Nocturia and bladder weakness during the night

The urge to urinate during the night is something most of us can relate to, especially as we age, during pregnancy or if we enjoy drinking right before going to bed. For some people, the urgency to void can also lead to nighttime leakage.

Nocturia is when you find yourself waking up multiple times during the night to use the bathroom.1 It’s more common than you might think, especially as we get older. But that doesn’t make it any less disruptive. Constant trips to the bathroom can leave you feeling tired and frustrated the next day.

Now, you might be wondering how this is different from general urinary incontinence. While incontinence is about unexpected leaks at any time, whether you’re laughing, sneezing, or simply going about your day, nocturia is all about that repeated urge to go during the night.1 Sometimes, though, nocturia can lead to adult bedwetting, where the bladder empties while you’re asleep without waking you up in time.

There are many reasons for frequent bathroom visits at night and there are things you can do to reduce the urge to urinate. For example, you can change your daily routine to improve your sleep or make some changes in what you drink and at what time. Learn more about this and get some tips on what you can do to avoid nighttime wake-ups.

As we grow older, our bodies change, and we naturally need to go to the bathroom more often than before. Having to go once or twice during the night is, in other words, normal. There are several different causes for this. A younger person's bladder can hold up to half a liter of urine, but as we age, this is normally reduced by about half as the bladder muscle becomes less elastic. Another reason for a more pressing urge to urinate as we age, is that our ability to concentrate urine decreases. The total amount of urine produced day and night doesn’t necessarily change, but often more is produced at night.

There are also lifestyle-related behaviors that can affect how much you urinate, like drinking large amounts of liquid. Caffeine and alcohol after dinner can also lead to a need for urinary urgency at night.

There are both medical conditions and medicines that can cause and increase nighttime urination.¹ If you suspect that there is an underlying health condition, or that your medicine is causing nighttime urination, contact your physician. Sometimes, a simple change in when you take your medicine can help reduce the side effects.

Here are a few of the common medical conditions that cause nocturia:

• Overactive bladder (OAB): If you experience sudden, frequent urges to go, even when your bladder isn’t full, you might have overactive bladder. This can make nighttime wake-ups more common.²
• Diabetes: Diseases like diabetes have been linked to nocturia.¹
• Urinary tract infections (UTIs): An infection can irritate the bladder and cause frequent urination both day and night. If you’ve ever had that constant “gotta go” feeling with a UTI, you’ll understand why it can interrupt your sleep. Learn more about urinary tract infection in women and how it can affect bladder habits.²
• Sleep disorders (like sleep apnea): Poor sleep and nocturia often go hand in hand. With sleep apnea, for example, interrupted breathing can trigger signals to the body that lead to nighttime urination.²
• Menopause: As estrogen levels drop, bladder control can become more of a challenge. Many women find that incontinence during menopause and nocturia start to appear around this stage of life.¹

If any of this sounds familiar, it’s worth chatting with your doctor. Understanding the “why” behind nocturia is key to finding the right solution for better nights.

Bladder leaks at night (called nocturnal incontinence) are different from nocturia, where you simply wake up often to use the bathroom. With nocturnal incontinence, your bladder empties while you sleep, sometimes without you realizing it.

There are a few common causes: weak pelvic floor muscles, issues with the bladder’s sphincter muscle, or nerve-related conditions that interrupt communication between your brain and bladder. In some cases, excessive urine production (known as polyuria) can also contribute to nighttime leaks.

Lifestyle factors matter too. Caffeine, alcohol, and diuretics can irritate the bladder or increase urine production, and drinking too much fluid late at night can add to the problem. Small changes can help with managing nocturnal incontinence.

If you’re experiencing nighttime leaks, understanding what’s behind them is the first step toward reducing bladder leaks, finding relief and getting a better night’s sleep.

Reducing the amount of times you need to go to the bathroom can improve your general well-being, and help you understand how to stop peeing at night.

Here are a few bladder control tips that may help:

• Avoid coffee, tea, and alcohol before bedtime. These can irritate the bladder or increase urine production.¹
• Make sure to go to the bathroom before going to bed.
• Try to limit your fluid intake two hours before bedtime.
• If you have swollen legs, the use of compression stockings and afternoon leg elevation can reduce nighttime urination. It helps the body handle fluid stuck in the legs.
• Waking up in the middle of the night can trigger the need to go. If you suffer from insomnia or disturbances at night for different reasons, nocturia can be reduced if these problems are overcome.
• Use overnight protection. If you experience leaks during the night, try using a women’s overnight incontinence pads designed to keep you dry and comfortable while you sleep. Add a bed pad for an extra layer of protection and peace of mind.
• Try bladder training and pelvic floor exercises. Bladder training can help you gradually extend the time between bathroom visits. Alongside that, practicing pelvic floor exercises for women (like Kegels) can strengthen the muscles that support your bladder and reduce leaks over time.¹

More urine is typically produced while we’re awake, so individuals with conditions that disrupt sleep may find themselves needing to use the bathroom more often at night. There are many chronic medical conditions, for instance restless legs, sleep apnea, as well as Alzheimer’s and Parkinson’s disease that can cause insomnia. Many chronic illnesses also cause discomfort or pain, so treating any underlying medical disorders and delivering proper pain management will benefit sleep and help reduce urine production at night.

Steps to Improve Your Sleep to Reduce Nighttime Urination

Poor sleep patterns and constant awakenings can make you more aware of bladder urges, turning a simple need to urinate into a full-blown disruption of your night. When your sleep isn’t restful, you’re more likely to wake up at the slightest sensation, including the urge to go. Here are some practical tips for a good bedtime routine:

• Create a consistent bedtime routine: Going to bed and waking up at the same time each day can help regulate your sleep cycle and improve the quality of your sleep.
• Manage stress and anxiety: Stress and anxiety can keep you up at night, making you more likely to wake up and feel the urge to urinate. Try relaxation techniques like deep breathing or meditation before bed.
• Adjust sleeping positions: Experiment with different sleeping positions to reduce pressure on your bladder. Sleeping on your side with a pillow between your legs can help minimize bladder pressure, allowing you to sleep more soundly.

By improving your sleep habits, you can help your body stay more relaxed at night and reduce those unwanted nighttime trips to the bathroom.

Why Can’t I Hold My Pee at Night?

If you’re tired of waking up to use the bathroom, there are a few simple steps you can take to help minimize nighttime trips:

• Bladder training and voiding: This is all about gradually teaching your bladder to hold more urine. Try spacing out bathroom visits during the day, so your bladder gets used to holding it longer, which can help you sleep through the night.³
• Adjust your fluid intake: Cutting back on fluids at least two hours before bedtime, especially things like caffeine, alcohol, and large amounts of water, can help reduce the urge to go when you're trying to sleep.³
• Tweak your diet: Certain foods and drinks can irritate your bladder. Avoid spicy foods, citrus, or too much caffeine in the evening to keep things calm before bed.²

If you’ve tried these tips and still find yourself waking up at night, it might be a good idea to check in with a doctor. Sometimes, there’s an underlying issue that needs a little extra attention.