I’m writing this article at 2 a.m.
Not because I suffer from insomnia, but because I just woke up to pee. Now, like so many others, I can’t fall back asleep. Instead of scrolling aimlessly through social media, I figured — why not write about my experience?
I’m in my 40s and healthy, and I generally sleep well. But lately, I’ve found myself waking up once a night to urinate. Some nights, I roll over and drift right back to sleep. Other nights, like tonight, my brain kicks into overdrive, and I start thinking about work, family or the stock market (bad idea).
Since I’m a urologist, I have experience working through this symptom for my patients. For tonight’s case, I think I know what’s causing my problem.
Recently, I started drinking a “relaxing” nighttime tea to help me wind down and sleep better. But instead of helping me sleep through the night, I’ve noticed I’m waking up more frequently to urinate. As it turns out, the tea might be acting as a natural diuretic, pushing more fluid through my system and irritating my bladder.
Why you keep waking up to pee
Most of us assume waking up to urinate is purely a bladder issue, but that’s not always true. Frequent nighttime trips could be caused by hydration habits (as with my case), hormonal shifts, medications or even an undiagnosed sleep disorder.
Chances are you’ve experienced something similar. Maybe you wake up once, twice or even more during the night. Maybe it’s occasional, or maybe it’s every single night.
Either way, it’s not just happening to you. Frequent nighttime urination, known medically as nocturia, is one of the most common sleep disruptors, affecting many of my patients and many other people. While it may seem like just an annoying part of getting older, it can sometimes signal deeper health issues.
Let’s say you stop drinking that nighttime “relaxation” tea or other beverage and you’re still getting up. It could be an early warning sign of an underlying medical condition like high blood pressure, uncontrolled diabetes or sleep apnea.
So before you blame your bladder entirely, let’s sort through the most common reasons for nocturia.
Are you drinking or eating too much before bed?
This may seem obvious, but what you consume and when matters. You might assume your bladder is to blame, but your evening eating and drinking habits could be sabotaging your sleep.
Let’s start with what’s in your cup. Caffeinated drinks, alcohol and even certain herbal teas can act as diuretics, increasing urine production. That late-night glass of wine or after-dinner espresso could be the reason you’re up at 3 a.m. And while many reach for a “relaxing” nighttime tea, some herbal blends, such as chamomile or valerian root, have mild diuretic effects. Sure, you might fall asleep faster, but you could also be waking up to pee more often.
It’s not just about what you drink — it’s also what you eat. Foods with high water content can contribute significantly to nighttime urination. Fruits and veggies like watermelon, cucumbers, celery, oranges and grapes can increase your fluid intake. A bowl of fruit before bed may seem healthy, but it might also send you running to the bathroom multiple times. Soup and broth-based meals, especially when eaten late, can have a similar effect, overloading your bladder overnight.
What can you do? Try cutting off fluids two hours before bedtime and be mindful of water-heavy foods at night. If you suspect your nighttime tea is the culprit, try skipping it for a few nights to see if your sleep improves. Keeping a bladder diary that tracks evening foods and drinks can help pinpoint hidden triggers.
Your hormones are changing
As we age, our bodies naturally produce less antidiuretic hormone (ADH), the hormone that signals our kidneys to retain water overnight. With lower ADH levels, our kidneys produce more urine during sleep, leading to frequent awakenings.
For women, hormonal changes after menopause also contribute to nocturia. Lower estrogen levels can reduce bladder capacity and weaken pelvic floor muscles, increasing urgency and nighttime urination.
For men, hormones influence the prostate gland. Age-related changes in testosterone and dihydrotestosterone (DHT) levels stimulate prostate growth, known as benign prostatic hyperplasia (BPH). An enlarged prostate compresses the bladder and urethra, causing incomplete emptying, urgency, and more frequent bathroom visits, particularly at night.
Could it be a sign of a bigger problem?
Frequent nighttime urination can sometimes signal underlying health issues beyond just the bladder. Fluctuating blood pressure overnight can increase urine production, disrupting your sleep. Diabetes can also be a factor, as elevated blood sugar levels cause the body to flush excess glucose through urine, increasing frequency.
Sleep apnea also can play a major role in nocturia. Undiagnosed obstructive sleep apnea (OSA) leads to frequent awakenings throughout the night. Many people mistakenly attribute these wakeups to bladder issues, but it’s actually disrupted breathing patterns causing increased urine production.
If nocturia persists despite lifestyle adjustments, especially if accompanied by high blood pressure, loud snoring or daytime fatigue, it’s worth discussing with your doctor. Identifying underlying conditions can greatly improve your sleep and overall health.
Your medications could be a factor
Certain medications, especially diuretics (water pills) prescribed for high blood pressure or heart conditions, can significantly increase nighttime urination by boosting urine output. While beneficial for managing blood pressure, these medications can disrupt sleep if taken later in the day.
Other medications — including antidepressants, sedatives, muscle relaxants, diabetes medications and calcium channel blockers — can also influence bladder function or fluid balance, inadvertently worsening nocturia.
If medications seem to be contributing, ask your doctor about adjusting dosages or timing. Simply taking diuretics earlier in the day can help reduce overnight bathroom trips without compromising treatment effectiveness.
Your sleep cycles change as you age
Sometimes, it’s not really your bladder waking you up — you’re waking up anyway. As we age, we spend less time in deep rapid eye movement, or REM, sleep, resulting in lighter sleep and easier awakening. Minor disturbances, such as noise, movement or a slightly full bladder, can now easily interrupt sleep.
When younger, your body could ignore minor bladder signals and remain asleep. With age, sleep becomes fragmented, making you more likely to wake up and then register the urge to urinate. This explains why nocturia often worsens even with a healthy bladder.
Improving overall sleep hygiene by maintaining a consistent bedtime, keeping your bedroom dark and cool, and avoiding screens before bed can help you to sleep more deeply. If you wake briefly, try relaxing and returning to sleep before automatically heading to the bathroom.
Don’t ignore the wake-up calls
Frequent nighttime urination isn’t just inconvenient; it’s disrupting your sleep, your mood and potentially your overall health. Let’s face it: Waking up at 2 a.m. to pee isn’t how anyone wants to spend their night.
The good news is you’re not stuck with it. If small changes such as limiting fluids before bed or adjusting medications don’t help, it’s time to look deeper. The real issue might be your hormones, prostate, heart health or sleep quality itself.
So next time you shuffle to the bathroom at night, don’t accept it as normal.
Listen to your body. It might be sending you an important message. (And make sure to install some night-lights in the bathroom to spare your toes.)