Frequent need to urinate during night time when you sleep is known as nocturia.
Most people sleep for 6 to 8 hours without having to urinate. Waking up too often in a night to pee may cause insomnia in serious case. Not having enough sleep definitely leaves you fatigued the next morning even before you start the new day. I personally do not like that experience – awake to feel the discomfort with pressure building in lower abdomen and have to to make a trip to bathroom. The need to urinate once in a blue moon is not cause for concern. However, if you need to wake up at least once every night, you may want to read on to find out why and the ways to prevent it from happening so that you have a good night sleep.
Before we delve further, let’s understand the urge of urinate. The pressure starts to build up against bladder when it is half full. The desire to urinate begin when it is about three quarter full. As the bladder gets fuller, it send nerve impulses to the brain. The brain will try to hold back the urge until it is convenient or until the bladder is totally full. When we wake up at night to pee, we thought that we have a full bladder, in some cases, the brain is right, but in some cases, not really.
Now, let’s understand what causes nocturia. Night-time urination depends on several factors:
- It can be as simple as excessive fluid intake. The more you drink closer to the time you go to bed, the more likely you will have to get up later to pee. I used to drink a glass of milk before I sleep and I realized that I had to wake up few hours later to go to toilet.
- Older people, including women, often wake up to urinate at least once. If you wonder why nocturia is related to age, here is the explanation:
- Young child produces urine at a steady rate around the clock. After the age of 7 years old, the body changes to minimize disruption to sleeping. Healthy young adults produce urine 3 times during the day than night. Brain puts out extra amounts of anti-diuretic hormone (ADH) at night. ADH causes kidneys to reabsorb water so they produce small amount of concentrated urine. That is why your first urine in the morning is always dark yellow.
- As people get older, you will experience changes in urine production by kidneys, changes in the capacity of kidney and presence of disease, especially in the urinary tract. The circadian rhythms that control salt and water excretion start to change. As a result of changes in ADH, older people revert to the young children pattern of steady urine production around the clock. They may urinate less during the day, but they also pay for that advantage by voiding more at night.
- For older men above 50s, night-time urination may be caused by enlarged prostate [benign prostatic hyperplasia (BPH)]. The prostate presses on the urethra and prevents the bladder from emptying completely and therefore older men have the urge to go to toilet more often.
- As for women, the common cause of nocturia is urinary tract infections. Inflammation reduces the bladders’ capacity to hold urine. Even small amounts of urine in bladder will cause discomfort. It is normal for pregnant women to urinate during night time. The amount of blood in the body increases dramatically for pregnant woman, which leads to a lot of extra fluid getting processed through the kidneys and ending up in bladder. Kidneys work harder throughout pregnancy to flush waste products out of your body. In addition to that, pregnant women may also feel pressure on the bladder from the growing uterus.
- Even without the above two factors, fluids tend to accumulate in the legs of both men and women as we get older. Water is in the tissue and it may get worse with unbalanced high sodium diet with processed food. Gravity tends to keep the fluid in the lower body during the day. When you lie down to sleep in horizontal position, the fluids flow out from the tissue and dumped in the bladder, making one has to frequent the bathroom at night. For pregnant woman, after baby is born, the need to urinate decreases. No more getting up five times a night to get to bathroom.
Here are few ways to prevent nocturia:
- Avoid taking diuretic medications in the evening. Ask your doctor if a milder preparation is possible, but do not make changes on your own.
- Also, try not to take alcohol (wine or beer) and caffeine which are diuretics. Cocktail before dinner or espresso with dessert may also trigger nocturia. These drinks are natural stimulants that cause the body to produce more urine than usual.
- Do not drink too much 3 hours before you sleep. Just drink enough to quench your thirst to maintain good hydration. I know of a friend who keeps track of how much he drinks, what he drinks and what time to help him find out the best way to avoid night-time urination problem.
- For men with BPH, the best way is to consult a doctor. Men over the age of 50 should have regular check. Doctors may prescribe medication or recommend surgery to treat it.
- If you have to go to urinate at night, make sure your path to bathroom is not an obstacle course. Use a dim light to navigate. If the light is too bright, you may find it difficult to get back to sleep.
Hopefully, with a little planning, you can minimize the number of times you get up at night and maximize the time you spend on sleeping. Good night sleep is important to prepare our bodies and minds for the next day.
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