.

⚡️ Forward this protocol

If you wake up in the middle of the night and your mind is on, do not lie there trying to force sleep.

That teaches your brain that the bed is a place for stress, rumination, and clock-watching. 

Instead, try the Sleep Re-Association Protocol:

1️⃣ If you’re awake for ~15 minutes, get out of bed. 

2️⃣ Move to a quiet, low-light space. (No overhead lights, no phone.) 

3️⃣ Choose one calming reset: 

• Slow breathing: 

  Inhale 4 seconds, exhale 6–8 seconds. Aim for ~4–6 breaths per minute to activate the parasympathetic nervous system.

• Body scan:
  Starting at your feet, slowly move attention upward, relaxing one body part at a time.

• Simple meditation:
  Sit comfortably and repeat a neutral phrase (“here,” “soft,” “safe”) or focus on the sensation of breath. 

4️⃣ Return to bed only when sleepiness returns.

This retrains your brain to associate the bed with sleep, not anxiety. It’s one of the most effective behavioral tools we have for middle-of-the-night insomnia.

🤓 What to know: 3 a.m. wakeups have real biological causes.

Most middle-of-the-night insomnia isn’t “just stress.” It’s your nervous system or biology nudging you awake during light sleep.

Here are the most common culprits:

🧠 Anxiety + cortisol awakening response

• Cortisol naturally begins rising between 2–4 a.m. to prepare your body for waking.

• If baseline stress is already high, normal rise can overshoot, pulling you into full alertness and triggering insomnia (Clinical Translations in Neuroscience). 

🏃‍♀️ Exercise (or lack of it)

Exercise is one of the strongest predictors of sleep quality we have (Cureus).

Regular moderate-intensity movement:

• Increases slow-wave (deep) sleep (Scientific Reports) 

• Improves sleep efficiency

☕ Caffeine timing + genetics

• About 50% of people are slow caffeine metabolizers, meaning caffeine can linger in the system for 8–10+ hours.

• Even 200mg of caffeine reduces total sleep time and deep sleep (Journal of Clinical Sleep Medicine).

​​🍷 Alcohol (even just one drink)

According to wearable data from 600,000 users, alcohol: 

• Raises resting heart rate

• Lowers HRV

• Suppresses deep and REM sleep

🌡️ Temperature matters more than you think

• To stay asleep, your core body temperature needs to drop.

• A room that’s too warm—or bedding that traps heat—can prevent deep sleep and trigger awakenings during lighter sleep stages.

• Optimal bedroom temperature: 60–67°F 

🩸 Hormones: progesterone in particular

• Progesterone is converted to allopregnanolone, which binds to GABA-A receptors to boost the calming effects of GABA.

• Dips in progesterone right before your period, during perimenopause → lighter, more fragile sleep.

🍽️ Blood sugar dips

Nocturnal hypoglycemia (low blood sugar) is a well-described driver of sleep disruption. 

• High-carb dinners—especially with insulin resistance or prediabetes—can cause blood sugar to drop overnight.

• Your body responds by releasing cortisol and adrenaline to bring glucose back up.

😮‍💨 Sleep apnea, snoring, and mouth breathing

• Sleep-disordered breathing is wildly under-diagnosed in women (Sleep and Breathing).

• Women with sleep apnea are more likely to present with insomnia, fatigue, depression, and nightmares—not loud snoring (Medical Principles and Practice) 

• Snoring, mouth breathing, jaw tension and morning headaches are all signs of fragmented sleep from micro-arousals.

🔥 Cortisol dysregulation + chronic disease

Conditions that increase inflammation or disrupt hormonal signaling—like:

• Thyroid disease

• Autoimmune conditions

• Chronic pain

• Depression

All interrupt normal sleep architecture and increase early-morning awakenings.

Insomnia is often a symptom, not the root cause.

💪 What to do: The 3 a.m. sleep stabilization protocol.   If you’re waking up consistently in the middle of the night, your goal is stable circadian signaling.

