Nocturia: When Your Bladder Won’t Let You Sleep

If you wake up multiple times to urinate in the middle of the night, you’re not alone. Nearly 30% of Americans over age 30 do the same thing, according to the Urology Care Foundation. Known as nocturia, this condition affects more than your nighttime routine. Waking up to pee at night can have negative consequences on you throughout the day and night.

“Waking up to use the restroom at night affects your overall quality of life,” says Matt Baker, PharmD, PA-C, certified physician assistant at Beaufort Memorial Urology Specialists. “It makes you feel tired during the day, which reduces your productivity and puts you in a bad mood. As you age, waking up to use the restroom also puts you at risk for dangerous falls and fractures.”

Understanding what’s causing your nighttime urination needs can help you know what steps can reduce your need to urinate so you can sleep and feel better.

Common Causes of Nocturia

There are many reasons you may wake up at night to urinate. While there are many causes of nocturia, they all fall under two umbrella causes: lifestyle choices and underlying health conditions.

Read More: What Your Urine Smell, Color and Flow Are Telling You

Health Conditions That Can Wake You Up for a Bathroom Break

Along with lifestyle choices, certain health conditions increase the odds that you’ll experience nocturia.

“Many people who wake up multiple times every night to urinate have a medical condition that affects how the body functions,” Baker says. “As a result, they wind up needing to urinate at night, when they should be sleeping.”

Conditions that can cause this problem include:

• Bladder infection
• Diabetes
• Chronic kidney disease
• Congestive heart failure
• Enlarged prostate (benign prostatic hyperplasia)
• Excess urine your body produces that your bladder cannot hold at night (nocturnal polyuria)
• Heart disease
• High blood pressure
• Overactive bladder
• Pelvic prolapse
• Sleep disorders, such as insomnia, sleep apnea or restless legs syndrome
• Urinary tract infection (UTI) in males or in females during pregnancy
• Vascular disease

How Your Lifestyle May Lead to Nighttime Urination

What you do with your daytime routine can have negative consequences while you sleep. A few lifestyle choices that can cause nocturia include:

• Drinking habits — Drink fluids right before bed, and your body may force you to get rid of them during the night. Any nighttime fluid intake increases your risk for nocturia, but your likelihood of nighttime bathroom breaks is highest when you drink alcohol and caffeine.
• Medication schedule — Some medications, such as diuretics, make you need to urinate. If you take these when you’re getting ready for bed, expect to have your sleep disrupted by your bladder.
• Mental training — You can train your body and brain to do all sorts of things. If you train it to wake up to use the restroom, you’ll wake up to pee even when there’s only a little urine in your bladder.

When to Seek Medical Attention for Nighttime Urination

Tired of waking up in the middle of the night to use the restroom? It may be time to seek professional help.

Talk with your health provider if you experience the following:

• Frequent rousing — You wake up multiple nights in a row to urinate.
• Irritating awakening — Waking up to urinate annoys you.
• Painful urinating — It burns or otherwise hurts while urinating.

Any one of these symptoms indicates it’s time to seek medical attention. Otherwise, your nocturia symptoms may worsen over time. Untreated nocturia may even lead to other health problems, such as high blood pressure.

Nocturia can reduce your quality of life and put your safety at risk. It’s also annoying. Fortunately, you don’t have to accept it as a normal part of aging.

“A urologist can help detect the cause of your problem,” Baker says. “Once that’s determined, you can work together to create a treatment plan that works for you that helps you sleep all night long, without interruption.”

Read More: Enlarged Prostate Affects More Than Half of Older Men

Detecting the Cause of Nocturia

To diagnose your condition, your health provider will ask questions about your lifestyle and symptoms. If necessary, you may undergo various tests. These help determine if an underlying condition is responsible for your nighttime waking.

Tests you may undergo include:

• Bladder scan — This shows excess fluid left in your bladder after urinating.
• Blood testing — A simple blood test can check for diabetes, anemia and other health issues.
• Cystoscopy — A tiny camera at the tip of a thin, narrow tube shows inside the bladder. Your care provider uses this to detect tumors or other abnormalities.
• Urine tests — These look for blood in the urine, infection and other urinary tract issues.
• Urodynamic testing — A series of tests that show how well your lower urinary tract handles urine.

Treating Nocturia

Once the underlying cause of your nocturia is identified, your care team will develop an appropriate treatment plan. Treatment options that may reduce your need to urinate during the night include:

• Lifestyle changes — “If lifestyle choices cause you to wake up at night, lifestyle changes can often reverse the problem,” Baker says. Lifestyle changes that may help include cutting off fluids early in the evening, avoiding caffeine and alcohol and only using the bedroom for sex and sleep. Adjusting when you take medication and exercising regularly can also help bring relief.
• Medication — Depending on the root cause of your condition, medication may help. For example, antidiuretic hormone therapy can help with nocturnal polyuria, and alpha-blockers can help address an enlarged prostate.
• Managing other conditions — If another health condition causes your symptoms, work with your health team to manage that condition. Proper management may help reduce your symptoms.
• Therapy — Training your mind and body can reduce symptoms of nocturia. Techniques include suppressing the urge to urinate and strengthening your pelvic floor with Kegel exercises.

Read More: No Longer Controlled by an Overactive Bladder

“The right treatment can really improve quality of life,” Baker says. “It may not eliminate every nighttime bathroom break, but it can reduce the frequency by half or more. This kind of improvement is possible, and it starts when you overcome any embarrassment and reach out to your health provider.”

Nocturia: Quick Facts

Nocturia occurs when you wake to use the restroom multiple times. This condition disrupts your sleep and affects your quality of life during the daytime.

1. Your lifestyle habits can result in the condition. Examples include drinking too much fluid or taking diuretics or other medications too close to bedtime.
2. Serious health issues, such as heart disease and pelvic prolapse, can also cause nocturia.
3. Diagnosing and treating the problem helps reduce nighttime interruptions and improve your sleep.

Is something affecting your bathroom habits? Find a urology provider at Beaufort Memorial who can detect and treat your problem.