Is Frequent Urination Keeping You Up at Night?

Learn more about how to manage your symptoms and take back control over your sleep

By Sheryl Grassie

Medically Reviewed by Dr. Ramprasad Gopalan, MD, Infectious Disease Specialist in Boynton Beach, FL.


Having to get up and go to the bathroom several times a night may just seem like a minor inconvenience at first, but those midnight trips add up and significantly affect your sleep cycle leading to serious sleep disturbances. Luckily, there are several well-understood reasons for frequent nighttime urination, and solutions to go with them. If you’re ready to take back your sleep and enjoy your rest without being awoken by your bladder, keep reading.

How Frequent Urination (Nocturia) Affects Your Sleep

It might seem like no big deal, waking up to use the bathroom a few times each night, but in reality, nocturia can cause serious problems for your sleep. Nocturia interrupts the sleep cycle and over time these nightly wakings can cause cumulative sleep deprivation.

In one study that looked at over six thousand participants, nocturia was closely linked to sleep disruptions, like reduced total sleep time, poor sleep efficiency, less time spent in rapid-eye movement (REM) sleep and more. Jeffrey P Weiss, MD

Sleep deprivation and disruption can cause increased stress, inflammation, and risk for heart disease, high blood pressure, diabetes, and more; that’s why we want to help you understand the causes behind your nocturia and help you find solutions that will work for you.

To read more about the factors that contribute to frequent urination, click here.

How Do You Know If You Have Frequent Urination at Night (Nocturia)? 

Frequent urination at night (also known as nocturia) is more than just occasionally waking up once during the night to use the bathroom. People with nocturia typically wake up two or three times to urinate every single night. The unfortunate reality is that frequent urination affects a lot of people, with some studies estimating that 1 in 3 adults over 30 wake up to use the bathroom two or more times each night.

Nocturia isn’t caused by one specific disorder or condition, and there are actually three different types of nocturia based on what is causing the frequent nighttime trips to the bathroom.

To read more about the different types of nocturia, click here.

Symptoms of Nocturia

Studies have also found that nocturia is more common in elderly adults and Black and Hispanic adults and that more women tend to experience nocturia at a younger age compared to men, but men tend to experience nocturia more as they age. There is really only one main symptom of nocturia: waking more than once per night to urinate on a regular basis. 

If you have nocturia due to polyuria, you may also experience an increased volume of urination at night, and as a result of your nighttime bathroom breaks, you could also experience daytime sleepiness and fatigue. But the main symptom that defines nocturia is consistently waking up throughout the night to use the bathroom more than once.

Managing Frequent Nightime Urination

While there is nothing pleasant about tossing and turning at night trying to settle back into your sleep after another late-night trip to the bathroom, frequent urination at night is not a hopeless cause. 

There are several different approaches you can take to address symptoms and take back control of your sleeping habits and overall well being. One way of doing this is to figure out which type of problem you may have so that you can make the right plan of action for managing your symptoms. Another important thing when it comes to managing nocturia is to start by managing your symptoms directly. 

Addressing Lack of Sleep

As we have established, frequently getting up to pee at night can take a serious toll on your sleep, and in turn, negatively affect your overall health and wellbeing so it is important to address your lack of sleep head on and take opportunities to catch up on those zzzs whenever you can. 

Sometimes the best way to do that is just by taking a nap during the day. Even the Cleveland Clinic recommends that patients with nocturia take a nap when they get the chance.

Seated in bed in the morning middle-aged woman touch face with hand closed eyes suffers from barometric pressure headache migraine, old female feels unhappy upset health or personal problems concept

Medication Options For Nocturia 

There are several factors that could be contributing to frequent nighttime urination. Oftentimes, addressing pre-existing conditions will help to get nocturia symptoms under control as well. But it is also important to note that there are different medications and treatment options out there. 

Medications for Nocturia 

Demopressin is one of the most common medication options for nocturia, but it’s not right for everyone. Demopressin is specifically designed to reduce urine production, which is good for people whose nocturia is caused by polyuria, but won’t be very helpful for those whose nocturia is caused by weakened muscles, blockages or erroneous urges to urinate.

