Reviewed by dietitian Karen Ansel, MS, RDN
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Key Points
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The need to pee frequently during the night can be a hidden sign of some health conditions.
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These include diabetes, sleep apnea, overactive bladder or benign prostatic hyperplasia.
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If you regularly wake up more than once a night, talk to your healthcare provider.
Imagine this: You are fast asleep and in the middle of a big dream, when you feel uncomfortable waking you up. He calls your bladder, telling you it’s time to use the bathroom. Of course, waking up at night happens to everyone sometimes. But if it’s happening more than once a night, it could be a sign of an underlying health issue.
“You should be able to sleep six to eight hours without getting up to go to the bathroom,” says urologist Justin Dubin, MD “If you’re getting up two or more times a night, that’s considered abnormal.”
The medical term for those excessive bathroom stops is nocturia. While nocturia itself is not a disease, it can be a symptom of one. 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 concerned? To find out, we talked to urologists and a dietitian about conditions that can cause those trips to the bathroom at night, what is considered normal, along with practical suggestions to prevent them.
Conditions That Cause Excessive Peeing at Night
There are many potential causes of excessive urination at night, including lifestyle habits, bladder capacity, some medications and underlying health conditions. Here are four of the most common health issues that could be the culprit.
Diabetes
If you find yourself getting up to use the bathroom more often than usual, it could be one of the first signs of blood sugar problems. Frequent urination is one of the early signs of diabetes, says urologist Scott D. Miller, MD, MBA, a diagnosis he makes several times each year.
It is estimated that 15% of American adults are living with diabetes, and approximately 3% are unaware of it. When diabetes is undiagnosed or mismanaged, elevated blood sugar levels can lead to more frequent visits to the bathroom.
How does it happen? “Elevated blood glucose levels can cause osmotic diuresis, which results in excessive urination at night,” says Elizabeth Shaw, MS, RDN, CPT. This is when the kidneys try to lower blood sugar by excreting excess glucose in the urine, and water follows. “This leads to increased urine production around the clock, including during the night,” adds Miller.
Sleep Apnea
“Many patients are surprised to learn that their bladder symptoms are actually sleep-related,” says Miller. One to watch out for is sleep apnea. “Sleep apnea occurs when the throat muscles relax during sleep and block breathing, causing people to wake up repeatedly during the night,” says Shaw. A tip-off you have is snoring or gasping for air while you sleep.
Sleep apnea can also be a sneaky reason you’re getting up to use the bathroom. Beyond disrupting sleep, sleep apnea can reduce oxygen levels in the blood, which triggers changes in hormones that encourage the production of urine at night, says Miller. Specifically, it leads to an increase in the secretion of atrial natriuretic peptide (ANP), a hormone that helps your kidneys remove water from the body.
Overactive bladder
If you find that you go to the bathroom frequently during the day and more than twice a night, you may have an overactive bladder. “Overactive bladder is a condition in which the bladder is overly sensitive and sends frequent or sudden signals to urinate, even when it is not full, leading to 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 are always running to the bathroom, talk to your health care provider.
Benign Prostatic Hyperplasia
As men age, the prostate gland naturally enlarges. This condition is called benign prostatic hyperplasia (BPH). “When the prostate is enlarged, you can’t empty your bladder as well, so [bladder] he may feel fuller more often, and the time for you to tolerate holding urine may decrease,” explains Dubin. Fortunately, for many men, lifestyle changes can help (more on that soon!).
What is Normal?
For most adults, up to one nightly trip to the bathroom is considered normal. Miller says that waking up consistently two or more times a night (especially if it’s new, worsening or exhausting) merits a medical visit.
“You should be concerned whenever nocturia interferes with daytime sleep or energy,” he says. “When nocturia occurs suddenly or is associated with painful urination, excessive thirst, swelling in the legs or shortness of breath, you should seek medical attention promptly.”
Tips to Reduce Peeing at Night
In addition to working with your health care provider to find out the cause of those trips to the bathroom at night, experts recommend that you try these tips.
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Stop drinking two hours before bed: Cut back on all fluids two hours before bedtime, especially alcoholic and caffeinated beverages, says Dubin. Both alcohol and caffeine are diuretics that can make you urinate more often.
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Check your medicines: Some medications, such as diuretics for high blood pressure or heart conditions, can increase urination. For men with BPH, some antihistamines and over-the-counter cold meds can also be triggers. Ask your healthcare provider if it is possible to take these medications in the morning instead of in the evening, or if there is an alternative medication that might work for you.
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Treat the underlying conditions: Untreated sleep apnea and diabetes can worsen sleep and increase urination. “It’s best to get them under control to help pee at night and sleep better,” says Dubin.
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Address leg swelling: Your legs can swell at night for various reasons. Some can be serious, which is why you should never ignore it. But there are also benign culprits, such as standing or sitting too long during the day, taking certain medicines, or eating a lot of salty food. Swollen legs can also make you need to pee more often. “Elevating the legs or wearing compression stockings in the evening can help move fluid earlier, reducing nighttime urine production,” says Miller.
Take our Expert
It is normal to get up at night to pee occasionally. But if it happens more than twice a night, it could be that your body is trying to tell you that there is a problem. “Getting up at night to urinate may not just be a bladder issue, it may be your body’s way of raising a red flag,” says Miller.
Conditions such as diabetes, sleep apnea, overactive bladder and benign prostatic hyperplasia can all cause you to need to pee frequently during the night. While one nightly trip to the bathroom is considered normal, anything else could indicate an underlying issue. Therefore, be sure to inform your health care provider. In addition to treating underlying health conditions, experts recommend reducing fluids two hours before bed, reviewing your medications with your healthcare provider and addressing leg swelling. In return, you can cut down on those evening bathroom trips and finally get the rest you need.
Read the original article on EatingWell