According to insomnia specialist Kathryn Pinkham, founder of the Insomnia Clinic, waking at 3am is a common experience often linked to heightened alertness rather than underlying health issues. Pinkham, who has helped over 6,000 people improve their sleep in 15 years, says that most people simply need correct information rather than therapy.
Pinkham advises that if you wake up feeling alert, it is better to leave the bedroom and read or watch TV until you feel sleepy again. Spending too much time awake in bed can weaken the association between bed and sleep, making insomnia worse.
She notes that occasional poor sleep is normal, especially under stress. However, insomnia develops when a cycle of worry about sleep takes hold. Key signs include sleep affecting daytime function, mood, or thinking, and persistent sleep difficulties lasting more than a few weeks.
Cognitive behavioural therapy for insomnia (CBT-I) is the gold-standard treatment, focusing on behavioural and psychological patterns rather than temporary fixes. Pinkham acknowledges that one-to-one CBT-I may not be accessible for everyone, so she created an online programme to provide structured, evidence-based strategies.
For women experiencing sleep disruption due to hormonal changes, Pinkham explains that while hormone replacement therapy (HRT) can help with symptoms like hot flushes, it may not resolve sleep issues that have become habitual. The brain can become vigilant around sleep after a period of poor nights, perpetuating the problem.
