Waking up at four or five in the morning can be due to physiologic and pathologic factors. Common pathological factors include: high blood pressure, anxiety and depressive states. 1. Physiological factors: If the sleeping environment is too noisy or if you fall asleep in an unfamiliar environment, it is easy to wake up early. In addition, most of the elderly people will also have early waking up because their sleep time is relatively shortened with the change of sleep rhythm, which is a normal physiological phenomenon and does not require special treatment. 2. High blood pressure: patients generally in the early morning and the morning blood pressure is more likely to rise, which can easily lead to dizziness and other uncomfortable symptoms, resulting in waking up at 4:00 or 5:00 in the morning. 3. Anxiety and depression state: Anxiety and depression patients can have sleep disorders, such as difficulty in falling asleep, waking up early, etc. Patients usually wake up 2 to 3 hours earlier than usual. In conclusion, if it is caused by pathological diseases, waking up at 4 or 5 in the morning, it is recommended to go to the hospital in time to do the examination, clear diagnosis and targeted treatment.