Healthy Body

Waking Up To Pee at Night? A Common Sleep Disorder Could Be the Culprit

Phpto: Stocksy/ BONNINSTUDIO
It's estimated that nearly 22 million Americans experience sleep apnea, a breathing disorder that causes short, frequent pauses in breathing during sleep. It's a challenging disorder to diagnose because many of the symptoms happen when you're, well, asleep. As a result, a considerable percentage of moderate to severe cases go undiagnosed, says Kent Smith, D-ABDSM, ASBA, president of the American Sleep and Breathing Academy, a diplomate of the American Board of Dental Sleep Medicine.

One common symptom to look out for? Getting up to pee two or more times in a night. Two or more instances of nighttime urination (nocturia) are observed in approximately 80 percent of people with obstructive sleep apnea, says Carleara Weiss PhD, MSH, RN of Aeroflow Sleep. However, it does not mean that everyone that wakes up to use the restroom has sleep apnea. This is just one clue you can use to figure out what's going on with your health.

What is sleep apnea

As mentioned above, sleep apnea is a breathing disorder that causes short, frequent pauses in breathing during sleep, says Dr. Smith. These pauses only last seconds at a time but can occur hundreds of times throughout the night, reducing oxygen flow and impacting both sleep quality and overall health, he adds. There are a few different types of sleep apnea, Dr. Smith says.

One of the most common types of sleep apnea is obstructive sleep apnea which is when the airway is disrupted because of the mechanics of the throat. Central sleep apnea is characterized by mix-messaging between your brain and body—which essentially results in skipping a breath beat while you sleep. There’s also, according to the Mayo Clinic, a combination type that features both sources of the disorder called complex sleep apnea syndrome.

Research shows that sleep apnea negatively impacts our quantity and quality of sleep and puts us at a higher risk of experiencing negative events like a car crash or developing conditions, such as diabetes or heart disease. These risk factors make it critical for those impacted by sleep apnea, or those who suspect they might be, to visit a doctor and get treated for their condition.

What are the symptoms of sleep apnea

Some of sleep apnea's most common symptoms are snoring, frequent breaks in breathing, excessive fatigue or sleepiness during the daytime, morning headaches, insomnia, depression, acid reflux, irritability, and frequent nighttime urination.

However, symptoms present themselves differently across gender. Men traditionally fit the stereotype of a loud snorer more frequently, whereas women typically replace snoring symptoms with hot flashes and night sweats. And as we mentioned, the most significant barrier to diagnosis is that most people may not be aware they have the condition.

When is waking up to pee every night a sleep apnea sign

Getting up to use the bathroom frequently throughout the night can be a sign of sleep apnea if accompanied by the other symptoms mentioned, Dr. Smith says. Peeing at night is a condition known as nocturia. It's estimated that 50 million American adults suffer from the condition, with only 10 million of those diagnosed.

Other nocturia symptoms to look out for include fatigue, drowsiness, memory loss, or an uncharacteristically short attention span. It's not uncommon for nocturia and sleep apnea to be misdiagnosed.

"Although the exact mechanism is not fully understood, the thought is that during sleep apnea episodes, the body gets less oxygen which makes the heart pump more blood faster, which can cause an increased volume of blood filtering through the kidneys, which makes more urine," says Aleece Fosnight MSPAS, PA-C, CSCS, CSE, NCMP of Aeroflow Urology. More urine equals a fuller bladder which equals more peeing during the night.

Both Fosnight and Weiss recommend patients track their urinations throughout the night in a log, along with other symptoms like snoring, waking up with a dry mouth or dry throat, headaches, daytime sleepiness, dehydration, and mood swings.

Common treatments for sleep apnea

Diagnosis is super important for sleep apnea, says Dr. Smith. Treatments are largely based on the type of disorder you have, the severity, and your symptoms. One popular form of treatment is called, continuous positive airway pressure (CPAP), according to the Mayo Clinic. This therapy involves wearing a mask connected to a machine that pumps a constant stream of air to ensure your body is getting the right amount of oxygen, despite sleep apnea’s influence on your breath. Surgery is an option for curbing some symptoms, and you can talk to your doctor about mouthpieces you can wear to support your airways.

What to look out for and understand

There are many physiological reasons someone might wake up frequently to pee, says Fosnight. As we age, we don't get enough deep sleep which leaves us more susceptible to easy wakening. Waking up is a biological trigger for the bladder to signal that it's time to pee; however, if you're not sleeping deeply, it can result in waking you up to pee and consequently making it hard to fall asleep, if this happens every night—it can deprive you of quality sleep, too.

Trying to limit the intake of liquids to 90 minutes before sleep and avoiding bladder irritants like sodas, alcohol, and acidic drinks can all prevent you from getting up to pee at night. If you adhere to these rules and continue to experience nocturia—consider talking to a provider about your symptoms.

Many adults associate nighttime urination with a "normal" part of aging and don't bring it up to their doctor, says Dr. Smith. However, it is important to discuss bladder health at your next check-up—along with any other observed symptoms.

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