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Nighttime No. 1 causes daytime tiredness

Many things can negatively affect your quality of life. One that may not be on your radar is how frequently you use the bathroom at night—but it should be. Waking up frequently to urinate can be frustrating and exhausting. If it happens often enough, it can leave you feeling sleepy and less able to concentrate throughout the day.


“The frequent need to urinate at night is called nocturia,” explained Dr. John Danella, Geisinger urologist. “It becomes more common as you age and if you have certain medical conditions.”


What’s normal at night?

The body naturally produces a hormone called antidiuretic hormone (ADH), which tells your kidneys how much water to retain. It’s your body’s way of balancing the amount of water in your blood to keep you functioning normally.


At night while you sleep, levels of ADH increase to keep you from waking up to go to the bathroom. As you age, ADH levels decrease, which is why it’s more common for older people to have to urinate at night.


People without nocturia can usually make it through a full night—six to eight hours of sleep—without having to use the bathroom. If you have to get up once during the night to urinate, you’re likely still in the normal range. More than once can indicate a problem that will leave you feeling tired.


“Drinking too much before bed, especially diuretic beverages such as alcohol or caffeine, can cause you to wake up a few times at night,” said Dr. Danella. “Certain medical conditions can also lead to the need to urinate frequently when you should be asleep.”


These medical conditions include urological infections, bladder and prostate tumors, bladder prolapses and problems with sphincter control. Nocturia is also more common in pregnant women and people with heart failure, liver failure and poorly controlled diabetes.


Too much salt could be the culprit, too

Researchers studied the effects of high salt intake and the frequency of nighttime urination to see if there was a connection. The first group of study participants reduced their daily salt intake from 10.7 grams (g) to 8.0 grams. They saw a corresponding drop in the average number of times they needed to use the bathroom, from 2.3 to 1.4 times per night.


The second group of participants increased their salt intake from 9.6 g to 11.0 g and saw a corresponding increase in their average nighttime bathroom trips—from 2.3 times to 2.7 times.


Your body gets rid of most excess salt and the water it causes you to retain through urination. This means more trips to the bathroom at night. Keeping your sodium intake at or below 2,300 milligrams per day—and ideally closer to 1,500 mg—can help combat nocturia.


“This study shows that a simple dietary change may help with frequent nighttime urination,” said Dr. Danella. “Making a change to reduce your salt intake will not only help with this problem, but also helps to reduce your risk for heart disease and high blood pressure.”


If you’re experiencing frequent nighttime urination, reduce your salt intake and also talk to your doctor about other health issues that could be contributing to the problem.


Geisinger urologist Dr. John Danella, MD, sees patients at Geisinger Urology in Wilkes-Barre. To schedule an appointment with Dr. Danella or another Geisinger urologist, please contact 570-275-6401 or visit


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