Why are so many women waking up at 3am?

[00:15] Liz: Welcome back to the Health Revival Show. Today we are going to talk about something we hear from so many women, and that is the 3am wake up. So if you are waking up 3am consistently every night, you've got belly fat that won't budge no matter what you do with your diet, your mind is racing, maybe you feel anxious. The good news is you're going to learn a lot in today's episode because these two things are connected. And your body isn't broken, it is simply trying to signal you. So that's what we're going to dive into today.

[00:42] Becca: Yeah, I'm excited because I think a lot of women mask this, they end up on sleep medications, which are extremely addictive, don't truly give you a deep sleep. And that is very clear in you are essentially in a sedated state when you are on benzos. And sleep is, I would say, top two to three most important things to your health. I always joke, I would rather someone sleep seven to eight hours and eat cheeseburgers than eat a perfectly healthy diet and sleep five hours. Broken sleep.

[01:14] Becca: It is that impactful on your health. And so we want to talk about today why this is happening, the things that you need to be looking into, because it can be a couple of things. A lot of times they're intertwined and it's not just one simple fix. If it is, great, that's always our favorite. But if you are waking up at 3 a.m., a lot of times you're waking up with like racing mind. And then the next day you're more hungry. That is also shown in research that I think it's on an average you eat 300 to 500 more calories when you're sleep deprived.

Editor's note: The figure here is in line with a meta-analysis of 11 sleep-restriction studies, which found people ate about 385 more calories on short sleep (see Sources).

[01:44] Becca: And then they're telling you it's just because you're getting older or, oh, you're distressed or take Unisom or here's a Benzo or here's an antidepressant or whatever it might be. Do not do that as your first option. Let's dive into it. There are so many other things that you can try that aren't even supplements or medication either. We're going to talk about some little hacks that you can put in. So stick around, because I do think that this will be very helpful for those of you that are struggling.

[02:11] Becca: Because it's consuming. When I do not sleep, I am a bear. My husband is afraid of me. He handles that lack of sleep so much better than I do.

Should progesterone be used as a sleep medication?

[02:21] Liz: Same. I am very sleep deprived as we are in Chicago podcasting in person. And we had the little one with us last night who was up almost every hour and a half, two hours and in the bed with us, kicking me in the face, all the things. And so I definitely feel a lot more run-down. It's like a hangover, honestly. And so we've got some extra creatine on board. We're going sipping on some of the good things for our brain throughout the day because we've got a lot to cover.

[02:49] Liz: And so when we think about sleep, I was actually just writing a protocol to someone in the car on the way over here because they were saying, well, I think I might increase my progesterone. I said, wait a second. Progesterone is not, nor should it be looked at as a sleep medication. There are many other things that we can do through nutrition, through bedtime routine, blue light blockers, all these things. But first and foremost, I think it's important for you to understand what is actually happening so that you can be compliant because a lot of times you hear these things on social media, tips and tricks and do this, do that.

[03:20] Liz: And it's one end of the spectrum. You feel very overwhelmed because there's so much, right? You don't know what supplement to choose or you just don't do anything because it, again, is so overwhelming. You're paralyzed by that. And so when we think about the why, this will help you think what might work best for you.

Why is 3am the time my body wakes me up?

[03:39] Liz: And first and foremost, cortisol, when we think about stress, you know, your body is, it has its built in defense system, right? This is the ramp up system. If someone cuts you off in traffic, we need adrenaline. We need that boost to fight and flee that situation. And this is where cortisol comes to play because we need that energy. And so cortisol, it is the lowest around midnight. It starts rising in the early morning hours. If you have ever done a DUTCH test with us or anyone, you've seen a cortisol awakening response, right?

[04:09] Liz: So it should be highest in the morning, get you ready for the day teeter down throughout the day and lowest at midnight. For most people though, they're pretty dysregulated and this can happen for a variety of reasons. And therefore our stress system is imbalanced. We call this our circadian rhythm. This can be the cortisol rhythm as well. And so the 3am isn't random. This is when your body is starting the morning shift and it's stressed out already early. And so I would challenge you to kind of think about what is happening when you are waking up at 3am because if you're waking up with this racing mind, you know, but you are not necessarily like ready to get up and be energized throughout the day, this can be something different.

