Sleep is so vital to health that losing it consistently can contribute to mental health issues, difficulty concentrating, memory loss, high blood pressure, weakened immunity, and an increased risk of developing type 2 diabetes, dementia, and Alzheimer’s disease. It can also just make you grumpy AF, which is why few things are so maddening as being awoken by your bladder in the middle of the night and not being able to go back to sleep once you’ve relieved the pressure.
Experts in This Article
board-certified urologist and founder of Prestige Medical Group in Santa Ana, California
clinical psychologist, sleep specialist, author of The Women’s Guide To Overcoming Insomnia, and Director of Sleep Health at Sleepopolis
If this happens to you regularly, you may be suffering from nocturia, which is a condition that sounds a lot cooler than it is. The word is actually just Latin for “urinating at night.”
“We define it as waking two or more times during the night to urinate, not counting the time when you awaken for the day,” says urologist Lamia Gabal, MD, FPMRS. “This is differentiated from nocturnal polyuria (NP), in that NP is making more than about 40 percent of your total daily urine volume at night, thereby causing nocturia.”
Waking up more than twice a night can be problematic for an all-too-obvious reason. “It can prevent your body from getting adequate rest,” says Dr. Gabal. It’s also, she adds, one of the most common ways that elderly women break a hip—waking up at night to urinate and falling on the way to the bathroom. Plus, it’s been linked to higher overall mortality. In other words, it’s no joke.
Dr. Gabal adds that nocturia becomes more prevalent as we age, with 42 percent of women and 59 percent of men over the age of 60 waking up two or more times per night to urinate. It’s also more in Black and Hispanic populations for reasons that aren’t quite yet understood.
Part of what makes nocturia tricky is that it isn’t caused by just one thing; in fact, there are many different reasons someone might experience it. “The most common reason people wake up at night to pee is they’re up for another reason: someone snoring, an ache or pain, or just plain insomnia,” says Dr. Gabal. “Overactive bladder [OAB], drinking too much before bedtime, taking certain medicines like diuretics at bedtime, peripheral edema [swelling of the lower extremities], and sleep apnea are other common causes.”
So if you’re struggling with waking at night to pee, the first and most important thing to do is to figure out with your doctor which of the above causes might apply to you. “If you’re a light sleeper, taking a sleep aid, e.g. melatonin, can be helpful,” says Dr. Gabal. “If you wake up having wet the bed, that indicates that it’s actually a bladder storage issue, like OAB, and you can see a urologist to help with that. Also, treatment of sleep apnea or insomnia can also cut down on the number of times someone awakens to urinate.”
More generally, she advises avoiding fluids two hours prior to bedtime. Shelby Harris, PsyD, behavioral sleep medicine specialist and author of The Women’s Guide to Overcoming Insomnia, actually recommends avoiding them for three hours before bed. “If you must have some liquids, make sure that you just have a few sips,” Harris says. “If you are excessively thirsty at bedtime, make sure you’re drinking enough water during the day and you’re not backlogging it all at the end of day.” And it’s especially important, Dr. Gabal adds, to avoid alcohol and caffeine at night. “They are diuretics and will make you produce more urine, thereby increasing the nocturia,” she says.
Waking at night to pee is pesky, but it’s more than that, too. It can have serious health consequences, so it’s important to address the issue before it spirals into real problems. You’ll sleep better at night, not just because your bladder isn’t rousing you but also because you’ll know you’re allowing your body the rest it needs to stay healthy long term.
Still having trouble sleeping? Check out these foods that can support restful sleep, vetted by an RD:
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