Is It Normal To Pee at Night?
Hello friends! Imagine this: it’s 1 am and you’ve been sleeping comfortably in bed. Suddenly, you’re awake with the urge to go to the bathroom to pee. You get up and go to the bathroom then head back to bed. Now it’s 4 am and you’re waking up with the urge to pee again! Does this sound familiair?
Nocturia is a medical condition in which an individual wakes at night to go pee (Kim, 2016). There are mixed opinions in the research on whether nocturia is defined as peeing more than once or more than twice per night (Bliwise, 2019; Weiss, 2019; Kim, 2016).
It is so common that many people do not consider it to be a medical symptom and instead assume it is a natural part of aging (Kim, 2016).
Nocturia can have both physical and mental health impacts due to sleep interruption (Weiss, 2019). Some common effects of nocturia include:
Daytime fatigue (Bliwise, 2019)
Cognitive impairments (Bliwise, 2019)
Mood alterations (Bliwise, 2019)
Increased susceptibility to disease (Bliwise, 2019)
Decreased work performance (Bliwise, 2019)
Dizziness (Bliwise, 2019)
Increased risk of falls (Bliwise, 2019; Weiss, 2019)
Depression (Bliwise, 2019)
Mortality (Bliwise, 2019; Weiss, 2019)
Nocturia can be caused by medical conditions like congestive heart failure (CHF), diabetes, obstructive sleep apnea, peripheral edema, and excess nighttime fluid intake (Weiss, 2019; Doyle-McClam, 2018).
It is recommended that lifestyle and behavior modifications are tried to treat nocturia before medications are used (Weiss, 2019). Lifestyle modifications can include:
Limited fluid intake 2 hours before bed (especially alcohol and caffeine) (Weiss, 2019)
Limiting fluid intake throughout the day to less than 2 liters (about 67 ounces)(Weiss, 2019)
Emptying the blader before going to bed (Weiss, 2019)
Barrier-free access to a toilet (Weiss, 2019)
Increasing exercise and fitness levels (Weiss, 2019)
Pelvic floor muscle exercises (Weiss, 2019)
Decreasing salt intake (Weiss, 2019)
Weight loss for overweight individuals (Weiss, 2019)
Elevating the legs a few hours before going to bed (for patients with leg swelling) (Weiss, 2019)
Treating sleep apnea (Doyle-McClam, 2018)
That being said, if you’re already up with baby (or someone/something else) and you feel like peeing before returning to bed, you may be more comfortable. Night time is not the time where we work to retrain the bladder-daytime is!
If these lifestyle changes are not successful at treating nocturia, your provider may recommend medications. The medications prescribed vary and aim to treat the underlying cause of the nocturia (Andersson, 2018).
Ask your provider for a referral to a pelvic floor therapist near you to help with pelvic floor muscle exercises and bladder retraining. You can also find one at www.mypfm.com/find-a-pt.
To learn more about your pelvic floor muscles, check out these great resources:
Watch our YouTube playlist on Bladder Concerns and Your Pelvic Floor
Watch Netflix for Your Pelvic Floor at Pelvic Flicks
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Treatments for OAB with Dr. Sarah Boyles, MD, MPH, FACOG, FPMRS
Written by Emily Reul, PT, DPT
Andersson KE, Van Kerrebroeck P. Pharmacotherapy for nocturia. Curr Urol Rep. 2018;19(1):8.
Bliwise DL, Wagg A, Sand PK. Nocturia: a highly prevalent disorder with multifacted consequences. Urology. 2019;133S:3-13.
Doyle-McClam M, Shahid MH, Setha JM, Koo P. Nocturia in women with obstructive sleep apnea. Am J Lifestyle Med. 2018;15(3):260-268.
Kim JW, Moon YT, Kim KD. Nocturia: the circadian voiding disorder. Investig Clin Urol.2016;57(3): 165-73.
Weiss JP, Everaert K. Management of nocturia and nocturnal polyuria. Urology.2019;133S:24-33.