Is There a Solution for Insomnia Caused by Waking up to Use the Bathroom?

A fellow caregiver asked...

Is there any solution for insomnia caused by waking up to use the bathroom and then not being able to go back to sleep?

Expert Answer

Senior Editor Melanie Haiken, who is responsible for's coverage of cancer, general health, and family finance, discovered how important it is to provide accurate, targeted, usable health information to people facing difficult decisions.

Yes, but to find a solution to this sleep problem -- officially known as nocturia -- you'll need to start by identifying and treating the underlying health conditions contributing to it.

First off, it's important to understand that as we get older, our bodies' ability to hold fluids for long periods decreases, thanks to a decline in antidiuretic hormones. So even though we're drinking the same amount, we have to go the bathroom more often. This is why middle-of-the-night bathroom runs become so common as we age. (According to the National Sleep Foundation, 65 percent of older adults have sleep deprivation resulting from waking up frequently to use the bathroom.)

Since our bodies are losing the ability to hold fluids -- and since aging also makes it more difficult to fall back asleep after we wake up -- the best solution to this problem is to try not to wake up in the first place.

Here are strategies that can help relieve pressure on the bladder and prevent other digestive symptoms:

*Don't drink liquids for three hours before bedtime.

*Cut down consumption of coffee and tea, which irritate the bladder.

*Don't eat foods with high liquid content, such as soup or fruit, for dinner or after dinner.

*Don't eat for the three hours before going to sleep if you're prone to heartburn or gastric reflux.

A prescription antidiuretic can cut down on nighttime urination if this is the only problem.

However, it's also possible that a separate health condition is leading to the nocturnal bathroom problem. In men, frequent urination at night is often a sign of prostate trouble. Inflammation of the prostate, benign prostatic hyperplasia (BPN), and prostate tumors can all cause this symptom, so call your doctor for a prostate exam and PSA test if nighttime waking to urinate suggests a possible prostate condition.

In women, frequent urination can go hand in hand with urinary issues such as incontinence, overactive bladder, urinary tract infections, or cystitis. So, women, you'll also need to see your doctor for a checkup if you suspect any of these problems.

Urinary tract problems such as overactive bladder can be helped with Kegel exercises -- both men and women can learn these exercises to strengthen the muscles at the neck of the bladder.

Once you're awake, a separate set of issues ensues. You may have developed some habits that work against your return to slumber. Here are some suggestions for getting back to sleep quickly:

*Keep the room dark. If you typically have to get up at least once during the night, keep a small book light or mini flashlight next to your bed and use it to navigate your way to the bathroom. Or put a dim night-light in the bathroom and leave the door cracked, so you can use the sliver of light to find your way there. Whatever you do, don't turn on the overhead light in the bathroom once you're there.

*Don't give in to the temptation to turn on the TV or computer. The idea that watching TV can soothe you back to sleep is a misconception; TV and computers function as stimulants. The light from the screen "resets" your internal clock and makes it harder for you to fall back asleep.

*Don't eat unless you're truly hungry. If you're sure a growling stomach is going to keep you awake, have a small snack. Otherwise, getting your digestive system revved up can keep you awake.

*Keep a pen and paper next to your bed. If you're often kept awake by your mind racing or by the common tendency to worry and make to-do lists in your head, keep a pen or pencil and a small pad of paper by your bed and write down your list. As you put each item down on paper, imagine yourself setting aside that concern. (Again, use a book light; don't turn on the overhead or a bright bedside light to write.)

*Do a simple isolation and relaxation exercise. If your body feels tense once you lie down again, try to relax methodically. Starting with your feet, tense the muscles as hard as you can, then relax completely. Do the same with your calves, thighs, buttocks, hands, arms, and on up. By the time you get to your neck and head, you should have banished much of the tension.

*Use an eye mask and ear plugs if noise and shadows are keeping you awake. Some people find that when they wake in the middle of the night, they're much more sensitive to light and sound than they are in the evening, so they need to take steps to block out as many stimuli as possible.

Waking up to urinate more than once a night can also be one of the indicators for sleep apnea. If the problem persists, ask your doctor to evaluate you for sleep apnea or Upper Airway Resistance Syndrome, a milder breathing issue associated with sleep disorder. It's possible that what's happening is that a breathing problem is waking you up or causing you to sleep lightly, which in turn makes you aware of the need to go to the bathroom. While you feel as if you have a full bladder, you would have been able to sleep through the night if you hadn't awakened in the first place.