Ask Dr. Darria: Why Am I Suddenly Waking Up at Night to Urinate?

Ask Dr. Darria: Why Am I Suddenly Waking Up at Night to Urinate?

I’m a 58-year-old man, and notice that recently I’ve been making more bathroom trips in the middle of the night to urinate. Is this normal?

The women of the world may feel poetic justice in finding their male counterparts suffer from the same frequency of urination as they age! While in early adulthood, women outnumber men in nighttime bathroom trips, by the age of 60, more men than women do. Arising from sleep to urinate -- called “nocturia” -- is common as we age, but may also be a sign of a health condition. What is frequent urination? Clinically speaking it means getting up to urinate two or more times a night.

One of the biggest consequences of nocturia is quality of life. Interrupting sleep repeatedly can cause increased rates of depression, missed work, poorer physical and mental health, and even increased risk of falls and fractures (those half-awake trips in the dark to the bathroom are a set-up for falls).

Common causes of frequent urination include:

  • Obesity
  • Medication use. This is a big one, especially with patients on diuretics (“water pills”). These increase the volume of your urine, so you’re urinating more in general -- including at night. Antidepressants can also lead to nocturia.
  • Sleep apnea: nocturia occurs in approximately 50% of people with sleep apnea, and sometimes may be the first sign of it. This is especially true if you’re under age 50.
  • Benign prostatic hypertrophy (BPH): As your prostate enlarges, it makes it more difficult to urinate. You’re unable to totally empty your bladder and need to urinate again in a short period of time.
  • Prostate cancer
  • Diabetesheart disease and heart failure
  • Hypertension
  • Acute worsening of any of the above conditions, or a combination of them.

Nocturia is also very common in pregnant women, but usually resolves about three months post-partum and is unrelated to the above causes.

What to do:
Record in a journal:

  • What time you went to bed and how many times you awoke in the night to urinate.
  • Your fluid intake, especially immediately prior to bedtime, and of “diuretic fluids” such as caffeine or alcohol.

Ask your doctor:

  • If any medications may be causing this.  If so, taking them at a different time during the day may help (for instance, switching your nighttime dose of a diuretic to mid-afternoon).
  • Whether you have signs of any of the conditions listed above as “causes”
  • If you need to check for a urinary tract infection or prostate enlargement
  • If you continue to have problems, your doctor may do other tests, including measuring the volume of your urine, checking your bladder after urination and other testing.
  • Once any dangerous causes have been ruled out, your doctor may prescribe medications such as terazosin, finasteride, or others to control symptoms.

What kind of doctor should I see?
Start with your primary care doctor (PCP). Depending on what he or she finds, you may be referred to a urologist, but your PCP is the best place to start.

Medically reviewed in December 2019.

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