Overactive bladder (OAB) refers to a group of urinary symptoms, the most prominent of which is a sudden, urgent need to urinate.

Research has estimated that its prevalence in the United States is between 16.5 and 35.6 percent.

OAB happens when your bladder muscles involuntarily contract when your bladder isn’t full. While the exact cause is unknown, this may happen due to improper signaling between your brain and bladder. It may also be caused by bladder muscles that are too active.

Living with OAB can greatly impact your quality of life since it may be hard to do daily activities without frequent trips to the bathroom. Because OAB can come on suddenly, you may also feel anxious if you’re not close to a bathroom.

Sleep can also be affected. It’s estimated that 85.6 percent of people with OAB have nocturia, which is when you wake up multiple times at night to urinate. Poor sleep can have negative consequences on both your physical and mental health.

If you have OAB, you may be wondering if certain sleep positions may help reduce your need to urinate at night. Keep reading as we explore this topic and other ways to promote a good night’s sleep with OAB.

There’s not currently much specific research into what’s the best sleeping position for OAB. A general rule of thumb is to select one that’s both comfortable to you, leads to restful sleep, and doesn’t contribute to pain upon waking.

There are a few points about OAB, sleep, and body position that are important to know. Let’s examine these now.

Side sleep for sleep apnea

Sleep apnea has been linked to OAB symptoms in both men and women. This may be due to the effects of apnea events, which can cause low tissue oxygen in the body, including in the urinary system. However, more research is still needed.

If you have sleep apnea and OAB, sleeping on your side may help. It’s estimated that moving from sleeping on the back to sleeping on the side can eliminate sleep apnea symptoms in about 20 percent of people.

Managing sleep apnea can also help with your OAB symptoms. A 2021 study found that participants who used continuous positive airway pressure (CPAP) or surgery for sleep apnea had a significant reduction in OAB symptoms.

Consider daytime body positioning

It may seem counterintuitive, but making some adjustments to your body positioning during the day may lend you a hand at night.

Lying down can actually contribute to increased urination. Research from 2009 on people with nocturia found that fluid accumulation in the legs during the day is associated with increased urine volume at night.

This is because the fluid that’s built up in your legs while you’re upright is better distributed into your bloodstream when you lie down. Since your kidneys filter excess fluids from the bloodstream, this can contribute to urine production.

Elevating your legs throughout the day and wearing compression socks may help to redistribute fluids back into your bloodstream during this time instead of letting them accumulate. This may help prevent multiple bathroom trips in the middle of the night.

This may be particularly helpful if you have OAB and another health condition that causes fluid buildup in the legs and ankles. A few examples include:

Similar to sleeping positions, there’s not really any research into what type of mattress is optimal for OAB. When looking for a mattress, it’s important to find one that maximizes comfort while providing support for your body.

Research from 2015 suggests that a medium-firm mattress is best for sleep quality, comfort, and spinal support. However, you’ll need to take your specific needs into account as well, such as:

  • the position that you sleep in
  • your body type
  • whether you share your bed with a partner
  • if you have preexisting neck or back pain
  • your price range

Some people with OAB may also experience something called urge incontinence. This is when a strong urge to urinate comes on and urine leaks out before you can get to the bathroom.

If you find that you experience urge incontinence due to OAB, you may consider using protective products for your bed and mattress. Some examples include:

There are several things that you can do to help prevent having to pee at night due to OAB. These include:

  • Reduce fluids in the evening. While it’s important to stay hydrated during the day, limit your intake of fluids, especially ones that contain alcohol and caffeine, in the 2 to 4 hours before you go to bed.
  • Double void before bed. Some people with OAB have trouble fully emptying their bladder. Double voiding, or emptying your bladder twice, can help. Before going to bed, empty your bladder once, wait several minutes, and then try again.
  • Avoid triggers. Some foods and drinks can irritate the bladder and may increase your need to urinate. Some that you may want to avoid, especially later in the day, are:
    • alcohol
    • coffee
    • tea
    • soda and other carbonated drinks
    • beverages made with artificial sweeteners
    • chocolate
    • acidic foods, like citrus fruits and tomatoes
    • spicy foods

Since coping with nocturia due to OAB can be stressful, it’s also a good idea to make sure your bedroom is an environment that promotes sleep. A few things to consider include:

  • setting up a sleep schedule and a relaxing bedtime routine that you can stick to
  • making sure that your bedroom is dark, quiet, and a comfortable temperature
  • limiting or avoiding the use of TVs, cell phones, and computers or tablets in your bedroom
  • making sure the path to the bathroom is clear, in case you need to get up to urinate

If you have OAB, there are various treatments that can help. These include both medical treatments and things you can do at home.

