December 3, 2022

Troubled Peeing at Night: How to Deal with Nocturia

Written by
Edward Calleja
Bladder Conditions
Enlarged Prostate
Night Time Peeing
Wave Blue

Why am I waking up to pee at night?

More than half of those over 50 years wake up at night to empty their bladders.

Males are more affected than females.

Is waking up 1 to 2 times at night to pee normal?

Yes, this is perfectly normal. If you wake more than two times (Nocturia), you must seek medical attention. Frequent urination at night, more than twice, should be addressed.

What problems can interrupted sleep lead to?

1) Tiredness/fatigued

2) You can become moody, easily irritable or frustrated

3) Experience difficulty in remembering

4) Anxiety and being more stressed

5) Increased cravings that lead to weight gain

6) In the elderly, there is a risk of falls with serious consequences like fractures of hips and more.

The doctor's appointment is too far, can I do something to stop me from peeing all night?

1) Switch everything to decaffeinated beverages (both tea and coffee), avoid herbal teas that have a diuretic effect, and avoid juices, spices and fizzy drinks

2) The last drink should be three to four hours before sleep. If you need to take medications before bedtime, just take them with one little sip.

3) Avoid drinking during the night

4) Avoid alcohol intake late in the evening; if drinking that glass of wine or pint is essential to you, try to schedule it earlier in the day.

5) If you are diabetic, make sure that your sugar levels are well controlled. Avoid having big meals or high-sugar foods late in the evening, as your sugar levels in the blood will rise, making you need to pee more during the night.

6) Lower your salt intake, especially if your legs are swelling with fluids or have heart failure.

7) If you have swollen ankles, start lifting them up for twenty minutes late in the morning and late in the evening; this offloads the fluid building in them during the day rather than at night.

8) Check your blood pressure and get it under control

9) If you are overweight or obese, start losing weight.

What will you expect from your doctor?

Your doctor will take a detailed medical history, perform an examination, order blood and urine tests (to exclude certain medical conditions like diabetes, kidney failure, urinary tract infections, and others), prescribe medications, or, later, your current medications.

You will be asked to fill out a frequency-volume chart. On one side, you will jot down the time, the type of fluid you drink and how much (volume). On another sheet, you will write when you went to pee and how much urine (volume) you produced. You will need to keep this chart for 24 hours and repeat it thrice. This will give a good indication of what is leading to your troubles.

Imaging can be ordered by ultrasound of the kidneys and bladder to ensure you are emptying completely.

Flow studies can be ordered if your urinary flow is not so good.

What medications can you be given to treat nocturia

This will depend on the clinical and investigational findings. Discuss with your doctor.

1) Diuretics (water-producing tablets) commonly to help you get rid of excessive fluids

2) Prostate medications like alpha-blockers (Tamsulosin, Alfuzocin, / Silodosin) or prostate shrinking medications (Finasteride / Dutasteride) or phosphodiesterase medications - erectile helping medications (like Cialis).

3) Bladder-calming medications like anticholinergics (solifenacin / trospium / oxybutynin)

4)  Antidiuretic hormone (ADH) - Vasopressin. ADH causes your kidneys to pass out less water in your urine, so your urine becomes more concentrated. There are various formulations your doctor will discuss.