Frequent Urination at Night (Nocturia)

Imagine this: you’re deep in restorative sleep and wake up with the urge to got to the bathroom–only this isn’t your first trip to the bathroom. You may find yourself waking to go to the bathroom at night several times, making getting quality sleep impossible.

The truth is, frequent nighttime urination is a very common occurrence, and too little discussed. Excessive nighttime urination is sometimes a taboo topic, with far too many embarrassed to discuss it. Because of this, most of us don’t even know what’s considered excessive and don’t get the help we need.

This week, I’ll be discussing just how many trips to the bathroom a night is normal, the reason why you’re peeing more at night, and what you can to stop it.

What’s A Normal Amount To Get Up And Pee At Night?

First, let’s define what’s excessive for night time trips to the bathroom.

It’s normal to use the bathroom once a night for many people, while a majority of the population wakes up to pee every now and then. How often you urinate at night, as you imagine, can be influenced by a number of factors, especially fluid intake before bed. For example, while I love a cup of relaxing herbal tea in the evening, I enjoy it a few hours before hitting the hay.

Excessive urination at night, also nocturia, can either occur alone or be accompanied by extra trips to the bathroom during the day. While there is no hard and fast definition, most experts define nocturia as regularly waking up more than once every night to use the bathroom.

However, most don’t need to seek treatment until that number jumps to over twice a night or is causing disruptions.

How Common is Nocturia?

If you are using the bathroom a lot at night, you’re far from alone. While it’s hard to pinpoint exact prevalence, studies tell us that it’s almost certain you know someone suffering from nocturia.

A meta analysis of 43 studies, published in the British Journal of Urology found that excessive nighttime urination occurs in as many as 28 to 62 percent of women and men in their 70s and 80s, but also up to 18 percent of men and women in their 20’s and 30’s.

And despite common belief that going to the bathroom many times at night is a female problem, many studies have found no significant difference in occurrence based on gender.

Why is Going to the Bathroom So Much at Night a Problem?

If you’re waking up to pee several times a night, you’re likely not getting the sleep your body and mind needs to be at their best. I’ve often discussed the link between sleep deprivation and mental health, as well as physical health–but it’s especially true here.

Frequent nighttime awakenings, regardless of the cause, cause a disruption in your sleep cycles. Our body is supposed to transition through four stages of sleep per night, but what happens with frequent awakenings is you may only barely, or never quite reach slow-wave non-REM and REM sleep.

Slow-wave, or deep sleep, is responsible for producing growth hormones, tissue repair, and synaptic plasticity (in other words, our brain’s ability to process and store information). REM, the sleep stage where we experience intense dreams, regulates mood, learning, and memory.

REM Sleep Deficits are Linked to Lower Quality of Life, Premature Death

  • Higher rates of mortality; cognitive issues, such as memory loss, and even high blood pressure
  • A recent study published in JAMA Neurology found that a REM deficit may put individuals at a 13 percent higher risk of heart attacks, which supports previous research

Slow Wave Sleep Deprivation Puts You At Risk For Mood Disorders

  • Researchers discovered that those with less non-REM slow wave sleep tend to have less quality ‘white matter’ in the front and temporal lobes
  • Quality white matter is linked to rates of depression and mood disorders.

In short, the more often you’re waking up to go to the bathroom, the more likely you’re not getting to, or interrupting stage three and four sleep, both of which are critical for restoring both your mind and body.

Why Are You Going to the Bathroom So Much at Night?

I can assure you that there’s no shortage of reasons behind nighttime awakenings, from everyday stress and blue light exposure in the evening, to sweating through cotton, instead of temperature-controlled, breathable material.

But frequent nighttime bathroom trips actually have several possible causes.

You’re Drinking Too Many Fluids Before Bed

This is the most obvious cause–and arguably the easiest to fix! Common sense tells us that chugging down a lot of water or tea before bed isn’t the best idea.

The Solution

Everyone is different, but capping most fluids one to two hours before bed is the best way to stop those frequent bathroom trips. If you find yourself always thirsty at night, you should make sure you’re staying hydrated throughout the day. If you are, excessive thirst could also be linked to medications like anti depressants; diabetes; anemia and other health issues, so it’s best to see a doctor.

You’re Suffering From a Sleep Disorder

I’ve already discussed how using the bathroom at night can affect the quality of your sleep–but the inverse is also true. Underlying sleep disorders, such as sleep apnea, insomnia, and restless leg syndrome have been linked to increased nighttime urination.

When we’re sleeping, a healthy body naturally suppresses urine by releasing an antidiuretic hormone. But if we aren’t truly sleeping, our brains aren’t getting the signal that it’s not time to pee.

The Solution

If you’re experiencing any symptoms of a sleep disorder, such as excessive snoring, tingling sensations in your legs or waking up short of breath, it’s time to consult your doctor. Not only do sleep disorders increase the amount of times you go to the bathroom, but can carry long term health consequences. Chronic snorers may find relief by using a mouthguard like Zyppah, which opens up your airway passages while you’re sleeping.

You Have Another Unresolved Condition

This isn’t to scare you: like I said, going to the bathroom more than once a night occasionally probably isn’t a cause for concern. But if you’ve ruled out fluid intake and a sleep disorder, your nocturia could actually be a symptom of something else, including:

  • Urinary Tract Infections
  • Kidney Disease
  • Overactive Bladder
  • Diabetes Mellitus or Insipidus
  • Congestive Heart Disease

As you can see, these range in severity, from simple fix to long term management.

The Solution

If you find yourself taking frequent trips to pee not only at night, but also during the day, it’s a chance you could be suffering both from nocturia and excessive daytime urination. A simple trip to the doctor is a good idea to discuss symptoms and potentially run blood work and/ or a urinalysis in order to rule out conditions.

If your doctor determines you’re suffering from an overactive bladder he or she may suggest exercises and medication. No matter what, it’s important to see a doctor instead of suffering through restless nights.

You’re Getting Older

This is the most frustrating reason you wake up at night to use the bathroom: you’re aging. I mentioned the antidiuretic hormone before, and unfortunately, the release of that hormone naturally declines with age.

However, if you notice a sudden change, or you’re peeing more than twice a night, every night, don’t just chalk it up to age. It’s important not to make assumptions.

The Solution

If you and your doctor rule out other health conditions, the good news is that, just because you’re older doesn’t mean you have to suffer through excessive bathroom trips and the health risks of not getting enough sleep.

Lifestyle changes include limiting your intake of bladder irritants, including caffeine, chocolate, sugar free food, and spicy food, especially at night. 

Excessive trips to the bathroom may seem common, but you don’t have to resign yourself to restless nights. With a little knowledge and widely available treatment, you can get the restorative sleep your body needs.