Excessive Urination at Night (Nocturia)

Nocturia can happen as a result of certain lifestyle choices or medical conditions.

Medical conditions

A variety of medical conditions can cause nocturia. Common causes of nocturia are a urinary tract infection (UTI) or bladder infection. These infections cause frequent burning sensations and urgent urination throughout the day and night. Treatment requires antibiotics.

Other medical conditions that can cause nocturia include:

• infection or enlargement of the prostate
• bladder prolapse
• overactive bladder (OAB)
• tumors of the bladder, prostate, or pelvic area
• diabetes
• anxiety
• kidney infection
• edema or swelling of the lower legs
• obstructive sleep apnea
• neurological disorders, such as multiple sclerosis (MS), Parkinson’s disease, or spinal cord compression

Nocturia is also common in people with organ failure, such as heart or liver failure.

Pregnancy

Nocturia is a fairly common symptom of pregnancy. It can develop at the beginning of pregnancy, but it also happens later, when the growing womb presses against the bladder.

Medications

Some medications may cause nocturia as a side effect. This is particularly true of diuretics (water pills), which are prescribed to treat high blood pressure, congestive heart failure, or any type of fluid retention.

You should seek emergency medical care from a doctor if you lose the ability to urinate or if you can no longer control your urination.

Lifestyle choices

Urinating too much over 24 hours is called polyuria, which can be caused by excessive fluid consumption, typically more than 40 milliliters per kilogram (mL/kg) per day. As part of that, you may also have nocturia or excessive urination at night.

Alcohol and caffeinated beverages are also diuretics, meaning drinking them causes your body to produce even more urine. Therefore, consuming alcohol or caffeinated beverages in excess can lead to nighttime waking and needing to urinate.

Other people who have nocturia may have developed a habit of waking up during the night to urinate.

Learn more about alcohol use disorder.

Diagnosing the cause of nocturia can be difficult. Your doctor will need to ask a variety of questions. The doctor will also usually ask you to record what you drink and how much, along with how often you need to urinate in a 24-hour period.

Questions your doctor may ask you also include:

• When did the nocturia start?
• How many times per night do you have to urinate?
• Are you producing less urine than you did before?
• Do you have accidents, or have you wet the bed?
• Does anything make the problem worse?
• Do you have any other symptoms?
• What medications are you taking?
• Do you have a family history of bladder problems or diabetes?

They may also have you undergo testing such as:

• blood sugar test to check for diabetes
• other blood tests for blood counts and blood chemistry
• urinalysis
• urine culture
• fluid deprivation test
• imaging tests, such as ultrasounds or CT scans
• urological tests, like cystoscopy
• tests to check if your bladder is fully emptying when you urinate

If your nocturia is caused by a medication, taking the medication earlier in the day may help.

Treatment for nocturia can sometimes include medications such as:

• anticholinergic drugs, which help lessen the symptoms of an overactive bladder. However, recent research has associated these drugs with an increased risk of dementia in older people.
• Beta-3 adrenoceptor agonists, like mirabegron (Myrbetriq), can help relax the bladder muscles and reduce symptoms of overactive bladder
• desmopressin (Nocdurna), which causes your kidneys to produce less urine at night

However, nocturia can be a symptom of a more serious condition, such as diabetes or a UTI, that could worsen or spread if left untreated. Nocturia due to an underlying condition will usually stop when the condition is successfully treated.

Learn more about an overactive bladder at night.

There are steps you can take to lessen the impact of nocturia on your life.

Reducing the amount you drink 4 to 6 hours before going to bed can help prevent you from needing to urinate at night.

Avoiding drinks that contain alcohol and caffeine may also help, as can urinating before you go to bed. Some food items can be bladder irritants, such as chocolate, spicy foods, acidic foods, and artificial sweeteners. Kegel exercises and pelvic floor physical therapy can help strengthen your pelvic muscles and improve bladder control.

Pay close attention to what makes your symptoms worse so you can try to modify your habits accordingly. Some people find it helpful to keep a diary of what they drink and when.

Learn more about drinking water before bed.

Nocturia affects about 50 million Americans, including 1 in 3 adults over age 30 and about 24% of people over 65.

Because nocturia can affect your sleep cycle, it can lead to sleep deprivation, fatigue, drowsiness, and mood changes.

Talk with your doctor to discuss lifestyle changes and treatment options that can help you.