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Why You Shouldn't Need to Pee at Night

Hi friends! Do you ever find yourself getting up in the middle of the night to use the bathroom? Maybe even more than once? This is called nocturia—needing to get up regularly during the night to pee (Leslie, 2021). Like urinary leakage (incontinence), nocturia is often thought of as a normal part of aging, but this is not true. One of every three people over the age of 30 get up at least two times each night to use the bathroom (Leslie, 2021). While nocturia is common, it is not “normal.”


Many health conditions can increase your risk of having nocturia (Melville, 2005; Jackson, 2004; Sampselle, 2002; Carter, 2012; Vasudevan, 2017; Leslie, 2021), including:

  • Diabetes

  • Chronic constipation

  • Interstitial cystitis (painful bladder syndrome)

  • Obesity

  • Depression

  • Cardiovascular disease

  • Venous insufficiency

Managing nocturia is important to having a good quality of life. Several research studies have found a link between getting up to pee during the night and daytime sleepiness, difficulty sleeping, and overall productiveness/attention during the day (Paraiso, 2006, Wyman, 2009).


Why is this? If you are having to get up frequently (or even just once) during the night, your quality of sleep will be lower. When we don’t sleep as well, our bodies are not able to function as well. Poor sleep is also associated with several other health issues, including chronic pain (Whibley, 2019).


Aside from quality of life, nocturia is important to manage, especially in the elderly, because it can increase the risk of falls (Hunter, 2013). Individuals who make two or more trips to the bathroom each night are more than twice as likely to have a fall that results in a fracture and other fall-related trauma (Leslie, 2021).


Treating and managing nocturia depends on what is causing it. Nocturia can be from bladder habits (drinking too much/too late), the side effect of certain medications, overactive bladder and pelvic floor dysfunction, and more. It is important to talk with your healthcare providers if you are having nocturia to determine the cause and to allow for proper treatment.


A pelvic floor physical therapist can be a helpful member of your healthcare team when treating nocturia. Pelvic floor physical therapists can help with pelvic floor muscle function, good bladder habits, and urge suppression techniques. You can ask your doctor for a referral to a pelvic floor physical therapist near you, or you can find one on myPFM.com under “Find a PT”.


Tips for Managing Nocturia

  • Stop drinking fluids 2-3 hours before bedtime (Griffiths, 1993)

  • Evenly space fluid consumption throughout the day/afternoon

  • If you have leg swelling, elevate legs 1 hour before bedtime and use light compression stockings during the day

  • Use urge suppression techniques while in bed and before standing up

  • Talk to your doctor about local estrogen cream if you are postmenopausal


To learn more about your pelvic floor muscles, check out these great resources:


For providers, check our online courses to help your clients with nocturia and incontinence. Consider joining our Ambassador Program and most of our courses are included with your membership!


Written by Emily Reul, PT, DPT


References

  1. Leslie SW, Sajjad H, Singh S. Nocturia. [Updated 2021 Sep 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing;20201 Jan.

  2. Melville JL, Katon W, Delaney K, Newton K. Urinary incontinence in US women: a population-based study. Arch Intern Med. 2005;165(5):537-542.

  3. Jackson RA et al. Urinary incontinence in elderly women: findings from the health, aging, and body composition study. Obstet Gynecol. 2004;104::301-307.

  4. Sampselle CM, Harlow SD, Skurnick J, Brubaker L, Bondarenko I. Urinary incontinence predictors in life impact in ethnically diverse perimenopausal women. Obstet Gynecol. 2002;100:1230-1238.

  5. Carter D, Beer-Gabel M. Lower urinary tract symptoms in chronically constipated women. Int Urogynecol J. 2012;23(12):1785-1789.

  6. Paraiso MFR, Abate G. Timed voiding and fluid management. In Davila GW, Ghoniem GM, Wexner SD (eds.). Pelvic Floor Dysfunction-A Multidisciplinary Approach. London: Springer Verlag:2006.

  7. Wyman JF, Burgio KL, Newman DK. Practical aspects of lifestyle modifications and behavioral interventions in the treatment of overactive bladder and urgency urinary incontinence. Int J Clin Pract.2009:63(8):1177-1191.

  8. Hunter KF, Voaklander D, Hsu ZY, Moore KN. Lower urinary tract symptoms and falls risk among older women receiving home support: a prospective cohort study. BMC Geriatr. 2013;13:46.

  9. Griffiths DJ, McCracken PN, Harrison GM, Gormley EA. Relationship of fluid intake to voluntary micturition and urinary incontinence in geriatric patients. Neurourol Urodyn. 1993;12(1):1-7.

  10. Vasudevan V, Moldwin R. Addressing quality of life in the patient with interstitial cystitis/bladder pain syndrome. Asian J Urol. 2017;4(1):50-54.

  11. Whibley et al. Sleep and pain: a systematic review of studies of meditation. Clin J Pain. 2019;35(6):544-558.

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