[04:52] Liz: Maybe it's your liver that's detoxifying and then you're just, you know, automatically thinking through different things. So there's different reasons. We also have blood sugar and that's another thing. So blood sugar, we know that the immune system is very active overnight doing a lot of detox processes for your brain, many different organ systems, and that requires our body to get rid of things. And so when your blood sugar is dipping overnight, because maybe you ate dinner at 6pm and then you didn't have anything before bed.

[05:20] Liz: Now your body is firing off adrenaline because it wants to maintain homeostasis. And so adrenaline is going to be that wake up hormone. So which is why you would then in that case, suddenly wake up with that energy and you are alert, right? So there's two different things here. We have the wake up mind kind of racing. That's going to be more cortisol where blood sugar is going to be that emergency response where you wake up and you've got that energy because you're ready to fight or flee.

[05:44] Liz: And so this could sometimes come with the racing mind. Not always though. Sometimes it comes with feeling a little bit shaky and maybe your temperature is elevated. So again, the body is fighting for you. It just really isn't subtle about it and you don't love it because it's interrupting your sleep.

Are night sweats a hormone problem or a blood sugar problem?

[06:00] Becca: Yeah. And this is where a lot of times night sweats and hot flashes are not a hormone thing. Like we see all the time people, it's a histamine response. It's a blood sugar issue because also when histamine will essentially cause vasodilation, it causes blood sugars to go up. It's the crashing after that at night that causes the adrenaline surge because your body is trying to keep blood sugars stable. It doesn't like when blood sugars go too low.

[06:23] Becca: And so then it's not even the drop, it's the adrenaline response after the drop that your body is waking you up from, like Liz just said. And so then you wake up hot. You're waking up, you know, like with those sweats and you're like, oh, I need more estrogen or I need hormones. And it's like, no, no, no. That's not the first step. The first step is fixing the blood sugar, fixing the cortisol response because those are truly what is waking you up. And in a lot of cases they take progesterone, everything's fixed.

[06:46] Becca: Perfect. They probably weren't dealing with these things, but there's a lot of women that take progesterone and they're like, it didn't help with my sleep. It didn't help with my symptoms. It's like, okay, progesterone wasn't the problem. These things are the problem. And so in Chinese medicine, yes, that 1 to 3 a.m. is also called liver time. But we just talked about too, the liver is dumping glucose, right? It's doing that to keep your blood sugars stable.

[07:07] Becca: And if there's a lot of immune system issues going on to keep the immune system fueled. And so if you have, you know, chronic viral activity, you have GI issues, you have, you know, whatever that's irritating an immune system, leaky gut, you will end up having the liver trying to keep the immune system fueled overnight by keeping out sugars. And so that will cause these swings and drops and swings and drops and all of these wakeups, right?

What wakes you up in the second half of the night?

[07:30] Becca: So we do know too, obviously wine is not great. It is not going to help you sleep. It is not going to give you a good sleep. Anyone that's been drunk and gone to sleep, you know, it's not actual great sleep. Like if the nights that I remember, I have not had one of these in a long time, thank goodness. But you are going to bed and you just pass out. And then you wake up, you're like, I feel like I didn't even sleep.

[07:52] Becca: That is very much so true. You do not get good sleep with alcohol. So the heavy late meal, the blood sugar roller coaster, all of these tend to show up in the second half of the night. They will not show up usually in the first half of the night. And so if you're someone that like you wake up at 11 p.m. midnight, that's not usually this necessarily. It can be other things. It can be sometimes cortisol, but usually these are showing up in like the 1 to 4 a.m. timeframe.

[08:17] Becca: And again, waking up briefly, not a huge deal. A lot of people will wake up once a night, fall back asleep very easily. The problem is waking up fully. Waking up, your heart is racing. Your brain is switched on. You do not go back to sleep. Like you are laying there wide awake. You know, you pick up your phone, you get up. You're like all those things because that is not a quick little wake up. That's not a big deal, right?

[08:40] Becca: This is something that is very much so the alarm is going off. There's cortisol, there's adrenaline, there's blood sugar. That is all stuff that then also turns into belly fat that becomes very stubborn to lose.

Why does undereating make my sleep worse?

[08:52] Liz: Yes. And we know that many people are trying to maintain a good physique, right? Get rid of the belly fat. And so obviously we want to look at what are the things that are going to prevent us from getting that body that we want outside of chronic underlying GI infections, driving a lot of inflammation, reactivity to food and things like that. We do have to think about stress. We have to think about how much you are under eating, under nourishing your body. Certainly in a season where you're going in for a cut or a leaning out phase done in 8 to 12 week segments, typically we get that.