Plus, many of the underlying conditions linked to nocturia require extra urine production to get rid of excess minerals that will cause much greater harm if allowed to build up in the body.

Diuretics are another possible medication option. It might sound crazy to treat excessive urination with a drug that promotes urination, but research shows that when nocturia patients take a diuretic six hours before bed, they have significantly fewer nighttime bathroom trips. Still, none of these medications help if you are waking to urinate far more often than you actually have to. 

That’s where anticholinergic medications come in. These medications block the chemical that tells the brain that it’s time to urinate so you can get a good night’s rest without being woken up by false alarms from your bladder.

Treating Underlying Conditions of Nocturia 

Treatment for nocturia depends largely on the underlying condition it’s associated with. For instance, if you have nocturia and anxiety, you might work with your doctor to find solutions for your anxiety that help you stay awake throughout the night, decreasing the likelihood of nocturia.

Or, for example, if you’ve been experiencing urinary incontinence after having a baby that has led to nocturia, your doctor might recommend a physical therapist who can help you regain muscle tone in your pelvic floor to reduce incontinence and help treat your nocturia. 

Mediation plans will vary based on the individual and underlying cause of frequent nighttime urination. Talk to your doctor to come up with a plan that is right for you.

Preventing Frequent Nightime Urination

In addition to treating nocturia, there are also several strategies for preventing it. If you’re tired of being tired from waking up again and again, night after night, there are little things you can do to help. Here are a few: 

Reduce your liquid intake a few hours before bed

Try to reduce your alcohol and caffeine intake throughout the day. Drinking a lot of liquids before bed increases the likelihood that you will wake up in the middle of the night to use the bathroom. 

Caffeine and alcohol specifically are problematic because they can both act as diuretics and both interfere with proper sleep patterns. By simply cutting back on caffeine and nighttime drinking, you can take an important step toward preventing nocturia.

Elevate your legs

Elevate your legs during the day, especially if they tend to swell. Swollen legs contain excess fluid that cannot return to the bloodstream until they are elevated above your heart. This typically only happens while you’re asleep, and the excess fluid is processed and turned into urine.

Elevating your legs during the day allows the fluid to circulate better, preventing fluid buildup at the end of the day and the resulting extra urine production.

Create a Comfortable Sleep Environment 

Make sure your sleep environment is as comfortable as possible. A cozy bed and soothing ambient lighting won’t solve everything, but if you are comfortable while you sleep, you’re definitely less likely to wake up unless it’s an emergency.

Start by checking in on your mattress to make sure that it is a good fit for you. Some people prefer a nice, firm mattress while others want a softer feel. Either way is fine, as long as it’s comfortable and allows you to fall asleep fast. 

Next, you want to try to block out excess lighting in your room. Light blocks the production of melatonin, the hormone responsible for making us feel sleepy. Blackout curtains can help you stay asleep, even if you live in a bright city. 

Make a Nighttime Routine

Another way to help manage symptoms of frequent nighttime urination is by creating a routine before bed so you can manage your time and habits wisely in the critical hours leading up to your sleep. 

When making a routine, try to implement putting the screens away half an hour before bed (again, the light prevents melatonin production) and engage in a soothing activity you can do in low-lighting.

Read a book, do some yoga, listen to music, whatever helps you relax. According to the CDC, a consistent routine can significantly improve sleep quality and duration. Nocturia can be frustrating. But there are ways to prevent and treat it so you can get a good night’s sleep again.

Consulting a Doctor 

If you suspect you have nocturia, make an appointment to see your doctor or a urologist and before you go, keep a record of your fluid intake and output for at least two days.

Record how much you drink, what you drink and when, along with how often and how much you urinate. You should also bring a record of any medications you’re taking, as they could influence your nocturia. When you see the doctor, they will review your fluid records and ask you some questions, and then they’ll decide whether or not to make a diagnosis from there. Once diagnosed, your doctor will recommend treatment.

