The surprising reason you might keep waking up to pee

If you’re always getting up to use the bathroom at night, you may have more problems on your hands than disturbed sleep: Your nighttime pee breaks might be signaling sleep apnea, according to a study presented at this year’s European Association of Urology conference.

Researchers from the Netherlands surveyed 256 patients with Obstructive Sleep Apnea (OSAS), a condition in which your breathing starts and stop while you’re sleeping. Signs of it include excessive snoring, daytime sleepiness, and morning headache.

When they asked the participants about their nighttime bathroom habits, they discovered that 69 percent of them reported nocturia, a condition where you wake up at night to pee. Then, they had the patients try continuous positive airway pressure (CPAP) masks to treat their sleep apnea. These devices increase pressure in your throat to help you breath uninterrupted during sleep.

They discovered that 65 percent of the patients with nocturia who used CPAP masks reported making fewer trips to the bathroom at night. In fact, 42 percent of those who awoke to use the bathroom twice or more per night experienced uninterrupted sleep—and the people who peed one to three times a night benefited the most. (Eat less of this so you won’t have to wake up to peet have to wake up to pee, too.)

There are two theories at play there: It’s possible that the deprivation of oxygen to your brain with sleep apnea could spark excessive urine production, making your bladder fill up quicker—and you to need to empty it more often. But it also just may be that treating sleep apnea allows you to sleep more deeply, so you don’t notice your full bladder, says study author Sajjad Rahnama’i, M.D., Ph.D., a research associate of urology at Maastricht University.

When Should You Worry About Waking Up At Night to Pee?

Sounds scary, but waking up at night to pee isn’t always a problem, says Dr. Rahnama’i—as long as you fall back asleep quickly and feel rested the next day. Over half of men over 50 suffer from nocturia, while only four percent have OSAS.

But if you’re always fatigued in the morning, see your doctor. The problem especially requires attention if it occurs more than four times a night, which could also indicate heart disease.

When you talk to your doctor about your frequent bathroom trips, make sure to mention whether you’ve been experiencing signs of sleep apnea. Check in with your partner, too—they might be able to tell you if you’ve been snoring, breathing heavily, or not breathing at all for periods of time.

Whether or not you experience nocturia, sleep apnea itself is a reason to see your doctor. In addition to CAP masks, it can be treated through surgery or weight loss.