Getting up in the night to pee is annoying, and disturbs our natural sleep pattern, often
leaving us feeling tired and unrefreshed.
If you are waking at least twice at night to pass urine, you are experiencing nocturia.
Several causes of nocturia exist, so let's examine the most common ones here.
Number 1 – Changing Hormones
As we age, our body produces less ADH, the Anti-Diuretic Hormone.
This Hormone, at night, promotes the natural retention of fluid by telling your kidneys
to slow the production of urine.
As levels of ADH drop, we produce more urine overnight.
Therefore, your bladder fills, and a reflex tells your brain to wake up and empty the
system.
Number 2 – Prostate Problems
The prostate is a gland that lives at the base of a man's bladder.
It plays its role in both the production of seminal fluid and the regulation of urine
flow.
Unfortunately, as men age, the size of their prostate often increases.
This increase in size can restrict urine flow.
Therefore, your bladder cannot completely empty, meaning you pee more often.
Because of this restriction, men with enlarged prostates wake multiple times during the night
to pass urine.
Number 3 – Bladder Issues
Sometimes nocturia can be caused by an overactive bladder, also known as urge incontinence.
Here the urge to pass urine comes on intensely, without warning, and with little ability to
delay going to the toilet.
This reduced control of your bladder may result in the leaking of urine at night.
Additionally, bladder urine infections cause you to pass urine more frequently, which may
occur through the night.
With this infection, you may experience fevers, cloudy, smelly urine and painful peeing.
Number 4 – Medical conditions
Specific medical conditions can also cause nocturia.
The first is diabetes.
In diabetes, high blood sugar levels make you thirsty, encouraging you to drink more.
This increased fluid intake makes you pee more, including at night.
Therefore, among diabetics close control of blood sugars can ease nocturia symptoms.
Individuals with heart failure also wake up during the night to pass urine.
In heart failure, the heart is not as effective at pumping blood around your body.
This causes fluid retention in your legs during the day, known as oedema.
When you lie down at night, you elevate your legs, encouraging retained fluid to be resorbed
into your bloodstream and removed by the kidneys in the form of urine.
This increased urine production means you wake up to pee at night.
Number 5 – Medications
Individuals with swollen ankles, such as those with heart failure, may be prescribed medications
to offload excess fluid.
These medications are diuretics which work by making you pee more.
Common examples include furosemide, bumetanide and spironolactone.
If this sounds like you, speak with your prescribing doctor to optimise your medication timing.
Restricting diuretics to morning doses, mean they work more during the day, limiting their
effect at night.
Number 6 – Poor Sleeping Pattern
Some individuals have poor sleep patterns, meaning they will wake up at night.
Being awake we are naturally more aware of our bladder and are more likely to feel the
need to pee.
The fundamental point here is that you don’t wake up because you need to pee, you wake
up regardless and then feel like you need to pee.
There are many reasons people have poor sleep patterns, often related to mental health issues,
other medical conditions and poor sleep hygiene.
We will discuss insomnia in a future video and how good sleep hygiene can make all the
difference.
Number 7 – Too much fluid
Alcoholic, and caffeinated drinks, have the double effect of irritating your bladder and
altering your sleep pattern.
Taking too much of either of these will increase your need to pee overnight.
So, try and limit your intake.
Whilst keeping hydrated and drinking plenty of water is important, drinking too close
to bedtime is not a good idea.
That extra glass of water before bed could be why you wake in the middle of the night.
Your body absorbs that water processes it, and excretes it through your kidneys, filling
your bladder.
A full bladder at night is that alarm bell that wakes you up at night to go pee.
How can we solve this?
Limit your fluid intake close to bedtime.
Aim to have your last drink 2 hours before bed, and ensure you fully empty your bladder
before hitting the hay.
As discussed, waking to pee at night can be caused by a host of issues.
Speak with your doctor about the options available for you.
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