Why you're up at 3am

The Night Shift, Part 2 of 4

Under the Hood is a weekly look at what's really driving your health, fixed 1% at a time.

Today: why you're waking up at night, the free stuff most men never actually try, and the one thing worth getting checked.

My wife and I have been trying to figure out my son Edyn's sleep routine.

Over the last several months we noticed he was waking up because he'd wet his diaper. This pattern went on for a while, until we tried to figure out how to keep him from interrupting our sleep, but also his own.

So we did some troubleshooting. What we found was that he was having too much water close to bed.

So we decided two things. He'd stop drinking water a bit earlier in the evening. And he'd need to pee right after we read him his last book.

After trying that out, we instantly noticed fewer wake ups and fewer wet diapers. Win-win!

Maybe one reason you keep getting up to pee is that you're drinking too close to bed time as well.

Obviously a four-year-old and a fifty-year-old aren't dealing with the same thing. But some of it overlaps more than you'd think.

Last week was all about testing and making notes on what was off in your sleep. A gauge for where you're at.

This week it's more of the troubleshooting. If you're serious about your sleep and you want to optimize from where it is now, some of the things I'm going to talk about today could be some easy low hanging fruit.

THE DEEP DIVE

What's actually waking men up.

I ask every client about their sleep. It's the foundation of optimal health, longevity, and being your best self.

But here's the thing. Most of them, and most men I've talked to, don't have trouble falling asleep. They can usually knock out quick.

It's that they wake up. And then they're lying there for twenty minutes. Sometimes it's a bathroom trip. Sometimes it's that their mind kicks on and they can't shut it back off.

(And look, some of you are up in the middle of the night for better reasons. Different newsletter... TA after dark 😆)

That's not just my guys either. Waking up during the night is more common than trouble falling asleep. In a survey of nearly 9,000 American adults, 35% were waking up at least three nights a week.

Here's what keeps showing up in the research.

Needing to pee. When they asked 1,400 adults over 55 what was wrecking their sleep almost every night, 53% said getting up to pee. The next closest answer was pain, at 12%. Over four times the gap.

Sleep apnea. About 29 million American adults have it. 23 million of them don't know. That's 80% walking around undiagnosed. And it feeds the first one.

The night itself. If you're waking between 2 and 4 most nights, there's a reason for that. Like I covered last week, the back half is lighter by design. You've already banked most of your deep sleep, so the same full bladder or warm room you'd have slept straight through at midnight pulls you all the way awake at three.

Your metabolic health. This one surprised me. Your blood sugar and your blood pressure both show up in your sleep. Men with diabetes get up at night a lot more than men without it, and it's worse the more times they're up.

Most of that list is downstream of how you've been living. So here's how I'd work through it.

What if you're just a light sleeper?

It's a real thing. Not a diagnosis, just a lower arousal threshold, and twin studies say about half of that is genetic. Fine. That's the half you didn't pick.

The half you control is the list below, and a low threshold means you don't get to be sloppy with it. The guy who sleeps through thunderstorms can have a beer at ten and get away with it. You can't.

Just watch the label. "I'm just a light sleeper" is the sentence that stops a lot of men from ever looking into it.

LEVEL 1. Run the free experiments.

Two weeks. Pick the one that's obviously yours. Don't try them all.

Liquids. Water starts hitting your kidneys within about five minutes of drinking it. Most of a glass is out of your stomach inside 45 minutes. Which means the water you drink at 9:30 is already in line by the time your head hits the pillow.

I heard it put this way once. Gulp first, sip later. Most of your water in the first half of the day, then taper after dinner. Same thing we did with Edyn. And go to the bathroom right before bed even if you don't think you need to.

Alcohol. It puts you down fast, then wrecks the back half of your night. It also blocks the hormone that normally tells your kidneys to slow down overnight. That's why a few beers is close to a guarantee you're up at two. Volume plus a hormone block. Drinking most nights and waking most nights? Start here. Two weeks, not forever.