The Takeaway

While no one wants to deal with the negative effects of frequent nighttime urination, take ease in the fact that this condition is one that has been widely researched and can be easily managed with the help of a medical professional. So if the constant urge to pee is keeping you up at night, call your doctor to find a treatment plan catered to your individual needs.


 

Additional Information on Frequent Nighttime Urination 

Nocturnal Polyuria

Nocturnal polyuria is a subtype of polyuria, a condition where a person urinates considerably more than normal. People with nocturnal polyuria urinate a normal or reduced amount during the day, and then at night they urinate much more frequently than normal. 

Bladder Storage Problems

Some people who experience nocturia don’t produce extra urine at night, they just have trouble with proper urine storage and disposal. For instance, some people wake up feeling the urgent need to use the bathroom even when their bladder still has plenty of storage space. Other people may find that their bladder really is full, but when they urinate, only a small amount comes out. This leads to more nighttime waking since the bladder will quickly fill up again. 

Mixed Nocturia

As the name implies, mixed nocturia is caused by a mixture of causes. People with mixed nocturia may have nocturnal polyuria and a bladder obstruction, or they could have a bladder infection along with general polyuria that continues to affect them at night, or some other combination of the issues listed above.

 Mixed nocturia is very common. According to a study that looked at 194 people ranging in age from 17 to 94, 36% had mixed nocturia with more than one cause for their frequent nighttime urination.

Other Factors that Contribute to Nocturia

Aging

One of the most common causes of nocturia is aging. In a sample of nearly 1500 adults aged 55 to 84, 53% reported that they experienced nocturia and that it interfered with their sleep. Nocturia and Disturbed Sleep in the Elderly Sleep Med Study

According to the U.S. National Library of Medicine, there are a few potential reasons aging can cause increased nocturia.

First, as we age, the tissue making up the wall of our bladder becomes less elastic, meaning it can’t stretch to hold as much urine so sometimes we have to wake up more often to make more room. 

Aging can also lead to blockage of the urethra, either due to weakened muscles in women or due to an enlarged prostate in men, making it more difficult to fully void the bladder and could lead to multiple nighttime bathroom trips. 

Finally, illness becomes more common as we age, and kidney disease or dysfunction can lead to changes in urination, like nocturia.

Urinary Tract & Bacterial Infections

Another common reason for nocturia is a urinary tract infection (UTI) caused by bacteria. UTIs create a consistent sensation of needing to urinate, even if you went to the bathroom just a few moments ago. 

These infections can also reduce the amount of urine that comes out when you go to the bathroom, making more frequent trips necessary. UTIs can be treated with antibiotics and the associated nocturia should disappear along with the infection.

Pregnancy 

If you’ve never experienced nocturia before and you are now that you’re pregnant, don’t worry. Even though it’s frustrating, it’s very common for pregnant women to have nocturia. Researchers have found a few reasons for nocturia during pregnancy, including increased nighttime urine production and reduced bladder capacity.

During the first two trimesters, most nocturia is caused by nocturnal polyuria, likely caused by the hormonal shifts happening at this time. During the final trimester, researchers found that the bigger issue causing nocturia was reduced bladder capacity, likely because the baby is taking up so much room at that point. Avoiding liquids a few hours before bed is the best way to cope with pregnancy nocturia to prevent excessive urine production and filling the bladder right before sleep.

Underlying Conditions Linked to Nocturia 

Diabetes

Diabetes is a chronic health condition that affects blood sugar levels, and it turns out it can also affect nocturia. When blood sugar levels are too high, which is common in diabetes, the body produces more urine to help get rid of the excess sugar

This excess urine can increase the need to use the bathroom throughout both day and night. Keeping blood sugar levels under control may help prevent nocturia, but you should talk to your doctor if that doesn’t seem to help.

