We’ve all woken up in the night urgently needing to pee, especially if we’ve drunk more liquids than normal. But if you’re waking up repeatedly to go to the bathroom, it could be a sign of nocturia, a condition characterized as needing to urinate once or more during the night.
From investing in the best mattress for your sleep needs to ensuring that you urinate right before bed to avoid any bedtime disturbance, many of us do everything we can to improve the quality of our sleep. However, if frequent nighttime urination is disrupting your slumber, nocturia may be the cause.
In addition to the long term effects of sleep deprivation, frequent urination can lead to daytime fatigue, low mood and impaired cognitive function. Nocturia could be caused by drinking too much before you get into bed, while certain drinks can also irritate the condition. However, it could also be a sign of an underlying condition such as diabetes or kidney problems.
Let's explore what nocturia is. We'll look at the latest research and talk to a urologist about the symptoms, causes, and the reasons it can be bad news for your sleep.
Nocturia: What is nocturia?
Most of us have times when we'll wake up in the middle of the night to urinate. But if you're consistently waking up once or more to go to the bathroom and it is significantly affecting your sleep quality, nocturia could be the cause.
Dr. Daniel Sadowski, a urologist at OSF HealthCare based in Rockford, Illinois, describes the condition as “when you wake up at night and feel the need to empty your bladder. This may happen many times throughout the night and cause poor sleep quality. You may feel tired during the day after not sleeping well.”
Most adults require around 7 to 9 hours of sleep a night to feel focused and refreshed. If our sleep cycle, especially our REM sleep, is affected, this could lead us to feel tired the next day.
The condition is more common than you’d think. Research shows that one in three over 30-year-olds are slightly affected by nocturia. The problem normally gets worse as we get older, and research shows it could affect up to 80% of older adults.
Studies indicate that men are said to be most affected by the condition, with 50% who are 70 or over having to wake up at least twice in the night to go to the toilet. Other health conditions such as urine infections, kidney problems, and even diabetes can make the condition worse.
Nocturia: What are the causes of nocturia?
Dr. Sadowski says that nocturia can be “one of the most challenging voiding symptoms to fix because there are a lot of possible causes. Often, you may wake up for other reasons and then decide to urinate.”
He adds that these other reasons could be: “Sleep apnea, chronic pain, restless legs syndrome, anxiety, depression and certain medications.”
However, these are some of the most common triggers for nocturia symptoms:
Too much fluid before bed
Whether you’ve just been trying to keep hydrated or you’ve had one too many wines, drinking too much fluid after midday could make you more prone to waking up and needing to pee.
Some drinks, such as those containing caffeine or alcohol, can act as bladder irritants too.
The urologist adds: “Drinking fluids in the evening or taking diuretic medications before bedtime will also cause you to have more urine output at night.”
Reduced bladder capacity
As we get older our reduced bladder capacity naturally leads to us needing to pee a lot in the night.
“If the bladder cannot hold as much urine, or if it does not completely empty when you urinate, then you may have to go to the bathroom more often,” says Sadowski.
Diabetes
Type 2 Diabetes causes levels of sugar in the blood to become too high. Certain symptoms of the condition mean it could also be one of the causes of nocturia.
"Diabetes may cause sugar to spill into the urine, which will make you pee more often," says the urologist. This, in turn, could wake you up in the night.
Kidney infection or disease
Nocturia could be an early sign of kidney disease or an infection. Healthy kidneys remove waste from your body in the form of urine. However, if you have an infection or the first signs of disease in this organ, it could cause you to pee more.
Nocturia: How to stop peeing so much at night
If frequent nighttime urination is disrupting your sleep, Dr Sadowski advises you do the following:
- Avoid bladder irritants after 12pm
- Limit fluids four hours before your bedtime
- Empty your bladder before going to sleep
- Elevate your legs before bed
- Get tested for a sleep disorder
- Talk to your doctor about medication
To begin with, avoid anything which could irritate your bladder after midday. “Bladder irritants include caffeinated beverages, coffee, tea, soda, alcohol and artificial sweeteners,” says Dr. Sadowski.
“Do not drink any fluids for four hours before bedtime," he adds. "A small drink of water to take medications is fine.” He also recommends completely emptying your bladder before you jump into bed.
The expert also says you could try elevating your legs while sitting or lying down for one hour before bedtime. This is said to help move fluids, such as urine, back into the bloodstream.
Snoring or a sleep disorder could also be waking you up at night. Dr. Sadowski goes on to advise: “If you snore loudly and have not been tested for sleep apnea, ask your primary care provider if you should have a sleep study.”
If you think your bladder has become weaker, he suggests that there could be a solution: "Prescription medications are available to treat an overactive bladder or obstructing prostate. Urologists also have a variety of procedures to treat the prostate.”
Dr. Sadowski also adds that laxatives can also help those who are constipated - and this could make a big difference. “Avoid foods high in salt," he says, "like processed foods, restaurant food, fast food, lunch meat and frozen meals. Happy bowels make for a happy bladder, so avoid constipation.”
Nocturia: When should I see my doctor?
If you occasionally suffer from nocturia, it’s not serious or life-threatening, especially if the condition stops after following some of the advice above. However, if your symptoms start to affect your life and you're constantly tired because of loss of sleep then it could be time to see your doctor.
Talking to your doctor could help you figure out if the cause of your nocturia is an underlying issue which needs medical treatment.
Of course, our urology expert Dr. Sadowski also adds it’s important to “notify your doctor if you see blood in the urine or have burning with urination. If you are bothered by nocturia, then you should discuss the problem with your provider to see what options are right for you.”