Here’s how to re-regulate: 

1️⃣ Prioritize consistent sleep and wake times. 

• Wake up at the same time every day (±30 minutes), including weekends.

• Bedtime can flex slightly—but wake time should not.

2️⃣ Get morning light—daily, no exceptions.

• Morning light suppresses melatonin early, which allows it to rise properly at night. 

• This is foundational for staying asleep—not just falling asleep.

• Aim for: 10–20 minutes of outdoor light within 1 hour of waking

3️⃣ Build an evening “off-ramp”

Your nervous system needs a predictable wind-down. Prioritize: 

• Dinner with protein + carbs (complex, high-fiber carbs helps blunt nighttime cortisol)

• Screens off or dimmed 60–90 minutes before bed (light exposure delays melatonin release) 

4️⃣ Stop expecting supplements to override circadian chaos

Supplements can help—but only after rhythm is in place.

Use these as a support to the steps above: 

• Magnesium glycinate or threonate (200–400 mg)

• L-theanine (100–200 mg) for racing thoughts

• GABA (100–300 mg) if anxiety is the dominant driver

5️⃣ Cut alcohol

• If sleep is a priority, alcohol is the lowest-hanging fruit to remove.

• If you want data: track resting heart rate and sleep efficiency with a Whoop after you drink. 

6️⃣ Cut off your caffeine intake

• If you’re one of the 1 in 2 people who are a slow caffeine metabolizer, that afternoon (or even late morning) coffee can linger. 

• Cut caffeine after 9 a.m.Welcome to RBMD Off Script, your home for the evidence-based, actionable information you need to be healthier this year! 

💛 The Momgevity Files

This past weekend, I went inward. I got back Friday afternoon from a whirlwind trip to LA and Phoenix for work (stay tuned for upcoming podcasts with Jeff Krasno, Dylan Gemelli, and Kelly Gores!) and could feel myself dragging in a new way. Too many planes, too many Ubers, too many time zones, too much talking and extroversion—even for me, which is saying a lot. I felt the opposite of grounded.

So, I skipped a big party Friday night and got 10 hours of sleep. I stayed inside Saturday, avoiding the 12-degree weather in NYC, and hung out with my kids—reading, playing, and cooking.

That night, I attended a meditation and sound ceremony, where we spent six hours doing breathwork, singing, absorbing the vibrations of music, and listening deeply in contemplation.

Sunday was another quiet day at home—more books, more cooking, more games, a bath, and an early bedtime.

No going out. No meals out. No workouts. And te clarity and insights that came through were profound.

One message was a clear call to be more present with my kids—the next ten years are a unique window before they become teenagers. I’ve decided I need a box for my phone where it stays from 6:30–8:30 p.m., Monday through Friday, so that my and my husband’s presence is felt more fully—by them and by us.

I also got clarity around some work goals: which ones feel authentic and from the heart, and which feel less aligned.
And I listened to my body, which has been feeling achy—turns out all this weight training requires some TLC—and gave it the rest it’s been asking for.

Deep rest is hard to come by in our world. Everything around us encourages us to skip it—to keep going, keep up with media and work, meet others’ needs, and maintain the pace. But the greatest insights and gifts often come when we pause.

There’s a sign hanging in my office that says: “Slow down. 5 MPH.”

We all need reminders.

This is yours: permission and encouragement to remember that if we’re playing the long game—true longevity—we must take our time.

Stay strong, stay curious and breathe, 

Robin

⚡️ One last thing…

Looking to take your nervous system reset practice deeper?

My personal teacher Dave Gandelman is offering an incredible meditation teacher training certification program for 2026 that blends meditation practice, energetic awareness, teaching skills, and practical guidance for holding space and guiding others.

I’ve been a guest lecturer for this course for a few years and I can honestly say that even if you’re not looking to teach meditation as a career, the power of the training to deepen your personal practice is huge. Learn more here. 

As always, this newsletter is for informational and educational purposes only and is not intended as medical advice. Always consult your healthcare provider before making any health decisions or changes to your treatment plan.