[09:26] Liz: We understand. But most of you listening to this podcast have dieted chronically. We know because we were you. We also know because we deal with you still to this day. And in our practice, it's like convincing women to eat enough. And I will say, it's still challenging for me if I'm not really cognizant in my day because I typically do great in the morning, midday gets so, so busy with work that I'm just like forgetting or not having enough time.

[09:51] Liz: And then I'm trying to back into the day. So we have to be cognizant of this as well, because if we're under eating all day, that is going to backfire. We know this to be true. There's research around this. And so this is going to lead to more of those blood sugar swings, more of that dysregulation, more of the cortisol dysregulation as well. And so this is where I would challenge you is to think about if I were to eat consistently with balanced meals throughout the day, and then have a blood sugar balancing snack before bed, do I notice that that helps me maintain good quality sleep overnight?

[10:26] Liz: Because as we talked about earlier with cortisol and blood sugar, if you're eating early or you're having alcohol, or you're having just a lot of sugar and things, right? And you don't have the adequate protein and the adequate fats that are going to help you, think of this as like a fire. If you are going to start a fire, what do you need? We need quick kindling. That's going to be your carbohydrates, sugars. If you want those logs to catch fire that are going to burn overnight and keep that fire going, that's going to be your protein and your fat.

[10:54] Liz: And so there's sleepy time mocktails. We can add things like pistachios, again, a spoonful of peanut butter, whatever it might be for you and see if that helps you. And then I would say too, the routine is going to be really important to maintain throughout the day to get that adequate intake in so that you're not ending the day with 800 calories when the entire day you starved yourself. And I know that this can be different for some individuals. If you're in a state of autophagy, if you're in a season that you're intentionally doing these things, that's not what I'm talking about.

[11:24] Liz: What I'm talking about is that chronic dieter who is doing it in the name of the scale, right? Like whatever it takes to get the scale to budge. Most of the time in this case, especially if you're waking at 3 a.m., that scale is going to start to go up. Even in our practitioner group, we had that conversation this week, right? Like one of our friends, she's been feeding up, tried to cut her calories back, scale goes up. She's like, what the heck?

[11:46] Liz: So this is a stress response too. And it is a way for your body to tell you, this is too much. I can't maintain homeostasis. And when we say homeostasis, this is where we want your blood sugar to be really between 70 and 90. You're going to have your increase, your rise and your fall back to the normal range. If you've had a balanced meal, about 30 point difference is what we would see there if you had a glucose monitor on. But if you're having imbalanced meals or you're eating foods that your body is not tolerating well, it's reactive to even protein, which we're going to talk about in another episode, you'll see peaks and valleys.

[12:21] Liz: And those valleys are again, what Becca was talking about with that stress response, glucose dumping, and then you're still waking up and you're now storing body fat because your cortisol receptors in your midsection, that's where they are and they love it. So that's why we sometimes see women struggling so much with that midsection waking.

[12:40] Becca: Yep. And it's night after night, right? If you are not sleeping night after night, you will get this response over and over again. And you will put on body fat and you will be like, I'm not eating more. I'm exercising the same. And it is a stress response, right? This is what we see all the time. Every single person, people don't come to us that are eating poorly and not working out. They have easy things to fix. The people that come to us are doing everything right.

[13:03] Becca: And they are still struggling with these things because stress aspect will keep weight on you and it will keep adding weight to you, which is the worst, right? We have to learn how to pull stress away from the system. And we will talk about that shortly here.

Why doesn't my daytime blood sugar tell the whole story?

[13:16] Becca: So a lot of times we also see when people track their blood sugar, they'll do it during the day, right? Unless you're wearing a CGM, which is an option. If you're tracking during the day, they're like, but my blood sugars are fine during the day. Well, you're not looking at them overnight. And so this is something called the dawn phenomenon. But basically before dawn, your body releases hormones that raise blood sugar, which ultimately wakes you up.

[13:35] Becca: That's a natural response. That's what should be happening. With healthy insulin levels, you don't really see this very much. But if your fasting number is slowly creeping up and you're like, Hey, I'm in the high nineties, low one hundreds. Now I'm in like the one teens, right? That can be a sign of early insulin resistance. So this is why we test fasting insulin. We don't just test fasting glucose. We test A1C, but insulin will move before A1C will because insulin goes up before blood sugars start to go up.

