What it means when you wake up in the night, from needing to pee to insomnia – and how many times isn’t normal

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EVER wake up in the night and stare at the ceiling? You’re certainly not alone.

And you might have wondered if this is a sign of serious issue.

A young woman lies awake in bed, struggling with insomnia.
Frequently waking up in the night can be the sign of an underlying health issue
Woman in pajamas running to the toilet with toilet paper.
If you find yourself needing to use the toilet a lot at night you could have nocturia

A few brief awakenings in the night is considered normal – with some awakenings so brief you won’t even be aware of them.

But waking up frequently throughout the night could be signalling something wrong with your health.

Our Health Kick survey of Sun readers found people wake up 2.3 times a night on average.

This is considered normal by Dr Lizzie Hill, a clinical scientist and senior lecturer in sleep physiology at The University of the West of England in Bristol.

She explained: “Most people will wake up once or twice and go straight back to sleep.

“We sleep in roughly 90 minutes cycles of light and deep sleep throughout the night, and it’s normal to wake briefly between cycles, sometimes turning over or going to the toilet.

“We can also be woken up external factors, such as our bedroom being too bright, too noisy or too hot or cold.”

Dr Zoe Williams, our resident GP, also says that waking in the night occurs as a result of turning sleep cycles.

So how many times is considered abnormal? It depends on what you are doing in those wake-up times…

Nocturia

Nocturia is when you frequently wake up in the night to pee.

In response to a reader’s question about repeated night-time peeing, Dr Zoe said:  “As adults we enter a new sleep cycle every 90 minutes or so, and when we progress from one sleep cycle to the next we have a period of very light sleep and often brief awakenings which are normal and do not impact us negatively. 

“It is in these moments of light sleep that we will notice the urge to pass urine and wake to do so.  

“So waking up briefly to pee, between sleep cycles, is not really detrimental to your sleep or health, as long as you get straight back off to sleep, when you get back into bed. 

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“Therefore it’s of utmost importance what you do when you wake up.

“Turning on too many lights, looking at your phone, checking the time, or even getting upset that you’ve woken up are all things that can prevent you from getting straight back off to sleep when you return to your bed. 

“So, when you first feel the urge to pee, it’s best to get straight up, go to the loo, and get straight back into bed whilst trying to stay as sleepy as possible. If you can do this.”

She says that one in three adults over the age of 30 will have nocturia.

“So it’s very common and it increases in prevalence as we get older,” Dr Zoe says.

Nocturia is common with elderly people who may be getting up twice a night, the NHS says.

But more frequent visits to the toilet may indicate a problem that can be treated.

Causes of nocturia include ageing, urinary tract infections, caffeine, alcohol and some medications.

But it could also be an underlying medical condition, such as diabetes, which causes increased thirst and trips to the toilet.

It could indicate prostate issues in men – an enlarged prostate can press on the urethra and prevent the bladder from emptying properly, so you need to pee more often.

Meanwhile, heart problems could also be causing nocturia.

The NHS says: “If you have a heart condition, your heart and circulation become less efficient and you will notice swelling around your ankles. When you are lying down or your feet are raised up, fluid is absorbed into your blood stream and removed by your kidneys. This increases the need to pee at night.”

Sleep apnoea

Waking up frequently in the night can be a sign of other underlying sleep disorders, said Dr Hill.

She said: “Breathing problems can cause us to wake up during the night – if you snore, wake up choking or gasping, are very restless or have been told you have periods where you stop breathing while you’re asleep, you could have a condition known as obstructive sleep apnoea.”

Sleep apnoea can be caused by obesity, alcohol, smoking, and some medications.

If other family members have sleep apnoea, you may be more likely to have it too.

Sleep apnoea can lead to excessive sleepiness during the day and headaches upon waking.

But it needs to be treated as soon as possible because it can lead to more serious problems, including high blood pressure, a higher chance of having a stroke, type 2 diabetes, heart disease and much more.

Woman covering her ears in bed next to a snoring man.
Sleep apnoea can lead to serious health problems if left untreated

Insomnia

Frequently struggling to get to sleep, worrying about getting to sleep, or spending long periods awake during the night could be signs of insomnia, said Dr Hill.

She advised: “You may benefit from treatment to break the cycle of poor sleep.”

The NHS says you can usually treat insomnia by changing your sleeping habits:

  • Go to bed and wake up at the same time every day
  • Relax at least one hour before bed, for example, take a bath or read a book
  • Make sure your bedroom is dark and quiet – use curtains,
  • Blinds, an eye mask or ear plugs if needed
  • Exercise regularly during the day
  • Make sure your mattress, pillows and covers are comfortable

When should you see a GP?

If you’re experiencing regular poor sleep or sleepiness which is affecting your daytime activities or quality of life, speak to your GP in the first instance.

Dr Hill warned: “Untreated obstructive sleep apnoea can lead to serious health problems including heart problems and diabetes, so see your GP if you have symptoms.

“The first line treatment for insomnia is cognitive behavioural therapy for insomnia.

“Sleepio is a digital cognitive behavioural therapy app which is recommended by NICE (National Institute for Care Excellence) and is available free to NHS patients: Onboarding Sleep Test – Sleepio.”

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