Reasons Why You're Getting up to Pee So Much at Night

Always getting up to use the bathroom at night? This could be why.

Nocturia is defined as waking up 1 or more times during the night to urinate, according to a 2017 article published in the International Journal of Clinical Practice. When the loss of sleep from nocturia leads to falls, reduced work productivity, symptoms of depression, or other problems, it is called clinically relevant nocturia, i.e., it affects your quality of life and treatment is needed.

It may be helpful to view nocturia as a possible symptom, not a disease. Nocturia often means that another underlying health condition is present, such as high blood pressure (hypertension), a sleep disorder, or a problem with your bladder. Regardless, in order to stop waking up at night to urinate, any underlying condition causing your nocturia will need to be treated.

This article explains several reasons why you may be waking up throughout the night to urinate. It also discusses how nocturia may be treated (depending on the cause).

Urinary Tract Infections Often Cause Nocturia

Nocturia is a well-known symptom of urinary tract infection (UTI)—the most common type of infection seen by healthcare providers in outpatient settings, according to a 2019 article in the journal Therapeutic Advances in Urology.

Urinary tract infections cause the lining of the urinary tract to become inflamed and irritated, which the Centers for Disease Control and Prevention (CDC) states can lead to the following symptoms:

  • Pain or burning while urinating
  • Needing to urinate frequently
  • Needing to urinate despite having an empty bladder
  • Blood in your urine
  • Pressure or cramping in your groin or lower abdomen

If you have been experiencing any of these other symptoms in addition to nocturia, make sure to let your healthcare provider know so that they can evaluate you for a UTI.

Hypertension and Nocturia Are Closely Linked

Research presented at the 2019 annual scientific meeting of the Japanese Circulation Society links high blood pressure to nighttime bathroom trips. "Our study indicates that if you need to urinate in the night—called nocturia—you may have elevated blood pressure and/or excess fluid in your body," study author Satoshi Konno, MD, said in a press release published by the European Society of Cardiology.

According to an article in the Journal of the American Heart Association, nocturia can generally be considered a symptom of hypertension, but there can also be other factors involved. In particular, hypertension is commonly treated with diuretic medications that, just like any other type of diuretic, cause frequent urination as a side effect.

If you are currently taking diuretic medications for your hypertension, but nocturia is affecting your sleep or quality of life, be sure to let your healthcare provider know. They may be able to prescribe a different kind of blood pressure-lowering medication for you.

Nocturia Can Be Related to Bladder Problems

A condition called nocturnal polyuria could be the reason you can't sleep through the night without a bathroom break. "Nocturnal polyuria is a syndrome where the usual day to night ratio of urine production is altered," according to a report from the American Society of Nephrology.

People with nocturnal polyuria produce more than 33% of their daily urine output at night, the report says. Congestive heart failure, neurologic diseases such as Parkinson's and Alzheimer's, chronic kidney disease, and obstructive sleep apnea are some conditions that can lead to nocturnal polyuria.

Some people with nocturnal polyuria also have low bladder capacity, meaning that their bladder does not have enough "storage" for the amount of urine being produced. A number of things can cause low bladder capacity, including infections and inflammation, confirms a 2019 article in the journal Current Bladder Dysfunction Reports.

Additionally, an overactive bladder or a bladder obstruction can cause low nocturnal bladder capacity. A report from the journal BMJ says many people who experience nocturia are affected by both nocturnal polyuria and low nocturnal bladder capacity. These are two separate issues, but people affected by both are diagnosed with mixed nocturia, the report noted.

Sleep Disorders Can Cause Frequent Urination at Night

Your body has a 24-hour rhythm, known as a circadian rhythm, that works like an internal clock—putting you to sleep when it is dark and waking you up when it is light. For people with circadian rhythm disorders, this sleep-wake pattern is dysfunctional or may even be entirely reversed, says a 2021 review in the journal Neurotherapeutics.

Circadian rhythm disorders affect more than when your body sleeps and wakes. They also affects your body's metabolic processes, including when you need to use the restroom. In other words, if your internal clock thinks you should be awake at night, it will also think you should urinate at night.

What To Do if You're Waking Up To Pee Too Often

If you find yourself losing sleep because of nocturia, the first thing you should do is see your healthcare provider for an evaluation.

Urgent issues like infections will need to be treated. You might be asked to keep a "fluid and voiding diary." This entails keeping a record of everything you drink and every time you have to go to the bathroom; the diary can help your provider figure out what might be causing your nocturia.

Treatment for nocturia might involve curing whatever ailment has led to the condition instead of curing the condition directly. For example, if a urinary tract infecting is causing your nocturia, you may need to take antibiotic medications. Or, if high blood pressure is causing your nocturia, your provider might recommend watching your salt intake or being more physically active.

If there's no underlying condition to address, a few simple lifestyle tweaks might help resolve your nocturia. Neil Grafstein, MD, an assistant professor of urology at New York City's Mount Sinai Hospital previously told Health that cutting back on the booze you drink when it's almost bedtime could put your nocturia symptoms to rest.

Additionally, drinking more water during the morning hours than in the evening could help. Lastly, cutting back on coffee might do the trick because caffeine irritates your bladder. This might not be the news you wanted to hear, but there's a possible silver lining: Maybe if you're getting better sleep you won't require as much coffee.

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