[14:03] Becca: It's kind of like, that's the first step to it. You could look at a CGM. Usually it's a two week trial that you run them for. Although CGMs can be a little, I would say a little variable. They're not super, I don't think that they are like the most accurate things in the world, to be honest. I think it can be helpful to understand like overall trends and averages, but I do not think that absolutely speaking they are the best thing in the world. So they have a time and a place, right?

Why is fat moving to my belly in perimenopause?

[14:27] Becca: But with perimenopause, you start to get these big drops in estrogen, right? And then also when we talk about weight gain, fat storage will shift from the hips and the thighs to the belly, even without weight gain on the scale. They're like, I haven't gained any weight, but like now my pants don't fit. I can't button things up, right? And you're not eating differently. You're not exercising differently. Your body is just starting to store it differently. And so this is where stress becomes the fuel line, right?

[14:53] Becca: And by the fuel line, we mean the thing that is feeding your symptoms. We look at, everyone looks at the fire. They look at the symptoms. They look at, I am gaining weight. I can't sleep. I'm doing all the same things. But we look at the fuel lines. We look at, for most women, blood sugar and metabolism, stress and hormones, gut and liver, and histamine. And there are a lot of healthy habits, quote unquote healthy habits, that people are doing that they think are helping, that are actually making things worse.

How does a toxic load spill over into sleep?

[15:23] Becca: I was listening to a podcast earlier today, talking about hiatal hernias and how histamine and mast cell activation is so...

[15:30] Liz: I saw that today too.

[15:31] Becca: Yeah. Missed, often missed.

[15:33] Liz: And then, you know, really, truly, when we're thinking about mast cells, this is why I do love the MRT in many ways, because it's looking at all these different chemical messengers that can create this chemical warfare and basically cytokine storm in the body, right? And one of the ladies was talking, she was on the Dr. Gabrielle Lyon show. She's like, you know, mold is a huge trigger for this, which we know, but we have all these other environmental toxicants. And so it's not one exposure. Yesterday, we were flying [on a commercial flight]. I have a little video that I made because I can see mold all the way in the top, throughout the plane for the, you know, where they spit out the air and everything.

[16:06] Liz: And then it was super fantastic to see, like, they were missing paneling on a piece so I could see the silver insulation. I was like, this is very comforting. No, it was a great flight. It was fine. But you have these exposures, so I can visibly see mold there. That tells me I know there's mycotoxins. Also an airplane, which is disgusting, right? All the environmental toxicants from the fumes, perfumes, whatever, you know, has gone on there that they're cleaning with and all this. So it's like, not one thing all the time.

[16:36] Liz: It's what accumulates in that individual's body and their bucket, if you will, that starts to then tip them over. And if it's not something where you are adequately hydrated, you are moving your bowels regularly, you are addressing your diet with high levels of antioxidants and all the things that we need to maintain a healthy lifestyle in the day and age that we live in, which is a toxic world, your bucket overflows. And then again, the sleep is impaired. We're anxious. We can't lose weight. We have brain fog, our joints hurt, all of the things.

[17:10] Liz: And so while we're talking about a lot in this episode, as Becca mentioned, there are many fuel lines, but it really boils down to three that we look at for individuals because you're seeing all of the symptoms at the surface, right? That's the fire, that's the smoke. When we can put out the fire because we've stopped the fuel going to the fire, then we're able to help you identify how you move forward after you've gone through that healing phase and maintain your progress. And I think that's something that not a lot of functional providers have taught people.

[17:40] Liz: I know I was just sharing today from one of my clients. She's like, I feel so equipped with the knowledge that you've given me to handle certain situations and exposures when they happen. And I was never given that before. And so that's what we do at FitMom, right? If you are somebody looking for that type of help, links are in the show notes, schedule a call with our team. And always start with blood work and review. That can be a really great place. If you're new to functional medicine, you're new to hearing about all of this.

[18:07] Liz: Oh, they're talking about perimenopause, blood sugar, toxins, stress, diet. I thought that it was just that I needed to take some melatonin or some progesterone. It's far beyond that. And truly based upon what we were talking about earlier with histamine too, we see a lot of women where progesterone actually makes things worse because they are intolerant to it. So stay tuned. We're going to be doing an episode on that soon, but let's get into things that you can do.

What can I do tonight to stop waking up at 3am?

