Why the urge to pee ruins sleep for some

By Joseph Castro
LiveScience

For most people, sleep is undisturbed by the need to pee, because our bladders seem to hold more urine over night. But just how this happens, and why some people are unable to do this, has remained a mystery until now.

New research shows that the body's internal clock controls the production of a key protein that helps regulate the bladder's capacity to hold urine before needing to empty.

The findings may someday yield new therapies to help children who involuntarily wet the bed or adults who frequently wake up at night to urinate, researchers said.

"In certain conditions there may be a derangement of the circadian rhythm so that the wrong amount of [the protein] is produced at the wrong time of day," Andrea Meredith, an assistant professor of physiology at the University of Maryland who was not involved in the study, told LiveScience.

By targeting the protein, called connexin43, researchers may be able to induce the correct amount of the protein at the right times, she said. [ 10 Things You Didn't Know About You ]

 Previous research has shown that mice with an increased amount of connexin43 have a lower functional bladder capacity — that is, their bladders require less liquid before it triggers the need to pee. The researchers in Japan wondered what role the protein plays in normal bladder function and how it's affected by the time of day. While scientists have long known that humans and other animals have day-night differences in functional bladder capacity, it's been unclear if these differences are due to light or if they are governed by an intrinsic circadian (daily) rhythm.

To find out, the researchers needed to determine how much and how often mice urinate throughout the day, a measurement that is more difficult than it sounds. "Mouse urination events are very tiny; it's not as simple as them peeing in a cup, you measuring it and moving on," Meredith explained.

So the researchers developed a machine that constantly moves filter paper beneath a mouse cage to capture the urine — they saw that the mice's day-night urination differences exist even when they are in 24-hour darkness. Moreover, this normal urination pattern was lost in mice with defective biological clocks, showing, for the first time, that urination is an intrinsic circadian rhythm, Meredith said.

The researchers also found that mice with an abnormal connexin43gene, which produces the connexin43 protein, urinate less frequently than normal mice. And when they looked at the bladder muscle cells of normal mice, they found that the expression of the connexin43 gene oscillates throughout the day and is governed by a certain circadian clock molecule.

Taken together, the results show that connexin43, which helps regulate functional bladder capacity, changes according to our biological clocks. If your body is producing the incorrect amount of connexin43 or if your biological clock is off, you may find yourself in the bathroom at night more than you'd like, the study suggests.

"This research explains why healthy people do not urinate during sleep, from the standpoint of bladder function," study co-author and urologist Dr. Akihiro Kanematsu, of the Hyogo College of Medicine in Japan, told LiveScience in an email.

However, both Kanematsu and Meredith stress that other circadian-regulated proteins and genes likely affect functional bladder capacity.

Whatever the case, the research has implications for treating nighttime urination problems in children and the elderly, Kanematsu said. Solving such problems, he explained, may involve looking at the urine production in kidneys and the arousal levels of the brain, in addition to bladder capacity.

"Thus we can conceive to treat these patients from two sides," Kanematsu said. The first approach is to fix the circadian rhythms themselves, either through behavioral means or medications. "The other way is to find therapeutic targets in each organ, like [connexin43] in the bladder."

The study was published today (May 1) in the journal Nature Communications.

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Discuss this post

Needing to urinate did not always cause me to wake at night. It wasn't until I went through around three years of having our daughter wake us 3-4 times a night. When she woke us, I always got up and used the rest room. Now, 10 years later, I still get up 2-4 times every night.

    Reply#1 - Wed May 2, 2012 9:11 AM EDT

    You ain't cool unless you pee your pants!! Look, Billy pee's his pants too!!!!

    • 2 votes
    #1.1 - Wed May 2, 2012 3:22 PM EDT
    Reply

    I am relieved to see that Mr Karnes knows the proper word to use is "urinate". I can't say the same for Joseph Castro, writer of this epistle. What in the world has happened to our sense of language decency??

    • 3 votes
    Reply#2 - Wed May 2, 2012 9:51 AM EDT

    It moved beyond the Victorian era quite some time ago. How did you miss that?

    • 4 votes
    #2.1 - Wed May 2, 2012 10:16 AM EDT

    This has become a very vulgar society. I thought that one of the most important tools for a writer was an extensive vocabulary.

      #2.2 - Wed May 2, 2012 11:01 AM EDT

      Absolutely agree with using the word "urinate" in this article instead of the term used by the author. Today's society has become so obsessed with the casual approach to issues/topics public and private that boundaries of what is appropriate and inappropriate for public consumption are beyond blurred. They are nonexistent. It is not a matter of being prudish about a bodily function. It is about a decent and/or dignified approach to a real issue that many face.

      • 4 votes
      #2.3 - Wed May 2, 2012 12:45 PM EDT

      wannadanc,

      Did you or did you not mean a pun when you used the word "relieved"?

      • 2 votes
      #2.4 - Wed May 2, 2012 1:09 PM EDT

      OMG - you are offended by the word pee? Let me guess...now you are offended I used "OMG."

      • 3 votes
      #2.5 - Wed May 2, 2012 8:39 PM EDT
      Reply

      Same here.

        Reply#3 - Wed May 2, 2012 9:51 AM EDT

        My comment was about MrKarnes' comment...

          #3.1 - Wed May 2, 2012 9:52 AM EDT
          Reply

          I'd rather live with my body the way it is than add another medical treatment to specifically keep me from waking up at 2:30 in the morning.

