Why Waking Up in the Middle of the Night Could Be Hurting Your Health

What role does the pelvic floor play in your bedtime and sleep routines? While the connection might not seem obvious, there’s more overlap than you think. As a pelvic floor physical therapist, I often address concerns about waking up at night to urinate, and this issue is more complex than it appears.

When patients share that they wake up once, twice, or even three times a night to use the restroom, I emphasize bladder irritants, the importance of proper hydration before bed, and strategies to “retrain” their bladder. These are essential steps, but there’s an even deeper reason why nighttime bathroom trips may be happening: they could signal a disruption in achieving REM sleep, a vital phase of our sleep cycle.

During REM (rapid eye movement) sleep, our bodies perform incredible restorative functions. This phase is essential for mood regulation, memory consolidation, and learning. Additionally, REM sleep is when our body secretes antidiuretic hormone (ADH). ADH’s main role is to reduce the amount of water excreted as urine, helping conserve fluids and preventing frequent bathroom trips.

If you find yourself waking up to urinate regularly, it may not just be a bladder issue—it could also be a sign that your REM sleep is being interrupted, depriving you of its critical benefits. Addressing this concern not only involves better hydration and bladder habits but also improving your overall sleep quality.