Night awakenings between 3 and 4 in the morning: possible causes and how to improve rest

Over 25 years of clinical practice, it has been observed that nighttime awakenings between 3 and 5 a.m. are rarely explained by aging or stress alone. In most cases, the body is sending specific signals of imbalances that should be identified and corrected.

Below, five real causes that often go unnoticed are discussed, along with a practical protocol to improve rest.

Five common causes of nighttime awakenings

1) Nocturnal sugar drop (hypoglycemia)

A dinner that is too light, too early or too low in protein and healthy fats can cause a drop in glucose during the early morning. Between 3 and 4 a.m., the body releases warning hormones (such as adrenaline and cortisol) to raise blood sugar, which disrupts sleep and can lead to palpitations, sweating, or anxiety.

Keys to observe: waking up with a feeling of hunger, nervousness, cold sweat or difficulty going back to sleep.

2) Overloaded liver

Alcohol consumption, fatty or very late meals, and stagnant bile can prevent deep sleep. The liver works intensely at night; When overloaded, body heat, night sweats, and repeated awakenings appear.

Keys to observe: night heat, sweating, digestive heaviness, waking up after copious dinners or with alcohol.

3) Hormonal imbalances

Hormonal changes have a decisive influence on rest:

• Women: perimenopause and menopause, with a decrease in progesterone and estrogen, can fragment sleep.
• Men: the decrease in testosterone also affects the continuity of rest.
• Thyroid: Both excess and deficit of thyroid hormones disrupt sleep rhythms.

Keys to observe: hot flashes, sweating, mood swings, persistent insomnia, daytime tiredness.

4) Sleep apnea and snoring

Breathing pauses during sleep can go unnoticed by those who suffer from them. However, they fragment rest and increase the risk of heart attack and stroke up to three times.

Keys to observe: intense snoring, pauses when breathing (observed by another person), awakenings with a feeling of suffocation, marked daytime sleepiness.

5) Magnesium deficiency

Magnesium is involved in muscle and nervous system relaxation. Its deficiency is associated with cramps, shaking in the legs, anxiety and nocturnal awakenings. It is estimated that 9 out of 10 people over the age of 40 do not consume enough magnesium.

Keys to observe: night cramps, restlessness in the legs, muscle tension, difficulty falling asleep or staying asleep.

Step-by-step protocol to improve rest

Organize dinner to avoid hypoglycemia

• Balanced dinner, not excessively early.
• Include protein (fish, eggs, legumes) and healthy fats (olive oil, nuts).
• Avoid simple sugars and alcohol at night.

Support the liver

• Reduce alcohol and heavy fats at dinner.
• Maintain regular schedules.
• If there are persistent symptoms, ultrasound and liver analysis should be assessed as indicated by the professional.

Hormone Evaluation

• Women: Consider estrogen and progesterone studies in the context of symptoms.
• Men: assess testosterone.
• Both: include thyroid function.
• Hormone therapy should only be considered after individual medical evaluation.

Sleep Apnea Suspicion and Study

• Observe snoring and breathing pauses.
• If there is daytime sleepiness or awakenings with choking, consult for specific sleep studies.

Magnesium: form, timing and dosage

• Prefer well-absorbed forms (e.g., citrate or glycinate).
• Take it in the evening, according to a dose recommended by a professional.
• Adjust according to tolerance and individual needs.

Sleep hygiene

• Cool and stable temperature.
• Darkness and silence.
• Avoid screens at least an hour before sleeping.
• Create relaxing nighttime rituals.
• 4-7-8 breathing: inhale 4 seconds, hold 7, exhale 8; Repeat several times to facilitate return to sleep without medication.

Important Notice

This content is not a substitute for an in-person medical consultation. If nighttime awakenings last more than a month, there is snoring with breathing pauses, chest pain or intense daytime sleepiness, it is essential to consult with a health professional for a proper evaluation.

Understanding the real causes of awakenings between 3 and 4 in the morning allows us to act specifically and safely. With targeted adjustments and professional tracking, it’s possible to regain a deep, restful night’s sleep.

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