Causes of Frequent Urination at Night

Nocturia is the medical term for needing to get up frequently at night to urinate. It can be a normal part of aging but is sometimes a sign of a medical condition like diabetes, heart disease, or bladder problems. You might also pee more at night because of factors in your lifestyle or the medications you take.

This article will go over the common causes of urinating frequently at night and how to treat them.

Why Am I Urinating More at Night?

Nocturia can have a negative effect on your well-being and quality of life. It can lead to sleep deprivation, daytime fatigue, impaired concentration, depression, and a loss of productivity.

Before you'll be able to get relief, you'll need to work with your provider to figure out what's causing nocturia. There are different factors that can make you have to urinate more often at night. Some of them are physical reasons like medical conditions while others are related to your lifestyle.

Physical Causes

Older age is one of the main factors associated with nocturia. Most people with the condition are over the age of 60.

There are likely many reasons that people have to pee more at night as they age. One well-known cause is a condition called nocturnal polyuria (NP). In this condition, the body makes high volumes of urine during sleep.

The size of a person's bladder also affects their risk of getting nocturia. Bladder size is one reason that younger people (especially kids) get nocturia, as the amount of urine that's made at night can be more than the organ can fit.

Lifestyle and Diet

The need to urinate at night can also be diet-related. These factors can trigger nocturia either directly (e.g., by causing the body to make your urine) or indirectly (by compressing the bladder).

Some of the most common dietary factors that contribute to urinating more at night are:

• Alcohol and caffeine. Coffee, soda, and other beverages with caffeine as well as alcoholic drinks have diuretic properties that stimulate urine production.
• Dietary salt. Excessive salt (sodium) can trigger nocturia in people with obesity or poor cardiac output. Sodium increases fluid retention. The fluid might be released at night when the bladder is full.
• Hyperhydration. Drinking too much water before bedtime can easily trigger a middle-of-the-night bathroom visit.
• Low-fiber diet. Chronic constipation can happen if your diet lacks dietary fiber. At night, the buildup of stool can cause the bowel to stretch and put pressure on the bladder, giving you the urge to pee.

Pregnancy

Nocturia can occur during all stages of pregnancy but for different reasons. The times when nocturia is most common in pregnant people are:

• Early pregnancy: In early pregnancy, people often feel the need to urinate at night as rising progesterone levels promote bloating and water retention. In some cases, nocturia can be an early sign of pregnancy.
• Later pregnancy: During the second and third trimesters, it is not uncommon for people to have frequent urination because the womb has started to compress the bladder. At night, certain body positions can intensify the compression and trigger nocturia.
• After pregnancy: People will sometimes develop bladder and pelvic organ prolapse after delivery, both of which can put pressure on the urinary tract.

Medications

Nocturia can also be a side effect of certain medications. This can happen in a few ways:

• A drug can promote the release of a compound that can provoke bladder contractions (acetylcholine).
• A drug can impair the release of a hormone that helps relax smooth muscles (norepinephrine), including the ones in the bladder.
• A drug can encourage the kidneys to get rid of more salt and water from the body (a diuretic effect).

Some of the drugs that are commonly associated with nocturia include:

• Darvon (propoxyphene)
• Declomycin (demeclocycline)
• Dilantin (phenytoin)
• Diuretics, such as Lasix (furosemide)
• Lanoxin (digoxin)
• Lithium
• Penthrox (methoxyflurane)
• Excessive amounts of vitamin D (for example, from a supplement

Acute Conditions

Nocturia can be a symptom of acute conditions of the urinary tract (urologic), such as:

• Kidney stones or bladder stones
• Bladder infection (interstitial cystitis)
• Kidney infection (pyelonephritis)
• Urinary tract infection (UTI)

With acute conditions, inflammation can trigger the sudden need to urinate due to contractions in the urinary tract (urinary urgency). Nocturia is often the continuation of urinary urgency that a person has during the day.

Once the cause of the inflammation is treated, the nocturia will usually get better.

Chronic Conditions

Nocturia can also be a symptom of a chronic condition. In these cases, it can go on for a long time and be hard to treat. Some of the causes are urologic and others are not.

The most common chronic causes of nocturia include:

• Benign prostatic hyperplasia (BPH)
• Bladder cancer
• Chronic heart failure (CHF)
• Diabetes
• Hypertension
• Multiple sclerosis (MS)
• Overactive bladder (OAB)
• Parkinson's disease (PD)
• Sleep apnea

There are a few ways that chronic conditions cause the need to urinate more at night:

• Nocturia can be associated with reduced cardiac output and increased fluid retention, which often occurs in CHF.
• Hypertension and sleep apnea both put pressure on the heart and stimulate the release of a compound (atrial natriuretic peptide) that triggers the release of sodium and water.
• Other conditions cause nocturia by compressing the bladder (e.g., BPH), reducing the capacity of the bladder (e.g., bladder cancer), or overstimulating the bladder (e.g., MS, OAB, PD).
• High blood sugar levels also promote nighttime urine production.

Summary

If you have to get up at night to pee, it can be disruptive to your sleep. While nocturia can be caused by something as simple as having a drink too close to when you went to sleep or having a small bladder, it can also be caused by some medications and health conditions.

If you’re finding that your sleep is being affected by having to get up to pee frequently, talk to your provider. They can figure out what is causing nocturia and make sure you get the right treatment.

A Word From Verywell

Nocturia may be considered a "sign of age" to some people, but it should never be ignored if it is severe and interfering with your ability to get a good night's rest. In some cases, it can be a sign of something that is either serious or imminently treatable. In younger people, nocturia should never be ignored.