What causes night time urination? 32 possible conditions

Nighttime Urination

A good night’s sleep helps you feel rested and refreshed in the morning. However, when you have the frequent urge to use the restroom at night, a good night’s sleep can be hard to achieve. If you find yourself waking up to urinate more than twice each night, you may have a condition called nocturia. This is most common in people over the age of 60. (NAFC)

Nighttime urination is not to be confused with a related condition called enuresis (bed-wetting), where you cannot control your need to urinate at night. While nighttime urination typically results in sleep loss, it can be a symptom of an underlying condition.

What Are the Symptoms of Nighttime Urination?

Most people can get a full six to eight hours’ rest without the need to urinate. However, nighttime urination causes you to get up several times at night to use the restroom. In its most severe forms, this condition causes you to get up between five to six times at night.

Symptoms associated with nighttime urination include:

  • overproduction of urine (urinating more fluid than you do normally)
  • urinating too frequently
  • feeling the urgent need to urinate, yet little urine is produced

Nighttime urination can be problematic because you cannot feel rested when you are frequently using the restroom. Also, nighttime urination can increase the likelihood for falls and injury in the elderly.

What Causes Nighttime Urination?

Aging is one of the biggest contributing factors to nighttime urination. As we age, the body produces less of the anti-diuretic hormone that helps us retain fluid resulting in increased urine production—especially at night. Muscles in the bladder can also become weak over time, making it more difficult to hold urine in the bladder.

Aging is not the only contributing factor to nighttime urination. Other common causes include:

  • chronic urinary tract infections
  • drinking excess fluids (especially caffeinated and alcoholic ones) before bed
  • bacterial infection in the bladder
  • medications that encourage urination (diuretics)

Women may experience frequent urination as a result of pregnancy and childbirth, which can weaken the bladder and pelvic floor muscles.

In some cases, nighttime urination is a symptom of an underlying medical condition. Disease and conditions associated with frequent urination include:

  • chronic renal (kidney) failure
  • congestive heart failure
  • diabetes
  • benign prostatic hypertrophy (enlarged prostate)
  • sleep disorders, such as obstructive sleep apnea, insomnia or restless leg syndrome

When to See A Doctor

Your doctor will diagnose your nighttime urination by evaluating your symptoms and performing a physical examination. They may ask certain questions to determine potential causes for the condition. Questions may include how many times you get up to urinate at night, how long you have been experiencing nighttime urination, and questions about your regular activities before bed. For example, if you are drinking lots of fluids or taking diuretics before bedtime, these can lead to nighttime urination. Certain tests may be ordered to help determine the cause of frequent urination, such as:

  • urinalysis (looks at the chemical compounds present in urine)
  • urine concentration (determines if the kidneys are properly excreting water and waste products)
  • urine culture
  • post-void residual urine measurements—this test involves taking an ultrasound of pelvic area to see how much urine remains in the bladder after urination

If your doctor suspects an underlying medical condition is causing nighttime urination, they may order further tests to make a diagnosis, such as:

  • blood sugar
  • blood urea nitrogen
  • blood osmolality (measures the concentration of chemicals in the fluid part of the blood)
  • creatinine clearance
  • serum electrolytes

These tests can determine how well the kidneys are functioning and measure the concentration of certain chemical compounds in your blood. These tests can help identify if nighttime urination is a side effect of kidney disease, dehydration, or diabetes-related health complications.

What Treatments Are Used for Nighttime Urination?

Treatment for nighttime urination often depends upon its cause. For example, if you are drinking too much before bed, your physician may recommend restricting your fluids after a certain time.

Certain behaviors can also reduce the frequency of nighttime urination. In addition to reducing your fluid intake at night, you also may need to take afternoon naps to feel more rested. Keeping your legs elevated during the day and/or wearing compression stockings to encourage fluid circulation also can help to minimize nighttime urination. (NAFC)

Medication

Medications may also help reduce nighttime urination, but are not always a first line of treatment. Medications can alleviate symptoms, but cannot cure nighttime urination—once you stop taking them, your symptoms will return.

A class of drugs called anti-cholinergics are prescribed to relax muscle spasms in the bladder and reduce the need to urinate more frequently. If you also experience bed-wetting, some anti-cholinergics can reduce this occurrence. However, these medications can cause side effects such as dry mouth, dizziness, and blurred vision.

Some doctors recommend taking a diuretic that encourages urination earlier in the day to reduce the amount of urine in your bladder at night. For some people, taking a synthetic form of anti-diuretic hormone may help to reduce nighttime urination.

