Waking consistently between 1:00 and 3:00 am can be frustrating and often dismissed as a sign of disturbed sleep or insomnia. However, according to the principles of Traditional Chinese Medicine, the specific time window may hold a deeper meaning. In TCM, this pattern may particularly signal an imbalance in the liver’s energy system.
Understanding the TCM organ clock
Traditional Chinese Medicine, is based on the concept of QI, or life force energy, one that flows through the organ systems in 24 hour cycle. Each organ in the body has a designated two-hour window when its energy is believed to be most active. The liver’s peak time occurs between 1:00 and 3:00am. These are the peak hours, the liver is responsible for cleansing the blood, supports digestion and regulates hormone. If sleep becomes disrupted during these hours, TCM interprets this as a potential disturbance in the liver function.
Possible TCM interpretations:
Liver Qi stagnation: Emotional stress, or physical fatigue can restrict the energy flowLiver heat or excess yang: Inflammation, overconsumption of alcohol, intake of spicy foods, repressed emotions may lead to internal heat and that disturbs the rest and sleep cycle too.Blood or Yin deficiency: Insufficient nourishing energy may weaken the liver’s ability to restore balance at night.The Traditional Chinese Medicine also says that unresolved anger, frustration are stored in the liver, making emotional health a significant factor in sleep quality, especially during this time.
Circadian rhythms
Although the TCM organ clock is not accepted in conventional Western medicine, new research in chronobiology has revealed that organs do have circadian rhythms. The liver, for instance, processes different metabolic and detoxifying functions mostly during sleep. While there is no direct evidence connecting wakefulness at certain hours with liver dysfunction, there are similarities between ancient precepts and current physiological cycles.
Bidirectional relationship between sleep and liver disease
A research published under the Lancet Gastroenterology and Hepatology, with the name Sleep and liver disease: a bidirectional relationship results show that over 50% of the patients with cirrhosis experience sleep-wake disturbances and this can worsen as liver disease progresses. A vicious cycle is described: liver dysfunction causes sleep disturbances, and poor sleep further worsens liver health.The bigger picture: Circadian rhythms and liver functionSleep is governed by both homeostatic pressure (sleep need) and circadian rhythms (biological clock). The liver itself has circadian rhythms, regulated by both central and peripheral clocks. Sleep disruption can throw off metabolic processes in the liver, contributing to NADLF and insulin resistance.
Lifestyle factors
Several lifestyle patterns may align with TCM explanations for disrupted sleep between 1 and 3 a.m.:
- Consumption of alcohol or heavy meals late at night
- Elevated stress levels or unresolved emotional tension
- Late bedtimes that interfere with the body’s rest cycles
- Exposure to blue light and mental stimulation before sleep
To promote better sleep and support liver health, the following practices are often recommended within the framework of TCM:
- Consuming a balanced diet rich in green leafy vegetables and limiting alcohol
- Establishing a consistent sleep schedule with a target bedtime before 11:00 p.m.
- Engaging in calming routines in the evening such as breathing exercises, light stretching, or mindfulness
- Using liver-supportive herbs such as dandelion, chrysanthemum, or milk thistle, with professional guidance
- Releasing emotional stress through journaling, creative activities, or therapy
When can a medical evaluation become necessaryFrequent waking up between 1 and 3 am, may indicate underlying medical conditions such as hormonal imbalances, liver diseases, sleep disorders and even anxiety. If these conditions persist, take quick action and seek professional medical advice as prolonged sleep problems can lead to unavoidable situations in the near future.