Salt. Sodium pulls water with it, so your body holds fluid at first and lets it go later. That's why electrolytes hydrate better than plain water. It also means a salty dinner can wake you up in the middle of the night.

I use electrolytes myself and they work for me. But everyone clears sodium at a different rate, so this is one to experiment with rather than take my word for. Try it in the morning first, before coffee. Then later on, try it 2 to 3 hours before bed and see what changes.

Last meal. Three hours before bed. You won't keep it perfectly. Try to be done eating by 6 or 7pm, and earlier is better.

The thermostat. Your body has to drop its core temperature to stay asleep. Most people land somewhere in the mid 60s. If your room is sitting at 72 you're fighting it all night.

The notepad. Write down whatever's rattling around before you get in bed. You're telling your brain it doesn't have to hold it all night.

Most men never actually run this. They assume they know the answer and skip straight to worrying.

LEVEL 2. Still up? Now start looking.

Track it. What's different about the nights you sleep through? This is where last week's notepad pays off.

Ask your wife if you snore. Or if you ever stop breathing. She knows.

Caffeine timing. Ten hours before bed is the number. And it's not just the stimulant effect. Caffeine also makes you produce more urine for a few hours after.

Your medications. Some of them do this. Your pharmacist can tell you in ninety seconds.

LEVEL 3. Get tested.

For a long time the assumption was that when an older man is up three times a night, it's the prostate. Makes sense. Right neighborhood.

But when they treat the prostate, a lot of these men keep waking up.

So what is it?

If you have sleep apnea, your airway collapses while you're asleep. But your body doesn't stop trying to breathe. Your chest and diaphragm keep pulling against a closed throat.

That turns your chest into a vacuum. The vacuum pulls blood in. Your heart fills more than it's supposed to. And when your heart stretches like that, it signals your kidneys.

Make fluid. Now.

So you're up at 3am because your chest spent the night working like a suction pump against a closed door. Dozens of times an hour.

It's not a plumbing problem. It's a pressure problem.

And the researchers are direct about this. If you've got an enlarged prostate and you're waking up a lot, get evaluated for sleep apnea.

The guys who ran that survey up top said it themselves. Getting up to pee might be the symptom, not the problem.

Here's where I stop.

I'm a fitness professional and a performance coach. I'm not a doctor. So anything at Level 3, anything that involves a deeper intervention, that's a conversation with your physician and not with me.

But here's what I'll tell you, same as I tell every client. You have to be your own advocate and take control of your own health. Nobody is going to care about your body and your health more than you do.

But if you're up two or more times a night most nights and you've already done the work, don't let anybody wave it off. Two is the number the research uses. Ask the question. Get the study.

That's not me diagnosing you. That's me pointing you at someone who can.

Want to dig in yourself? Here's the one on why this changes as you age. Free to read, and worth bringing to your doctor. Good ones won't mind.

QUICK HITS

FUEL — Go look at the label on your pre-workout. A lot of them run 200 to 300mg of caffeine a scoop. If you train at 6pm and take one, that's two cups of coffee before dinner. Nobody counts that one.

TRAINING — Don't try to train your way out of a bad night. I've had clients come in after three bad weeks of sleep asking to add a fourth day. That's backwards. Fix the night first, then we add.

FAMILY — Cooling the bedroom down is the easiest thing on that Level 1 list, and it's the only one you have to get your wife to agree to. If she runs cold, she can add blankets. That's easier than you trying to sleep hot.

MIND — If you've been laying there more than twenty minutes, get up. Go sit somewhere with the lights low. Read a book for ten minutes, put on a meditation app, say a prayer. Whatever gets you calm. Laying there mad about it never once put anybody back to sleep.

As always, if you know a man in your circle who values his health, feel free to share this with him. I appreciate the support.

Your body is worth stewarding.

1% BETTER

— Coach Joshua

Educational content, not medical advice. Partner with your physician, ideally one who believes in proactive care.

New here? Every issue lives in the archive. Last week I covered what's actually happening while you're asleep.