Nocturia: What’s Behind Frequent Urination at Night?

Making 2 or more bathroom trips at night? Learn tips to improve sleep.

You’re comfortable in bed, wearing your favorite pajamas wrapped up in a warm blanket. Until you wake up and need to use the bathroom — again. Was it too much water today? Or is it just the way your body works? Whatever the reason, this lack of sleep can leave you exhausted.

Frequent peeing at night — usually 2 times or more — is called nocturia. While it’s more common as we age, it’s not just part of getting older. With a few small adjustments, it’s likely you can cut down on those nighttime visits to the restroom.

Hormones regulate your urine

Throughout the day, your body naturally produces a chemical called antidiuretic hormone (ADH). This valuable substance tells your kidneys how much water to retain. And it works to balance the water in your blood to keep you functioning normally. But that’s not all it does.

“While you sleep, levels of ADH increase to keep you from waking up to go to the bathroom,” explains Yamunadevi Sadasivan, MD, a primary care doctor at Geisinger 65 Forward. That means most people can make it through an entire night — 6 to 8 hours of sleep — without using the bathroom.

If your levels don’t rise as much as they should, you might wake up to go.

Causes of nighttime urination

Several things could be to blame for midnight pit stops. When you’re up more than once a night, keep these tips in mind.

Too many beverages

Planning to fill your cup before you turn in for the night? Plan for a few trips to the restroom, too. “Drinking too much before bed, especially alcohol or caffeine, can cause you to go to the bathroom during the night,” says Dr. Sadasivan.

Excessive salt intake

When you reach for the saltshaker more than usual, it can make for a long night. 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. Cutting back on sodium can help combat nocturia. And that’s not all it can help with.

“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,” Dr. Sadasivan says.

Medications

Medications can cause more nighttime bathroom visits. Diuretic drugs are a common culprit. Often called a “water pill,” they remove excess fluid from your body.

“It can help to take diuretics 6 to 8 hours before you go to sleep,” suggests Dr. Sadasivan.

Other drugs that can cause more nighttime visits are:

Prescription medications: Beta blockers, anticholinergics, lithium and cholinesterase inhibitors
Over-the-counter medications: Diphenhydramine (Benedryl), brompheniramine (Dimetapp), dimenhydrinate (Dramamine) and doxylamine (Unisom SleepTabs). These medications can worsen BPH (benign prostate hypertrophy) symptoms.

“If you find medications are causing frequent urination at night, talk to your doctor or pharmacist about taking a different dose at a different time or changing drugs,” advises Dr. Sadasivan.

Sleep-disordered breathing and sleep apnea

Those constant late-night bathroom visits might be a sign you need testing for sleep-disordered breathing (sleep apnea).

When you stop breathing or snore deeply, it can disrupt your hormones, including ADH that reduces nighttime urine production. Plus, poor breathing can interrupt sleep enough that you get the urge to pee.

Weak bladder or pelvic floor muscles

Especially for women, weak bladder or pelvic floor muscles can cause frequent urination day or night. Pelvic floor care can often help.

“Patients often accept frequent bathroom visits as a part of aging or being female, but usually we can dramatically improve their lives with simple techniques and exercises,” says Dr. Sadasivan.

Medical conditions

Issues that can make you need to go at night can include:

UTIs
Diabetes
Heart or liver failure
Kidney disease
Bladder tumors
Enlarged prostate
High blood pressure

Other causes

More causes of frequent urination at night include:

Swelling in the legs
Aging (especially for men over 65)
Being overweight

How to stop excess bathroom trips

If you’re heading to the bathroom instead of heading off to dreamland, talk to your healthcare provider. They may recommend a few adjustments like:

Cutting back on fluids at night, especially alcohol and caffeine
Reducing salt intake
Maintaining a healthy weight
Taking or adjusting medications
Pelvic floor and bladder therapy

Before your doctor’s visit, track the number of times you get up and try to measure how much urine you produce or the number of seconds you urinate over 2 or 3 days.

To combat next-day tiredness, Dr. Sadasivan suggests taking a nap during the day when possible.

With some minor changes, you can focus less on visiting the bathroom and more on a restful slumber.