          • 3 votes
          Reply#4 - Wed May 2, 2012 10:04 AM EDT

          diuertics do it for me or a bladder infection,shift work for 47 years,there are many reasons for sleep time incontenence.

            Reply#5 - Wed May 2, 2012 10:06 AM EDT

            It's not considered incontinence to get up in the middle of the night to urinate, and the medical term for that is nocturia. Failure to get up at night to urinate and wetting the bed is incontinence, or nocturnal enuresis.

            • 3 votes
            #5.1 - Wed May 2, 2012 10:26 AM EDT
            Reply

            Mine turned out to be diabetes. Once that was controlled I quit waking up so often at night to urinate. Just thought everyone would like to know that.

            • 2 votes
            Reply#6 - Wed May 2, 2012 10:10 AM EDT

            It could also (if you are female with all your working parts) be a sign of out of control endometriosis.

              #6.1 - Wed May 2, 2012 6:13 PM EDT
              Reply

              I used to get up 3-4 times a night. Then I was diagnosed with Obstructive Sleep Apnea, and now use a CPAP machine every night. I only get up once now, and that is after 6 or 7 hours of sleep.

              • 1 vote
              Reply#7 - Wed May 2, 2012 10:18 AM EDT

              I would rather get up during the night then not, and wetting the bed, uck. Besides, no longer than it normally takes to empty the bladder, and get back to sleep is not a disturbing matter to me.

              • 2 votes
              Reply#8 - Wed May 2, 2012 10:45 AM EDT

              I believe that I could have saved the government quite a bit of money with this study. The simple rule I learned as a child was that if you don't drink any liquids 3 hours prior to bedtime, you'll be good for the night. Please pay me in cash only!

              • 3 votes
              Reply#9 - Wed May 2, 2012 11:03 AM EDT

              Not true. Tried it and it doesn't matter. I was thirsty when I went to bed and still got up half way through the night.

              Would like a refund from you.

              • 5 votes
              #9.1 - Wed May 2, 2012 5:11 PM EDT
              Reply

              For a man over 50 it may be Benign prostatic hyperplasia, an enlarged prostate!

              • 1 vote
              Reply#10 - Wed May 2, 2012 11:26 AM EDT

              My ole lady always pee pee's all over me after she has an orgasm. W T F is wrong with her?

                Reply#11 - Wed May 2, 2012 12:16 PM EDT

                I am 58 years old almost and never wet the bed much anymore.

                  Reply#12 - Wed May 2, 2012 12:21 PM EDT

                  "Mouse urination events are very tiny... as simple as them peeing in a cup, you measuring it and moving on," Meredith explained.

                  Great. Now I've go that image stuck in my brain.

                    Reply#13 - Wed May 2, 2012 1:11 PM EDT

                    I went to a urologist and found out that I was not fully emptying my bladder, and so going more often during the night. I was prescribed Flomax (tamsulosin) which allows me to fully empty my bladder and so go less often. In either case it does not ruin my sleep, just less interruption to it now. I am back to sleep quickly, not a problem.

                      Reply#14 - Wed May 2, 2012 2:29 PM EDT

                      Inquire from a trucker or former trucker how much sleep they get. While all you people are busy sleeping they are out on the road.........pickup a load in Chicago and need to be in L. A. 2 or 2 1/2 days later on a tight pickup and delivery schedule. Some of these guys have been out on the road over 40 years. And those female TV network new anchors who complain they don't get enough sleep because they have to get up at 3 A. M......................go drive a wagon train over Donner's Pass like the early settlers had to do to find out how much sleep they got....................

                      • 1 vote
                      Reply#15 - Thu May 3, 2012 4:39 AM EDT

                      When I have to urinate at night, I start dreaming about trying to find a bathroom, but they're always unsuitable for some reason -- the toilets are out of order (that's putting it nicely), or there are people who keep coming in when there's just one toilet and I can't get them to leave so I can have privacy, or I'm wandering around a huge Microsoft-like building looking for the restroom and finding myself in people's offices or auditoriums ... this just keeps getting worse until I wake up and actually walk to the bathroom.

                      • 3 votes
                      Reply#16 - Thu May 3, 2012 11:17 AM EDT

                      EmilyPhoebe, I've had exactly the same kind of dreams for years. Some of them are hilarious! It's almost always a huge bathroom with about 50 stalls but there's something wrong with each one - either already in use or absolutely out of the question. Finally I find a stall that looks nice and clean (and available) from the outside but it has no toilet! What surprises me is that I never recognize that I'm in this dream. I guess it's my body trying to stay asleep.

                      • 1 vote
                      #16.1 - Fri Jul 6, 2012 5:07 PM EDT

                      Yes I also dream about needing to find a bathroom as well....and eventually I will wake up and realize that it's not just in the dream that I need a bathroom.....I thought this happened to everyone but I guess not!

                        #16.2 - Tue Jul 10, 2012 12:39 PM EDT
                        Reply

                        I started eating Pumpkin seeds and after 2 weeks,never got up to go to the bathroom,i wouldn't even rush in the morning,It's the copper content of the seeds.

                        • 1 vote
                        Reply#17 - Fri May 4, 2012 8:54 PM EDT

                        when you have to go at night is not something you can control you can only control how often durring the night you have to go

                          Reply#18 - Mon Jul 2, 2012 9:45 AM EDT
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