This Common Nighttime Habit Can Be a Sign of Disease—Here’s When to Worry

Reviewed by dietitian Karen Ansel, MS, RDN

Highlights

• Feeling the need to urinate frequently throughout the night may be a hidden sign of some health problem.

• These include diabetes, sleep apnea, overactive bladder or benign prostatic hyperplasia.

• If you routinely wake up to pee more than once a night, talk to your healthcare provider.

Picture this: You are in a deep sleep and in the middle of a wonderful dream, when an uncomfortable feeling jolts you awake. Your bladder is calling you and telling you it’s time to use the toilet. Certainly, waking up to pee at night It happens to everyone from time to time. However, if this happens more than once a night, it may be a sign of an underlying health problem.

“You should be able to sleep for about six to eight hours without waking up to go to the toilet,” says the urologist Justin Dubin, MD “If you’re waking up two or more times a night, that’s considered abnormal.”

The medical term for these excessive bathroom breaks is nocturia. Although nocturia itself is not a disease, it can be a symptom of a disease. And it’s more common than you might think, affecting 50 million adults in the United States. Most are over 65, but even 1 in 3 of those over 30 say they get up to pee two or more times a night.

Should you be worried? To find out, we spoke to urologists and a dietitian about the conditions that may cause you to have to pee at night, what’s considered normal, and practical tips to prevent them.

Conditions That Cause Excessive Nocturnal Urination

There are many potential causes of excessive urination at night, including lifestyle habits, bladder capacity, certain medications, and underlying health conditions. Here are four of the most common health problems that may be the culprit.

Diabetes

If you find yourself waking up to go to the toilet more often than usual, it could be one of the following: first signs of blood sugar problems. Urologist says frequent urination is one of the early signs of diabetes Scott D. Miller, MD, MBAIt’s a diagnosis he makes several times each year.

An estimated 15% of American adults are living with diabetes, and approximately 3% are unaware of it. When diabetes is undiagnosed or poorly managed, high blood sugar levels can cause you to go to the bathroom more often.

How does this happen? “High blood sugar levels can trigger osmotic diuresis, which can lead to excessive urination at night,” he says. Elizabeth Shaw, MS, RDN, CPT. This is when the kidneys try to lower blood sugar by removing excess glucose through urine, followed by water. “This leads to increased urine production at all times of the day, including at night,” Miller adds.

Sleep Apnea

“Many patients are surprised to learn that their bladder symptoms are actually sleep-related,” says Miller. One thing to watch out for is sleep apnea. “Sleep apnea occurs when throat muscles relax and block breathing during sleep, causing people to wake up repeatedly throughout the night,” says Shaw. The clues you have are that you snore or pant while you sleep.

Sleep apnea can also be a sneaky reason why you’re getting up to use the bathroom. Beyond disrupting sleep, sleep apnea can lower blood oxygen levels, which can trigger hormone changes that encourage nighttime urination, Miller says. Specifically, it leads to increased secretion of atrial natriuretic peptide (ANP), a hormone that helps your kidneys remove water from the body.

overactive bladder

If you go to the toilet frequently during the day and more than twice a night, your bladder may be overactive. “Overactive bladder is a condition in which the bladder is overly sensitive and sends signals to urinate frequently or suddenly, even when not full, causing urgency and frequent trips to the bathroom, day or night,” explains Miller. The good news is that there are medications that can help calm your bladder. So if you’re constantly running to the bathroom, talk to your healthcare provider.

Benign Prostatic Hyperplasia

As men get older, the prostate gland naturally grows. This condition is called benign prostatic hyperplasia (BPH). “When the prostate is enlarged, you cannot empty your bladder, so your bladder [bladder] You may feel full more often and be less able to tolerate urination,” explains Dubin. Fortunately, for many men, lifestyle changes can help (more on this soon!).

What is Normal?

Up to one night of bathroom trips are considered normal for most adults. Consistently waking up two or more times a night (especially if it’s new, worsening, or tiring) merits a medical visit, Miller says.

“You should be concerned when nocturia disrupts sleep or daytime energy,” he says. “When nocturia occurs suddenly or is associated with urinary pain, excessive thirst, swelling in the legs, or shortness of breath, you should seek immediate medical attention.”

Tips to Reduce Nighttime Urination

Experts recommend trying these tips, as well as working with your healthcare provider to find out what’s causing you to go to the bathroom at night.

• Stop drinking two hours before bed: Dubin says they cut out all liquids, especially alcoholic and caffeinated drinks, two hours before bed. Both alcohol and caffeine are diuretics and may cause you to urinate more frequently.

• Check your medications: Some medications, such as diuretics for high blood pressure or heart conditions, can increase urination. Some antihistamines and over-the-counter cold medications can also be triggers in men with BPH. Ask your healthcare provider if it is possible to take these medications in the morning instead of at night or if there is an alternative medication that might work for you.

• Treat underlying conditions: Untreated sleep apnea and diabetes can worsen sleep and increase urination. “It’s best to get these under control to help you pee at night and sleep better,” says Dubin.

• Solution to leg swelling: Your legs may swell at night for a variety of reasons. Some of them can be serious, so you should never ignore them. But there are also benign culprits, such as standing or sitting for too long throughout the day, taking certain medications, or consuming too many salty foods. Swelling of the legs may also cause you to need to urinate frequently. “Elevating the legs or wearing compression stockings in the evening can help move fluid earlier and reduce nighttime urine production,” says Miller.

Our Expert Opinion

It’s normal to wake up occasionally at night to pee. However, if this happens more than twice a night, your body may be trying to tell you that there is a problem. “Waking up at night to urinate may not just be a bladder problem; it may be your body’s way of sending out a red flag,” says Miller.

Conditions such as diabetes, sleep apnea, overactive bladder, and benign prostatic hyperplasia can cause you to need to urinate frequently throughout the night. While going to the toilet once a night is considered normal, more than that may indicate an underlying problem. Therefore, be sure to inform your healthcare professional. In addition to treating underlying health problems, experts recommend reducing fluid intake two hours before bed, reviewing your medications with your healthcare provider, and addressing leg swelling. In return, you can reduce nightly bathroom trips and finally get the rest you need.

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