[18:32] Becca: And you've probably seen some of these and wondered, is that right for me? I will just say that every person is so bio-individual. Depending upon what your fuel line is, it's going to vary and it's going to be, you know, it depends situation. But I would recommend that you chart and you track. I was answering a question yesterday to someone and she was saying that she has intermittent heartburn overnight. And I thought, ah, I think this is probably progesterone related.

[18:58] Becca: And lo and behold, she did message me back and say that she is postmenopause. She does take it, but there could be other factors because it's intermittent. And so when you're charting, you're looking at patterns. You're looking at trends. You're not looking at one lab marker, one scenario. We want to see the patterns and trends. And so while progesterone could be very helpful for some women and it can be a game changer for them, for others, it might actually make things worse.

[19:21] Becca: So let's talk about what you can do before bed with your dietary routine, your lifestyle, and I'll just kick us off because we're going to rapid fire through this. Number one, you want to dim the lights in your house. I recently have been on a bit of a, I don't know what we want to call it, arguing train with my husband about lights in our house. Cause I like them on all the time, but dim the lights in your house when it is getting dark, right? Sun is setting, lower the lights in your house.

[19:50] Becca: If you're going to be watching TV, you're going to be on your computer. I do this a lot. And I'm working later at nighttime. Sometimes wear blue light blocking glasses. That's going to be very important because all of the technology, whether it's coming from your phone, your computer, your TV is stimulating your brain for that wake signal. And you want to know why we have dysregulated cortisol rhythms and cortisol awakening responses. It is because of technology. And I know I'm guilty of this too. So make sure that you're doing those two things.

[20:17] Becca: Those are simple and easy to implement. And if you want to up your game with blue blockers, they shouldn't be clear glasses. They should have the red tint to them or the orange tint to them. Technically that is fully blocking what you want. So just a little, little hack. I still wear my clear during the day.

[20:34] Liz: I have the clear during the day.

[20:35] Becca: Yes. And then I have my red, orange-ish ones at night.

[20:39] Liz: Do you know they make green ones for migraines?

[20:42] Becca: I did not.

[20:42] Liz: I was just evaluating that also this morning. Dr. Jockers sent an email about, cause I knew we were broadcasting on this today, just random tangent here. And it was from Amazon. And I was looking at them cause I also have some orange ones at home. I don't like them. They're wired and they hurt. So I was looking for ones. And a couple of people have recommended brands. I just haven't ordered them yet. So anyways, I was looking at the different shades. I'm like, well, what is the difference here? Is that aesthetic or a style? No, the green is actually for people who are more prone to migraines, which is a lot of our clients.

[21:10] Becca: Learn something new every day. Eating a small snack before bed. So when you eat early, which here's the hard part, right? A lot of people say to eat earlier because then you are not having to go to sleep with a large amount of digestion that has to happen, which is a stress on the body, right? And so you do want to eat earlier, but if you are not eating enough long periods of food, you know, without food becomes a stress on the body, especially if you're already depleted.

[21:39] Becca: And so in these cases, you can add a small snack before bed, which we've mentioned a couple of times already in the podcast, but think like a few bites of Greek yogurt with some peanut butter mixed in or a hard boiled egg or like half of a protein bar or a rice cake with peanut butter, you know, half of an apple, any of those are fine. Keep it small, not greasy, but you do want a little bit of fat with that because that is going to be more satiating to the body overnight. But do not have large meals before bed, right?

[22:08] Becca: So eating dinner too close to bedtime is 100% linked with more night wakings. So finish dinner a little bit earlier and then a small snack before bed can be a good little, you know, combo. Magnesium is great for most people, but if you are someone that is neurodivergent, if you are someone that has experienced PMDD, if you are someone that is also intolerant to progesterone, you may have a paradoxical effect with magnesium. So the type of magnesium is important. Magnesium glycinate tends to be the best for overnight sleep recovery, you know, getting you a little bit more tired.

[22:44] Becca: Citrate is going to be a little more of a laxative effect. Sometimes you can do like combined ingredient products, which is also fine. It's not like you're going to wake up with diarrhea, hopefully. But magnesium L-threonate is another option. If you do not tolerate glycinate, some people can tolerate L-threonate. So again, it's very case-dependent. Most people tolerate it. It is pretty low risk. We always say you can do up to 5 milligrams per pound of body weight with magnesium.

[23:12] Becca: You can dose it relatively high and a couple other little hacks. If it says that it has more than 200 milligrams of magnesium in a capsule, it is lying. You cannot include more than 200 milligrams of magnesium in a capsule. So you want to find ones that are like 120 milligrams or so. That is much more likely. And then you likely just need to take more than one.

