Seven reasons you might be waking up to use the loo at night
Regular toilet trips in the middle of the night (known as nocturia) can leave us sleep deprived and depressed – not to mention worried about our health. But if you do suffer, you are far from alone. A leading study of 30,000 people found that 69% of men and 76% of women over the age of 40 lived with nocturia episodes that woke them at least once in the night.
‘The bladder normally can hold urine for several hours before sending signals to the brain that it’s time to pee,’ says Helen Lake, specialist nurse at theurologyfoundation.org. ‘But while we sleep, the brain is able to suppress the signals to urinate until our bladder becomes full – or our brain tells us it’s full.’
Why do we wake up to go to the bathroom?
Bladder capacity can be affected by many conditions – but here are some of the most common reasons that you might have nocturia…
You are going through the menopause. ‘After the menopause, the tissues around your vagina and urinary tract become less springy as your oestrogen level drops, and your pelvic floor muscles may get weaker,’ says Good Housekeeping’s Dr Sarah Jarvis. ‘If your bladder muscles also weaken, as they sometimes do with age, this makes the problem worse.’
You have a bladder condition. You might be suffering from overactive bladder – when your brain tells you that your bladder is full even if it’s not, or a urinary tract infection. ‘UTIs are a common cause of frequent urination,’ says Helen Lake. See your GP to rule these out.
You are suffering from sleep apnoea. A disorder which means breathing stops and restarts during sleep, sleep apnoea is common – but often goes undiagnosed. ‘Oxygen drops, which means blood pressure becomes raised and this has an effect on the kidneys, causing them to filter and excrete more urine,’ says Helen. ‘It’s good to get checked out if your partner tells you that you snore loudly and deeply.’
Getting older. ‘As you age, you tend to produce less anti-diuretic hormone (ADH) that helps make your urine more concentrated,’ says Dr Jarvis. ‘That means you’re making a bigger volume of urine, so your bladder gets fuller.’
Prostrate issues. ‘In men, the commonest cause of getting up at night to pass water is an enlarged prostate, which gets much more common with age,’ says Dr Jarvis. ‘Other symptoms include a poor stream, a feeling of needing to rush to the loo but then having to wait for the stream to start when you get there.’
Drinking habits. Glugging back water in the evenings means you will be woken in the early hours when your bladder is full, so space drinks out throughout the day. ‘At night, the body adjusts to conserve fluid and prevent excessive urination,’ says Helen. ‘Alcohol and caffeine both work against this!’ Avoid caffeinated beverages late in the day as caffeine directly impacts the bladder and reduce intake of alcohol.
A sedentary lifestyle. ‘A lack of fitness and activity could contribute to nocturia because a sedentary lifestyle can lead to poor circulation, especially in the legs,’ says Helen. ‘This inactivity can cause fluid to pool in your lower limbs; when you lie down at night, fluid redistribution means that this is processed by the kidneys.’
Other factors that can increase the need to wee include kidney disease, pregnancy and medications – some high blood pressure medications act like diuretics and make you pee more at night. Nocturia can also be a sign of chronic conditions, such as hypertension and type 2 diabetes.
What can we do to reduce nighttime loo trips?
Specialist nurse Helen Lake recommends these steps to cut down our midnight bathroom visits.
Manage fluid intake; limit or stop fluids two to three hours before bed. Drink clear fluids throughout the day to stay hydrated but space these out to avoid excessive consumption in the evening. Avoid alcohol and caffeine from late afternoon or early evening, and avoid carbonated drinks, as well as those containing artificial sweeteners – these can irritate the bladder and increase need to urinate.
Avoid salt – salt intake can cause fluid retention and then gets peed out at night in fluid redistribution
Empty your bladder before bed. Take time to do this properly and don’t rush – even a small amount left in your bladder can get you up at night.
Stay on top of existing health conditions such as diabetes and hypertension.
See your GP about excessive, loud snoring.
Report any changes in frequency of urination. This also includes repeat UTIs – there could be an underlying cause, so get checked out!
The Urology Foundation has a support service and helpline: 0808 801 1108
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