Urinary Incontinence

Urinary incontinence covers a wide range of symptoms, from total lack of bladder control to the occasional urine leak during a sneeze. Many people deal with urinary incontinence, and it can be one of the underlying conditions related to nocturia. Studies show that the two often go together, but treating one may not necessarily treat the other. Talk to your doctor if you are experiencing urinary incontinence and nocturia.

High Blood Calcium Levels

According to the Cleveland Clinic, nocturia is one of the ways high blood calcium levels manifest as other symptoms. Like with diabetes and the high sugar levels, our bodies traditionally cope with excess calcium by removing it through urine.

This requires the body to create extra urine, leading to increased urination, possibly throughout the night. Treating the high calcium levels is typically the best way to treat nocturia in this situation.

Heart Failure

People with heart failure may experience something similar to diabetes or high calcium levels because of how blood filtration is affected by heart failure. When the heart muscle starts to fail and doesn’t pump blood as well as it needs to, the blood isn’t filtered as well as it needs to be either. This allows for excess sodium to build up in the blood, and in order to get rid of it, you have to produce extra urine. This can lead to polyuria during the day or night.

Chronic kidney failure

Chronic kidney failure is another common underlying condition that often goes hand in hand with nocturia. There are actually two main reasons chronic kidney failure can lead to nocturia: excess sodium and elevated blood pressure. 

As we discussed in the section above on heart failure, excess sodium has to be passed through the urine, which means increased urination. The other issue, elevated blood pressure is a little less clear.

In people without kidney disease, blood pressure typically lowers at night while you’re asleep, but studies have found that in people with kidney disease, blood pressure doesn’t drop during sleep. This elevated blood pressure appears to be linked to nocturia as well, making kidney disease a strong risk factor for nocturia.

Anxiety

Anxiety and other mental health conditions, like depression or post-traumatic stress disorder (PTSD) have been associated with nocturia, but not because anxiety causes increased urine production.

One study investigating male veterans found that even though participants with a mental health diagnosis got up to urinate more often than those without a diagnosis, they were typically awake due to other reasons and simply went to the bathroom because they were already awake. Working with a therapist and talking to your doctor about medication are both ways you can manage your anxiety and get a better night’s sleep.

Stroke 

Another potential underlying condition linked to nocturia is stroke. Studies show that 49% of stroke patients report issues with nocturia, which is much higher than the typical 33% of the general population.

This makes sense because in many cases, the nerves in charge of the bladder experience some damage, leading to urinary incontinence, one of the underlying causes of nocturia we discussed previously.

Types of Cancers 

Certain types of cancers, especially bladder cancer, have been associated with increased chance of nocturia. Because of how cancer changes the cells making up the lining of the bladder, people with bladder cancer find themselves waking up to use the bathroom far more often than people without any kind of nocturia. 

Bladder or kidney stones

Many people have heard of, or even experienced, kidney stones. These hard masses form in the kidneys from a buildup of minerals that have clumped together. But did you know the same thing can happen in the bladder? 

Bladder stones develop from different minerals, but they form much the same way as kidney stones. Either kind of stone can cause an increase in urinary urges and potentially lead to nocturia. 

Many kidney and bladder stones are painful but pass on their own, but some need to be surgically removed.

If you find yourself constantly getting kidney or bladder stones, you should increase your daily water intake and talk to your doctor about the best way to prevent kidney and bladder stones.

Radiation

Radiation is an incredible treatment that has helped save countless lives from cancer, but it does come with some unfortunate side effects. One possible side effect is nocturia.

Radiation irritates the urinary tract, causing increased urge to urinate throughout the night. Luckily, the nocturia typically disappears a few weeks after radiation ends. The National Cancer Institute

Sexually transmitted infections 

Some sexually transmitted infections (STIs) come with prominent symptoms, like burning, oddly colored urine or unusual discharge, but many STIs are asymptomatic or show minor symptoms. One of those minor symptoms may be nocturia. 

Some studies have found no link between STIs and nocturia, while others have found a link between nocturia and specific STIs, like Trichomoniasis (also known as “trich”). Luckily, many STIs are very treatable, including “trich” which typically goes away after a single dose of certain antibiotics.


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