Editor's note: For adults, the NIH sets the upper limit for supplemental magnesium at 350 mg per day unless a clinician directs otherwise, so higher doses should only be used under practitioner supervision. How much elemental magnesium fits in a capsule depends on the form: glycinate capsules typically land around 100–120 mg, while denser forms like oxide can legitimately carry more. Check the label for elemental magnesium.

[23:32] Liz: Yeah. I was going to say I really like Sleep Breakthrough and you can actually mix that. It comes in a powder with tart cherry juice and I would do about 4 ounces there and then put in maybe like a club soda or something. I'm just sending this to a client again this morning because it's a sleepy time mocktail. And so that can be a really nice blend, but you do want to pair it with some protein and fat. It's not necessarily bad to have carbs before bed because that also, carbs have an inverse relationship with cortisol.

[23:58] Liz: If cortisol is high at night, you can pull that down. And this is where we like things like glycine, right? Theanine. There's a lot of things that could work for individuals.

How do light and sound help reset your sleep rhythm?

[24:07] Liz: I will just add here too, that if you do really, really struggle, there is a free app that you can get called Solo Tones. And honestly, this can work for so many things. I was speaking with the owner this morning because he saw my story of just kind of feeling off the past few days. And he was like, get your earbuds out and do a round of Solo Tones because Ethan was sick. And then I was not feeling great yesterday. We got here.

[24:31] Liz: Thankfully it didn't happen during travel, but last night I was feeling real queasy. That's not like me. I got a headache. That's also not like me. And so Solo Tones is a free app. You can use REVIVAL6 or FITMOM6, but for the show, REVIVAL6 is going to give you a six month free subscription to that. And this is basically frequency sound waves that you can use. I did it the other day for our little guy.

[24:57] Liz: Who's going to be two. He doesn't like to nap at home. He naps great at school, but at home he doesn't three hours because I had that playing on a little speaker in his bedroom for him. And so Solo Tones is a great free thing that you can do. Red light. You can do that before bed as well, as long as there's no like blue light or things in there. So there's a couple of things that, you know, you could do from a device standpoint.

[25:20] Liz: One of the things in the morning time, especially as we head into the winter season that I would say, I think is very helpful for circadian rhythm overall is to get a 10,000 lux light, happy light. We've had them for years, obviously here in Illinois, Chicago, even, you know, in Texas, it's dark in the morning now. and I'm up early. So I like to have that because that 10,000 lux light mimics the sun. And so from again, a brain standpoint, this will signal the brain, Hey, awakening response here in the morning. And that can also help you on the back end. So it's a morning routine as well as a nighttime routine that is going to be supportive of having better sleep.

Am I waking up to pee, or peeing because I woke up?

[25:58] Becca: And let's just go through a few questions that we have, because I know some of you will say, well, I wake up because my bladder is full or I wake up because I have to pee or all of these things. And I think about a few years ago, you challenged our listeners and said, but do you really have to pee, or are you just going pee? Cause you've woken up. And I think that that's so true for so many people or the fact that they tell us I can't drink that much water because I'll be up peeing all night.

[26:21] Becca: And I think there's a few things we have to say. so if you limit water at the end of the day, you are actually more likely to wake up to pee because it's irritating to the bladder. So do not believe that myth. you are, or we need to look at pelvic floor therapy because you are not able to control well, or you're too tense there. And so it's causing more contraction and more feelings like you need to pee, which is why it tends to up postpartum.

[26:46] Becca: I experienced this as well with Taylor. I had to basically retrain my pelvic floor cause it was so tight. And I was also doing CrossFit and at that time and like lifting way too heavy. And I would pee when I would like max lift. And so I went to PT for that. But then I realized I was like, I'm peeing literally every hour during the day. Like it was, and it wasn't always fully emptying. And like, I basically had to retrain myself how to use the bathroom properly.

[27:10] Becca: And so kids are great. I love my children. my daughter told me yesterday, she's five that she loved the picture of the model in target. She said she loved him. So we're in that phase, whatever that phase is. but yeah, it's, it is also caffeine late at night. Obviously alcohol is an irritant caffeine in the morning. A lot of people experience this can be an irritant.

