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Hi Sage's Mom,

I was just thinking...not sure if I am helping here but here goes...

You said she is tethered by your bed. Could it be that she wakes up at 5:30 and pulls trying to walk/run someplace and chokes herself? I know that Coal will sometimes get a little hyper on his leash when he is tethered somewhere to the point where he starts kind of choking himself and coughing. I imagine that could lead to vomiting. Just a thought.

If this may be a possibility, then a crate may be a better option for Sage at night.
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