Have you ever wondered what role your pelvic floor plays in your pre-bedtime and sleeping habits? While the connection isn’t immediately obvious, you’ll soon see how important it is.
As a pelvic floor physical therapist, I often discuss the significance of waking up at night to urinate. If you’re frequently getting up once, twice, or even three times a night to use the bathroom, it could point to several issues. We often talk about bladder irritants, the importance of hydrating well before bed, and methods to “retrain” the bladder through healthy habits.
All these factors are crucial, but there’s another key reason we should avoid nighttime bathroom trips: waking up to pee at night may indicate that you’re not entering the vital REM (Rapid Eye Movement) sleep cycle. This stage of sleep is incredibly important for mood, memory, and overall learning.
During REM, your body goes through incredible changes, including the secretion of the antidiuretic hormone (ADH). ADH’s primary role is to reduce the amount of water excreted through urine, conserving the body’s fluid levels.
We urinate less and produce more ADH whenever our bodies need to hold onto fluids. Conversely, when we are well-hydrated, ADH levels lower, and we urinate more regularly—every two to three hours, with a good steady flow lasting eight to twelve seconds.
ADH not only plays a vital role in hydration but also significantly impacts our ability to sleep through the night. So, how can an adult who drinks sufficient water sleep for more than eight hours without needing to urinate?
Increased production of ADH during REM sleep reduces the volume of urine produced, allowing us to sleep without interruption. This means if you’re not entering REM sleep, your ADH levels may stay low, causing your nighttime urine production to remain at daytime levels, leading to those late-night bathroom visits.
To improve this situation, adopt healthy sleep habits that help you enter the REM cycle, increase ADH production, and ultimately avoid the need to wake up in the middle of the night to pee.
Be mindful of your fluid intake before bed. For example, consuming 32 ounces of water an hour before sleep may inevitably force you to wake up during the night. Alcohol is another culprit, as it inhibits the release of ADH, subsequently increasing urine production and leading to dehydration. This means that enjoying a glass of wine before bed might result in a nighttime trip to the bathroom.
Suggestions for Good Sleep Habits:
Establish a regular sleep routine by going to bed at the same time each night. Consistency helps signal to your body when it’s time to wind down.
Engage in calming nighttime routines such as meditating, taking a warm bath, or listening to soothing music. These activities prepare your body for sleep.
Regular exercise is crucial, but make sure to finish any vigorous activity at least two hours before bed to avoid disrupting your sleep.
Limit your intake of stimulants like nicotine and caffeine. Try to avoid caffeine after midday and recognize that initial nicotine withdrawal can initially make falling asleep harder, but you’ll sleep better in the long run.
Avoid eating right before bed. Aim to have your dinner at least two hours before sleep, though a light snack before bed can actually help some people sleep better.
Steer clear of alcohol before bed. While it might help you fall asleep quickly, it can disrupt your sleep cycle, causing you to wake frequently and sometimes inducing nightmares.
Take short naps during the day to build up a “sleep debt” and make it easier to fall asleep at night.
Reserve your bedroom for sleep and intimacy. Avoid activities like eating, watching TV, or working in bed to strengthen the association between your bed and restful sleep.
Stop using screens—TVs, phones, tablets, and laptops—two hours before bed. The light from these devices can confuse your brain into thinking it’s daytime, disrupting your natural sleep-wake cycle.
Make sure your bedroom is comfortable, quiet, and cool to create the perfect sleep environment.