[27:32] Becca: So like you need to look at, are you actually waking up to pee or are you peeing because you're waking up and sometimes you just have to white knuckle and retrain your body. Because if you've been doing this for so long, you're going to have to say it, stay in bed and tell yourself I'm okay. I can fall back asleep. And then you retrain the body. I don't have to pee at this time. I don't have to pee at 2 AM when I wake up every night. And then your body will get used to it again in most cases.

[27:57] Becca: So there's a lot of situations where people think it's normal, but they've also created a very kind of almost dependency on the system. And so you have to essentially be like, no, I'm wake up at 2 AM. Yes. I kind of have the urge to pee, but I'm not going to get up and let myself do it. I'm going to go back to sleep. And yeah, I did that. I used to be in the middle of the night all the time and now I don't ever get up to go.

Why does checking my phone at 3am make it worse?

[28:18] Becca: And the last thing that we'll say here is the worst thing you can do is get on your phone in the middle of the night. Because again, it's the blue light. I just got a new, actually we just put it on this morning cover for my phone that blocks all blue light. So instead of, you know, there's settings on your iPhone that you can turn it to yellow after a certain time. So mine was set for 7 PM. And then after that, but truly just trying to think about all these little things that add up because I've really been working hard on stress and trying to get my HRV up and just, you know, recovery and those types of things.

[28:49] Becca: So there's even now some of the different, um, phone screen protectors that you can get that will have blue light blocking in there. But if you're not sure what is fueling these wake ups, you can click the link in the show notes. There's going to be a quiz there. Take that. And we'll tell you what is the fuel line that may be part of your picture. And again, if you're looking for help with us, we're going to always schedule a call with our team. It's a free 15 minute consult to discuss you, your situation, your health history, the things that you've done, where you're at in life and how we can help.

Frequently asked questions

Why do I wake up at 3am with my mind racing?

A racing mind at 3am usually points to cortisol. Cortisol should be lowest around midnight, start climbing in the early morning, and peak when you wake. When that rhythm is dysregulated, FitMom's Liz Roman explains, your body starts its morning shift early and already stressed. Waking up jolted, alert, shaky or hot points more toward a blood sugar dip and the adrenaline that follows it.

Can low blood sugar wake you up in the middle of the night?

Yes. If you eat dinner early and nothing before bed, blood sugar can drop overnight. Your body treats that as an emergency and releases adrenaline to bring glucose back up, and adrenaline is a wake-up hormone. Becca Chilczenkowski of FitMom points out that the adrenaline surge after the drop is what actually wakes you, which is why you come to suddenly alert instead of groggy.

Are 3am night sweats always caused by hormones?

Not always. Shifting estrogen and progesterone in perimenopause are a real cause of night sweats, and hormone therapy from a physician is a legitimate option. But FitMom's practitioners regularly see women who wake up hot because of a blood sugar crash and the adrenaline that follows, or a histamine response. When hormone support doesn't fix the wake-ups, blood sugar and cortisol are the next place to look.

Does progesterone help you sleep through the night?

For some women, yes, and when it works the wake-ups stop. But FitMom's practitioners don't treat progesterone as a sleep medication. Many women take it and still wake at 3am, because the real driver was blood sugar or cortisol. Some women, especially those with histamine issues, don't tolerate progesterone and feel worse on it. Decisions about progesterone belong with your prescriber.

Why am I gaining belly fat when I'm not eating more?

Night after night of disrupted sleep keeps cortisol and blood sugar swinging, and cortisol favors storing fat around the midsection. In perimenopause, falling estrogen also shifts fat storage from the hips and thighs to the belly, sometimes with no change on the scale. FitMom's Becca Chilczenkowski says the women in this spot are usually doing everything right, which makes it a stress signal rather than a willpower problem.

Why is my blood sugar fine during the day but I still wake up at night?

Daytime checks miss what happens overnight. Before dawn your body releases hormones that raise blood sugar, a normal pattern called the dawn phenomenon that gets exaggerated as insulin rises. If your fasting glucose is creeping from the 90s toward the 100s or 110s, that can signal early insulin resistance. FitMom tests fasting insulin and A1C, not just fasting glucose, because insulin rises first.

Does eating a snack before bed help you stay asleep?

It can, especially if you eat dinner early or undereat during the day. FitMom's practitioners suggest a small snack with protein and a little fat, like Greek yogurt with peanut butter, a hard-boiled egg, or a rice cake with nut butter, to keep blood sugar steadier overnight. Keep it small and not greasy, because a large, heavy meal close to bedtime has the opposite effect.

