What it means when you wake up in the night, from needing to pee to insomnia – and how many times isn’t normal
SOME people have trouble getting to sleep, but for a large majority of us, staying asleep is the real problem.
While a few brief awakenings in the night is considered normal – with some awakenings so brief you won’t even be aware of them – waking up frequently throughout the night could be signalling something wrong with your health.
Our Health Kick survey of Sun readers found people wake up 2.3 times a night on average.
This is considered normal by Dr Lizzie Hill, a clinical scientist and senior lecturer in sleep physiology at The University of the West of England in Bristol.
She explained: “Most people will wake up once or twice and go straight back to sleep.
“We sleep in roughly 90 minutes cycles of light and deep sleep throughout the night, and it’s normal to wake briefly between cycles, sometimes turning over or going to the toilet.
“We can also be woken up external factors, such as our bedroom being too bright, too noisy or too hot or cold.”
Dr Zoe Williams, our resident GP, said it’s not how many times you wake or get up in the night that’s a concern, but what you do in that time.
Nocturia
Night-time peeing is normal said Dr Zoe, but waking up frequently in the night to pee (known as nocturia) could be a sign of a underlying health issue.
In response to a reader’s question about repeated night-time peeing, she said: “As adults we enter a new sleep cycle every 90 minutes or so, and when we progress from one sleep cycle to the next we have a period of very light sleep and often brief awakenings which are normal and do not impact us negatively.
“It is in these moments of light sleep that we will notice the urge to pass urine and wake to do so.
“So waking up briefly to pee, between sleep cycles, is not really detrimental to your sleep or health, as long as you get straight back off to sleep, when you get back into bed.
“Therefore it’s of utmost importance what you do when you wake up. Turning on too many lights, looking at your phone, checking the time, or even getting upset that you’ve woken up are all things that can prevent you from getting straight back off to sleep when you return to your bed.
“So, when you first feel the urge to pee, it’s best to get straight up, go to the loo, and get straight back into bed whilst trying to stay as sleepy as possible. If you can do this.
“One in three adults over the age of 30 will have nocturia, so it’s very common and it increases in prevalence as we get older. How to manage nocturia will depend on its cause.”
Causes of nocturia include ageing, urinary tract infections, caffeine, alcohol, some medications, underlying medical conditions such as diabetes, as well as menopause in women and prostate issues in men.
Waking up frequently in the night can lead to excessive sleepiness during the day and can be a sign of other underlying sleep disorders, said Dr Hill.
Sleep apnoea
The first is breathing problems. She said: “Breathing problems can cause us to wake up during the night – if you snore, wake up choking or gasping, are very restless or have been told you have periods where you stop breathing while you’re asleep, you could have a condition known as obstructive sleep apnoea.”
Sleep apnoea can be caused by obesity, alcohol, smoking, and some medications.
If other family members have sleep apnoea, you may be more likely to have it too.
But it needs to be treated as soon as possible because it can lead to more serious problems.
Insomnia
Frequently struggling to get to sleep, worrying about getting to sleep, or spending long periods awake during the night which are not related to breathing, could be a sign of insomnia, said Dr Hill.
She advised: “You may benefit from treatment to break the cycle of poor sleep.”
The NHS says you can usually treat insomnia by changing your sleeping habits:
- go to bed and wake up at the same time every day
- relax at least one hour before bed, for example, take a bath or read a book
- make sure your bedroom is dark and quiet – use curtains, blinds, an eye mask or ear plugs if needed
- exercise regularly during the day
- make sure your mattress, pillows and covers are comfortable
When should you see a GP?
If you’re experiencing regular poor sleep or sleepiness which is affecting your daytime activities or quality of life, speak to your GP in the first instance.
Dr Hill warned: “Untreated obstructive sleep apnoea can lead to serious health problems including heart problems and diabetes, so see your GP if you have symptoms.
“You can find more information at https://www.asthmaandlung.org.uk/conditions/obstructive-sleep-apnoea-osa.
“The first line treatment for insomnia is cognitive behavioural therapy for insomnia.
“Sleepio is a digital cognitive behavioural therapy app which is recommended by NICE (National Institute for Care Excellence) and is available free to NHS patients: Onboarding Sleep Test – Sleepio.”
The best sleep routine and environment
Thomas Høegh Reisenhus, TEMPUR® sleep specialist & sleep counsellor, reveals the key components of a good bedtime routine and environment...
A sure-fire way to facilitate a better night’s sleep is to practice good sleep hygiene.
Establish a sleep routine that works for you and stick to it.
This will help your body establish a consistent, natural sleep-wake cycle which can do wonders for your overall sleep quality.
As such, try to avoid making up for lost sleep with a lie-in.
Instead of sleeping in, spend your morning reading a book in bed or having a leisurely coffee in the kitchen.
Ensure that your bedroom, bedding, and sleepwear are fit for purpose too.
The ideal sleep environment is dark, quiet, and cool – much like a cave.
If you find unwelcome sources of light are keeping you up, consider investing in an eye mask or black-out curtains.
Adding soft furnishings can be a great way to reduce noise, with the surfaces having an absorptive quality, but if this doesn’t work, consider embracing a soothing soundtrack to block it out.
In terms of temperature, try to keep your bedroom at 18°C. You can further reduce the risk of waking up due to overheating by ensuring that all your bedding and sleepwear is made with natural, breathable materials such as cotton and linen.
Bear in mind that everyone is different; what might work for most, may not work for you!
Whilst knowing how much sleep you should get, how to overcome common barriers, and practicing good sleep hygiene can facilitate a great night’s sleep, if you continue to struggle with sleep or fatigue persistently, do not hesitate to visit a doctor or health professional for support.