Sticking to your OAB treatment plan can help prevent frequent trips to the bathroom, both during the day and at night. Let’s take a look at some of the treatment options for OAB now.

At-home remedies

Some of the steps that you can take at home to manage OAB include:

  • Reduce fluid intake. Reducing fluid intake to 6 to 8 glasses of water per day can reduce the amount of urine you produce. However, it’s important to stay hydrated, so follow your doctor’s instructions on fluid intake carefully. Also consider not drinking too much water close to bedtime.
  • Avoid triggers. As we mentioned above, certain foods and drinks can irritate your bladder and make your symptoms worse. Consider limiting or avoiding these triggers.
  • Avoid smoking. Smoking cigarettes increases your risk for many health conditions and can irritate your bladder. If you currently smoke, consider speaking with a doctor about developing a quit plan that you can stick to. This is often difficult, but a doctor can help create a plan that works for you.
  • Bladder training. Bladder training involves urinating on a regular schedule and can help increase the capacity of your bladder. You’ll usually start with a short interval, such as 30 minutes, and gradually increase the time between trips to the bathroom, sometimes up to several hours.
  • Pelvic floor exercises. Pelvic floor exercises, like Kegels, can strengthen your pelvic floor muscles. This can help you better hold in urine and suppress urinary urgency. Ask your doctor about physical therapists that specialize in pelvic floor therapy.

Tracking when you need to urinate with a bladder diary can also give you more information on how factors like fluid intake and foods impact your symptoms. It can also help you track the progress of bladder training.

Medical treatments

There are prescription medications that are available to help with OAB. A doctor may recommend them when at-home care isn’t helping to manage your symptoms.

Medications for OAB may be given as a pill, gel, or transdermal patch. These include:

  • antimuscarinics, like oxybutynin (Ditropan) and tolterodine (Detrol)
  • beta-3 agonists, like mirabegron (Myrbetriq)

These medications work by blocking certain types of nerve impulses to the bladder muscles. This can prevent these muscles from contracting when they shouldn’t.

If at-home care and the use of medications don’t lead to improvement, other potential medical treatments for OAB include:

  • Botox injections into the bladder muscle
  • stimulation of the nerve pathways that serve the bladder
  • surgery to increase bladder capacity or reroute the flow of urine

Sleep is important for both your physical and mental health. Poor sleep can impact your alertness and memory, increase your stress levels, and raise your risk of health conditions like heart disease, diabetes, and obesity.

Make an appointment with a doctor if you find that your OAB symptoms cause you to frequently get up to use the bathroom at night. They can recommend methods to help reduce your urinary frequency.

It’s also a good idea to talk with a doctor if the strategies you’re currently using to prevent nocturia become less effective or stop working. It’s possible that your OAB treatment plan may need to be adjusted.

Many people with OAB experience nocturia, which is frequent urination at night. There’s no single sleeping position that’s optimal for OAB. Generally speaking, it’s best to choose one that’s most comfortable for you while promoting good sleep.

Side sleeping may be the best option if you have both OAB and sleep apnea. Elevating your legs throughout the day may also help to reduce the need to urinate at night for some people.

Other ways to reduce nocturia with OAB include limiting fluids in the evening and double voiding before bed. Treatments like bladder training, pelvic floor exercises, and medications can help to improve your overall OAB symptoms.

Talk with a doctor if you have OAB that interferes with your sleep or if your methods of limiting nocturia stop being effective. They can help recommend other ways that may help to help reduce urination frequency at night.