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See a list of possible causes in order from the most common to the least.

1

Diabetes Overview

Diabetes is a group of chronic metabolic diseases caused by defects in insulin production or function. Advanced diabetes may cause stomach pain, nausea, dizziness, and cramps.

Read more »

2

Urinary Tract Infection

UTIs are usually caused by bacteria and can occur in any part of the urinary tract. Symptoms of upper UTIs include pain in the upper back, chills, fever, and nausea.

Read more »

3

Benign Enlargement of Prostate

Benign enlargement of the prostate, or benign prostatic hyperplasia, is a common condition where the prostate gland swells beyond normal size. It is a normal condition of male aging but can interfere with urination.

Read more »

4

Bladder Infection

A bladder infection is a bacterial infection. It also may be called a urinary tract infection (UTI), which refers to infection anywhere in the urinary tract, including the bladder, kidneys, ureters, or urethra.

Read more »

5

Urge Incontinence

Urge incontinence is a type of urinary incontinence. It occurs when you have a sudden urge to urinate. In urge incontinence, the bladder contracts when it should not, and may cause urine to leak past the sphincte...

Read more »

6

Congestive Heart Failure (CHF)

Congestive heart failure is a chronic condition that affects the four chambers of the heart. Early symptoms include fatigue and weight gain. Irregular heart beat and wheezing indicate a worsening.

Read more »

7

Menopause

Menopause is a natural biological process in women that marks the permanent end of menstruation and fertility. Hot flashes, vaginal dryness or pain, and frequent urination are signs.

Read more »

8

Night Terrors

Night terrors are a form of sleep disorder in which a person partially awakens from sleep in a state of terror.

Read more »

9

Diabetes Insipidus

Diabetes insipidus (DI) is a rare condition that occurs when your kidneys are not able to conserve water. It results in extreme thirst for water and frequent urination. There are several types of DI, and they can ofte...

Read more »

10

Heart Failure

Right-side heart failure occurs when the right ventricle can't properly pump blood to your lungs to collect oxygen. Excessive fatigue, shortness of breath and abdominal bloating are signs.

Read more »

11

Polycystic Kidney Disease

Polycystic kidney disease (PKD) is an inherited kidney disorder that causes fluid-filled cysts to form in the kidneys. Abdominal and back pain, easy bruising, and fatigue are possible signs.

Read more »

12

Hypercalcemia

Hypercalcemia is a condition in which you have too much calcium in your blood. Serious cases could cause symptoms like abdominal pain, nausea, constipation, and weakness.

Read more »

13

Membranous Glomerulonephritis

The human kidney is made up of a number of different structures. These structures aid in the removal of wastes from the blood and the formation of urine. Changes in the structures of the kidney can cause swelling an...

Read more »

14

Chronic Kidney Disease

Chronic kidney disease is a progressive, irreversible destruction of the kidneys. The most common causes are high blood pressure and diabetes. Symptoms don't show until about 90 percent of the kidney has been destroyed.

Read more »

15

Overactive Bladder

Overactive bladder (OAB) is a chronic condition of the bladder that causes sudden urges to urinate. It can happen suddenly, at any time, regardless of the amount of urine in the bladder.

Read more »

16

The Deadly Potential of Digitalis: Digitalis Toxicity

This condition is considered a medical emergency. Urgent care may be required.

Digitalis toxicity happens when you take too much digitalis, a medication for heart conditions. This results in nausea, vomiting, chills and sweating.

Read more »

17

Pyelonephritis

Pyelonephritis is an inflammation of the kidney and upper urinary tract. Symptoms include flushed skin, back pain, fever, and nausea.

Read more »

18

Gestational Diabetes

During pregnancy, some women develop high levels of blood sugar, a condition known as gestational diabetes, around the 24th week of pregnancy. In most cases, the condition develops in women who never had diabetes.

Read more »

19

Glomerulonephritis

Glomerulonephritis occurs when blood filtering vessels in the kidneys are damaged. This may contribute to kidney failure, which causes fatigue, insomnia, itchy skin, and other symptoms.

Read more »

20

Bedwetting

Bedwetting is the loss of bladder control during the night caused by psychological and physical conditions such as constipation, stress, and prostate gland enlargement.

Read more »

This feature is for informational purposes only and should not be used to diagnose.
Please consult a healthcare professional if you have health concerns.
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