What causes night time urination? 32 possible conditions

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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)


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.


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.

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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.

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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.

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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.

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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...

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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.

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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.

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Night Terrors

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

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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...

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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.

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Polycystic Kidney Disease

Polycystic kidney disease (PKD) is an inherited kidney disorder. It causes fluid-filled cysts to form in the kidneys. PKD may impair kidney function and cause kidney failure. According to the University of Chicag...

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Hypercalcemia is a condition in which you have too much calcium in your blood. Calcium performs important functions, such as helping to keep your bones healthy. However, too much of it can cause problems. Hypercalcemi...

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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...

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Chronic Kidney Disease

Chronic kidney disease (CKD) causes destruction of the kidneys. It is progressive and irreversible.Your kidneys are an essential part of your body. They have a number of functions: help maintain the balance of mineral...

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Overactive Bladder

Overactive bladder (OAB) is a chronic condition of the bladder that causes sudden urges to urinate. The urge comes from bladder muscle contraction. The urge can happen suddenly and at any time, regardless of the amoun...

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The Deadly Potential of Digitalis: Digitalis Toxicity

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

Digitalis toxicity (DT) occurs when you take too much digitalis (also known as digoxin or digitoxin), a medication used to treat heart conditions. Signs of toxicity include nausea, vomiting, and an irregular heartbeat...

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Pyelonephritis is a sudden and severe kidney infection. This condition causes the kidneys to swell, can permanently damage the kidneys, and can even be life threatening. It is important to recognize the symptoms so yo...

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Gestational Diabetes

During pregnancy, some women develop high levels of blood sugar, a condition known as gestational diabetes, or gestational diabetes mellitus. GDM typically occurs around your 24th week of pregnancy. According to th...

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The glomeruli are structures in your kidneys made up of tiny blood vessels. These knots of vessels help filter blood and remove excess fluid. If your glomeruli are damaged, your kidneys will stop longer work properly...

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Bedwetting is the loss of bladder control during the night. The medical term for bedwetting is nocturnal enuresis or enuresis. Bedwetting can be an embarrassing issue, but in many cases, it is perfectly normal. Th...

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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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