For most of my adult life, I barely thought about sleep, then I hit my forties and started waking up at 3am for no apparent reason. Wide awake and unable to get back to sleep.

Not every night, but often enough to notice, and judging by the number of women asking the same question, I’m clearly not alone.

For years I assumed I was doing something wrong, but the reality, as it turns out, is a little more complicated than that.

01. Why do I keep waking up at exactly 3am?

It feels oddly specific, doesn’t it?

One explanation is cortisol, the hormone that helps wake us up in the morning. Cortisol naturally starts to rise in the early hours as part of our body’s normal sleep-wake cycle, but during midlife, hormonal fluctuations can leave the nervous system more sensitive to stress, causing that rise to happen earlier or more sharply, pulling you out of deep sleep with a racing mind.

02. Is this a perimenopause thing?

Quite often, yes.

Perimenopause affects much more than periods. Falling levels of oestrogen and progesterone can disrupt the body’s sleep-wake cycle, making sleep lighter and more fragmented.

Hot flushes and night sweats are the obvious culprits, but even women who don’t experience them can notice changes in their sleep long before menopause arrives.

In other words, waking up at 3am isn’t always a sign that something is wrong. Sometimes it’s simply one of the many ways hormonal shifts show up.

03. Is it stress, hormones or blood sugar?

Annoyingly, it could be all three.

What surprised me most while researching this was how connected everything is.

Declining hormones can make the nervous system more sensitive to stress. Stress can increase cortisol. Hormonal changes can also affect how well blood sugar is regulated overnight, which may trigger the release of adrenaline and cortisol while you’re asleep.

By the time you wake up, it can feel like your brain has suddenly switched on for no reason at all. Often it feels completely random, but there is usually an explanation, it’s just happening quietly behind the scenes without us noticing.

04. What should I do when it happens?

The advice that came up again and again was surprisingly simple: if you’ve been lying awake for around 20 minutes, get out of bed.

It sounds counterintuitive, but staying in bed frustrated can teach your brain to associate your bed with wakefulness rather than sleep.

Read a book, keep the lights low, avoid scrolling and wait until you feel sleepy again before heading back to bed.

05. Should I be worried?

For most women, occasional early-morning waking is a normal part of ageing and hormonal change, but if broken sleep is affecting your daily life, it’s worth speaking to your doctor.

Sometimes sleep disruption is simply part of midlife, and sometimes there’s an underlying issue that needs addressing.

What surprised me most while researching this was how many different things can influence sleep during midlife.

We often assume we’re doing something wrong, but sometimes our bodies are simply changing.

The good news is that understanding what’s happening in your body can make these wake-ups feel a lot less mysterious and, perhaps more importantly, a lot less worrying.

What I’ve learned is that waking up at 3am is incredibly common during perimenopause and the years that follow, and it’s rarely caused by one thing alone.

More often, it’s a combination of changing hormones, shifting sleep patterns, stress and the realities of modern life all colliding in the early hours of the morning.

It’s not something to ignore, but it’s not necessarily something to worry about either.

Until the next edition,

Editor, MIDLIFE