Ever wondered why waking up to pee in the middle of the night isn’t ideal? As a pelvic floor physical therapist, I’ve got some insights to share with you.

When patients tell me they wake up once, twice, or even three times a night to use the restroom, I explain a few key points. There are bladder irritants to avoid, the importance of staying hydrated before bed, and methods to retrain your bladder to develop better habits.

But here’s the kicker: getting up at night to go to the bathroom can also mean you’re not reaching the crucial REM (rapid eye movement) stage of sleep!

REM sleep is vital because it helps with mood regulation, memory, and learning.

During REM, your body releases antidiuretic hormone (ADH). This hormone’s main job is to reduce the amount of water your body loses through urine, helping to maintain your body’s fluid levels.

Essentially, when we need to conserve fluids, we urinate less and secrete more ADH. On the other hand, when we’re well-hydrated, ADH levels drop, and we urinate more frequently—every two to three hours, with a robust flow lasting eight to twelve seconds.

ADH is not just crucial for staying hydrated; it’s also important for sleeping through the night.

An adult who drinks enough water usually needs to urinate every two to three hours. So, how do we manage to sleep for over eight hours without getting up?

Here’s where REM sleep comes into play. REM increases the production of ADH, which reduces urine production. This means less frequent urination and uninterrupted sleep.

If you’re struggling to reach REM sleep, your body won’t produce as much ADH. This keeps your urine production at “daytime” levels, leading to nighttime bathroom trips.

To tackle this, cultivate good sleep habits that help you enter REM sleep, leading to more ADH production and fewer nighttime trips to the bathroom. Of course, if you drink a large amount of water before bed, waking up is inevitable.

Additionally, alcohol inhibits ADH release, which boosts urine production and dehydrates the body. So, if you enjoy a glass of wine before bed, you’re likely to need the restroom during the night.

Suggestions for Good Sleep Habits:

1. Establish a Regular Sleep Routine: Go to bed at approximately the same time every night.

2. Create Soothing Nightly Routines: Meditate, take a bath, or listen to music to signal your body that it’s time to sleep.

3. Exercise Regularly: But ensure your workout is at least two hours before bedtime.

4. Cut Back on Stimulants: Nicotine and coffee can disrupt your sleep. Try to avoid caffeine after midday.

5. Avoid Late-Night Eating: Aim for a two-hour gap between dinner and bedtime. However, a light snack before bed can help some people sleep better.

6. Steer Clear of Alcohol: While it might help you fall asleep initially, it can disrupt your sleep cycle, leading to frequent awakenings and possible nightmares.

7. Take Short Daytime Naps: This can help collect “sleep debt,” making it easier to fall asleep at night.

8. Use Your Bedroom for Sleep and Intimacy: Avoid activities like watching TV or using devices in bed to associate your bedroom with sleep.

9. Limit Screen Time: Turn off screens at least two hours before bed. The light can confuse your brain into thinking it’s still daytime.

10. Make Your Bedroom Comfortable: Ensure your sleep environment is cozy, quiet, and cool.