Does drinking wine at night make 3am wake-ups worse?

Usually, yes. Alcohol can help you fall asleep faster, but research on alcohol and sleep shows it disrupts the second half of the night, which is exactly when 3am wake-ups happen. FitMom's Liz Roman and Becca Chilczenkowski note that a heavy late meal and a blood sugar roller coaster show up in that same 1am to 4am window, so the effects stack.

Should I stop drinking water at night so I don't wake up to pee?

FitMom's Becca Chilczenkowski says limiting water late in the day can backfire, because concentrated urine irritates the bladder and makes waking to pee more likely. Ask whether you're waking up to pee or peeing because you woke up. Pelvic floor therapy and gently retraining the habit help many women. If frequent nighttime urination is new, get it checked by your doctor.

Is it normal to wake up once during the night?

Yes. Waking briefly and falling straight back to sleep is common and not a concern. FitMom's practitioners pay attention to a different pattern: waking fully with your heart racing and your brain switched on, then lying there unable to fall back asleep. That is the body's alarm going off, driven by cortisol, adrenaline and blood sugar, and it usually shows up between 1am and 4am.

Key terms

Cortisol awakening response (CAR)

The normal rise in cortisol in the first hour after waking. It prepares you for the day. A flattened or mistimed CAR is one sign the cortisol rhythm has drifted.

Circadian rhythm

Your roughly 24-hour internal clock. It sets when cortisol rises and falls, and it's heavily cued by light, especially morning light and evening screen light.

Adrenaline surge

A fast release of adrenaline (epinephrine). Overnight, it can be triggered by a blood sugar drop and wakes you suddenly alert, sometimes hot or shaky.

Dawn phenomenon

A pre-dawn release of hormones that raises blood sugar. It's normal, but it becomes exaggerated as insulin resistance develops.

Fasting insulin

A blood test for insulin after an overnight fast. Insulin typically rises before fasting glucose or A1C do, which makes it an earlier signal of insulin resistance.

Hemoglobin A1C

A blood test that estimates average blood sugar over roughly three months. It's useful, but it moves later than insulin.

Insulin resistance

When cells respond less to insulin, so the body produces more of it to keep blood sugar in range.

Histamine response

Release of histamine from immune cells. It can widen blood vessels and is one overlooked reason some women wake up hot at night.

Fuel line

FitMom's term for what feeds the symptoms. Symptoms are the smoke; the fuel lines are gut, blood sugar and cortisol.

DUTCH test

A dried urine test that maps cortisol across the day, including the cortisol awakening response, along with sex hormone metabolites.

CGM (continuous glucose monitor)

A wearable sensor that tracks blood sugar around the clock, typically for about two weeks. Best used for trends rather than single readings.

Magnesium glycinate

A form of magnesium bound to the amino acid glycine. It's the form most often used for sleep and is gentler on digestion than magnesium citrate.

Blue-light-blocking glasses

Glasses that filter blue light from screens in the evening. Amber or red lenses filter far more than clear ones.

Sources

• Al Khatib HK, et al. The effects of partial sleep deprivation on energy balance: a systematic review and meta-analysis. Eur J Clin Nutr. 2017;71(5):614-624. https://doi.org/10.1038/ejcn.2016.201
• Ebrahim IO, et al. Alcohol and sleep I: effects on normal sleep. Alcohol Clin Exp Res. 2013;37(4):539-549. https://doi.org/10.1111/acer.12006
• Gooley JJ, et al. Exposure to room light before bedtime suppresses melatonin onset and shortens melatonin duration in humans. J Clin Endocrinol Metab. 2011;96(3):E463-E472. https://doi.org/10.1210/jc.2010-2098
• Burkhart K, Phelps JR. Amber lenses to block blue light and improve sleep: a randomized trial. Chronobiol Int. 2009;26(8):1602-1612. https://doi.org/10.3109/07420520903523719
• Tabák AG, et al. Trajectories of glycaemia, insulin sensitivity, and insulin secretion before diagnosis of type 2 diabetes: an analysis from the Whitehall II study. Lancet. 2009;373(9682):2215-2221. https://doi.org/10.1016/S0140-6736(09)60619-X
• NIH Office of Dietary Supplements. Magnesium: Fact Sheet for Health Professionals. https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/

This episode and page are for education only and are not medical advice. FitMom does not diagnose or treat disease. Talk with your own healthcare provider before changing medications or supplements. Individual results vary.