Why You Always Have To Pee Right When You Fall Asleep

Photographed by Michael Beckert.
Your guided meditation comes to a close. Your body sinks into your mattress. Your eyelids feel heavy. After the longest day ever, you're finally falling asleep. But then, like clockwork, you feel the familiar pressure on your bladder and realize you have to pee. Dragging yourself to the bathroom means you'll have to fall asleep all over again, but holding it could result in a urinary tract infection. So, reluctantly, you get up and pee, starting your bedtime process over again from the top.
As inconvenient as this natural alarm clock can be, there's a simple physiological reason why you often have to pee right as you drift off to sleep. For starters, we know that the amount of urine your body produces decreases at night, according to MedlinePlus. That's why most people can hold their bladder for six to eight hours as they sleep without needing to get up and pee. However, if you've had a lot of liquid within two hours of going to sleep, then you might have to pee right at the time that you've already fallen asleep. And if you've been drinking caffeine or alcohol, both of those substances can stimulate urine production and delay the bladder-emptying process, making late-night wake-ups more likely.
Most of the time, having to use the bathroom is a normal reaction to consuming fluid. But if you're waking up to pee multiple times a night, or if you experience pain or burning while you pee, that can be a sign of a more serious health concern. The medical term for needing to urinate multiple times per night is "nocturia," and it's caused by an overproduction of urine in the kidneys. Technically, nocturia is more common in adults older than 50 years old, because as we age, we make more urine at night and have weaker bladders, according to the National Sleep Foundation. In young people, nocturia can be a symptom of diabetes, pregnancy, UTIs, and kidney infections, per MedlinePlus. Given how nocturia impacts your sleep schedule, it's also often linked to sleep apnea and other sleep disorders.
The first line of defense against these nighttime wake-up calls is to keep track of how much you're drinking and urinating in general, MedlinePlus suggests. That way you can talk to your doctor about whether or not your nighttime bathroom trips are within the "normal" range. Obviously, decreasing your fluid intake, especially two hours before bedtime, would also ease your need to pee. And, depending upon the underlying cause, your doctor might recommend prescription medications that mimic the hormone vasopressin, the anti-diuretic hormone.
Regardless of the cause, getting a good night's sleep is a crucial part of your health, so it's worth it to pinpoint why you're waking up in the middle of the night. And if it means cutting back on your moon milk or peppermint tea nightcaps, well, it's worth it for those extra hours of sleep you'll get back.

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