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Be careful, you wake up one or more times during the night, seek medical help immediately
Written by SOT.COM.AL 24 Shkurt 2023
If you wake up once or twice at night to go to the bathroom even if you didn't drink a lot of fluids at dinner, only one question comes to mind: Why does it happen? And after that: Is there any way to stop this?
It is very irritating when you lie down to sleep and have to wake up because of the bladder that has started to bother you. Dr. Ilene Rosen, a member of the board of directors of the American Academy of Sleep Medicine, who specializes in sleep and internal body and lung problems, explains why it happens, the hidden problems that can cause it, and what you can do to control it.
Getting up only once at night is not that worrying, but when you have to get up twice or more it can become problematic and indicative of some problem in the body.
Like most sleep problems, the roots of nocturia, the medical term for frequent urination at night, have to do with the internal circadian rhythm.
"In general, our internal clock controls most of the functions in our body, but in addition to the central clock, there are also clocks at the cellular level, in all cells. That's why there are changes of this hour in different bodies", says Rosen.
When the internal rhythm is functional, a person produces less urine and has less need to go to the bathroom, but when the rhythm is dysfunctional, the bladder forgets schedules.
On the other hand, it's not always a matter of a misaligned internal clock: one of the most common causes is aging, which involves changes in bladder function, mainly because the bladder can't tolerate large volumes of urine, according to Rosen. A younger person can sleep through the night, while an older person producing the same amount of urine needs to be carried.
After these, the cause can also be a health condition, and the most common, according to Rosen, is obstructive sleep apnea.
"People with obstructive sleep apnea have psychological reasons for going to the bathroom at night. In an apnea, the brain signals to breathe and the chest muscles are activated, but the upper airways are closed," she explains.
Here's what happens: When the diaphragm contracts, the pressure between the lungs increases because the upper airways are closed and the pressure squeezes the heart. When the heart contracts, it releases the hormone atrial natriuretic peptide, which signals the kidneys to produce more urine. So when Rosen talks to a patient with nocturia, she asks about any other symptoms of sleep apnea, such as snoring.
According to Rosen, another cause could be leg cramps syndrome, because people get up in the middle of the night from their movement and confuse it with the need to go to the bathroom. Diseases such as heart problems or diabetes can be the reason that people wake up several times during the night. As well as pregnancy and obesity.
According to Rosen, any abdominal tightening that increases the pressure in the abdominal cavity gives people the impression that their bladder is full.
Once you've determined the cause of your unpleasant nighttime bathroom visits, the next step is to find out how you can control them. Unfortunately, there is no way to change the daily routine that prevents nighttime awakenings, other than controlling the amount of fluids you drink and taking some diuretic medication earlier in the day. However, if you are elderly whose bladder is overactive due to sphincter muscle spasms, you can do some pelvic exercises to improve control.
One of the best ways to manage nocturia, of course accompanied by a visit to the doctor to see if there is any health problem behind it, is to improve sleep hygiene. Set a consistent sleep and wake schedule, minimize pre-bedtime stimulants, and make going to the bathroom as easy as possible so it's not too stressful when the time comes.
Leave the trajectory free and turn on a small night light so you don't turn on the main lights that will disrupt your sleep and make it harder to fall back asleep when you turn over on your side of the bed.