One observation: If you're often waking up around 3am, it is a strong indicator for histamine/MCAS issues. This is fairly new research, so most people dont know about it, I haven't had a single doctor yet who was familiar with this.

The mechanism: mast cells (the immune cells that release histamine among other things) have their own circadian clock. The CLOCK gene controls their IgE receptor expression in a time-of-day manner, and both plasma histamine and tryptase peak during the night. In healthy people this is fine. In MCAS or histamine intolerance, this nightly mediator release is excessive, and it happens right in the window where cortisol (which normally suppresses histamine release) bottoms out around 2-4am. Histamine is itself a wake-promoting neurotransmitter, so you get woken up, often by something minor like a noise, reflux, or a temperature shift that wouldn't otherwise register. Signs it might be worth looking into: 3am waking with a racing heart, sweating, flushing, itching, or reflux/throat tightness. A good in-depth resource: https://health.programmerlife.org/en/