Why Do I Wake Up to Urinate at Night?
Our next Ask the Doctor question is, “Dr. Melissa did not address the waking up to urinate,” related to another piece of content about sleeping and prostate health. “I am 70 years old and get up every night to use the bathroom.” So, thank you for asking this wonderful question.
Organs and Glands are Hyper Alert
What I want to talk about specifically at the age of 70 and sleep imbalances, particularly when we’re waking up to urinate, there are several things happening from a physiological perspective, meaning certain kind of mechanisms and organs and glands are functioning a little bit more… I’m not going to say effectively, but they’re more alert at night than we need them to be. For instance, you should not be getting up multiple times at night to urinate. If that’s occurring, there’s several things happening.
Why the Liver May Not Be Able to Rest During Sleep
The first thing that’s happening is the liver is not in a resting state. There’s a period of time between 1:00 AM and 3:00 AM that the liver and other digestive processes go through a hibernative state. When that’s not occurring, it’s telling me there’s a lot of things going on.
The first thing that’s very common is for folks to have elevations in cortisol. A stress hormone that’s produced by the adrenals is called cortisol. Cortisol will spike at night, and that tends to be the main driver behind waking up at night and urinating. So, especially the need to urinate is what causes you to wake up. Sometimes people even have dreams like they’re urinating in their sleep, and that’s a body signal to wake up and urinate.
Inflammation Can Cause Cortisol Spikes
Now, if that’s happening, it’s telling us a lot of things are going on. There’s usually inflammation in the lower pelvic floor that might be related to bladder inflammation, as well as prostate inflammation for gentlemen.
For women that might be waking up in the middle of the night, it might be hormonally driven. It also might be related to inflammation in and around the bladder with interstitial cystitis, a particular type of inflammatory bladder condition that affects a lot of women.
For men that are waking up, especially in the age of 70s, so our 70 decade, it’s very common that the prostate gland is inflamed and is what is triggering the cortisol spike, and also triggering the need to urinate.
Deeper Details Help Determine More Specific Causes
So, I always ask follow-up questions. Specifically, when you get up and urinate, are you urinating fully? Do you feel like you’re emptying your bladder optimally? Do you feel like the flow is an optimal flow or is it a trickle? So, is it a fire hose, a stream, or a trickle? Those are going to tell us more about that potential source that’s causing you to wake up.
If you’re in the last 15 to 20 seconds of the urination and you’re getting a little bit of what we call inflammation or pain or irritation, it’s almost like a little burning sensation as the bladder is emptying, that is an indication that there’s pressure as the bladder’s emptying. There’s a little pressure and you’re feeling prostate inflammation. So, the prostate gland becomes a really important aspect of healing that’s required if we’re looking at frequent wake-ups to urinate at night.
Learn More About Prostate Health
I actually have a very specific prostate masterclass for gentlemen of all ages. I have some of my gentlemen in their early 40s that are dealing with prostate imbalance, elevations of PSA, benign prostatitis, all sorts of things, fungal infections to really intense lesions on the prostate. Sizes of the prostate that are causing the urethra to be constricted and limiting flow, all of those degrees of imbalance.
We need to zero in on inflammation factors, we need to look at nutritional imbalances, and then we need to zero in on cortisol, the stress hormone. A unique process in the male body where cortisol triggers a particular enzyme reaction, where the male body takes testosterone and converts it into estrogen, which tends to be the major root cause behind prostate inflammation.
So, if that’s something that’s occurring – so I don’t feel like I have all the information really answered this question fully and why I wanted to ask a few questions – but if you feel like that’s something that’s occurring, I’d recommend checking out my masterclass. It’s 60 minutes. You can take that and really, it’s a deep dive into addressing assorted root causes and imbalances of the prostate gland. But also, it’s something you want to address inflammation, you want to address the process flow of the bladder emptying, and you also want to address hormonal imbalances like elevations in cortisol and even elevations in estrogen.
Assess Dysfunctions in Organs, Glands, and Hormones
I hope that’s helpful. That probably isn’t necessarily the answer you wanted when it comes to sleeping. But as a naturopath, what I do is I go into a deep assessment of the root cause of imbalance. And so, if somebody’s waking up at night to urinate, I start to assess what organs and glands and hormonal dysfunctions are present that would cause that.
So, there’s often multiple things happening all at the same time that’s making it a more severe and challenging situation for you. So, I hope that’s helpful. Let us know if you need any additional resources or have any other questions specific to your condition. Thanks for asking the doctor.