Are you waking up at night to pee? It may be a sign of something wrong, doctor says

Urologic surgeon Dr. Dean Elterman breaks down the common causes of nocturia, waking up at night to pee, and what it could mean for your health.

Waking up at night to use the washroom is common, but doing it too often can disrupt sleep patterns and signal an underlying health issue.

Known as nocturia, the condition can affect people of all ages and, in some cases, cause fatigue and reduced quality of life. A study published by the U.S. National Library of Medicine tied nocturia to a 20 per cent increased risk of falls and 32 per cent increased risk of fractures.

How many times is too many?

Dr. Dean Elterman, a urologic surgeon at University Health Network, says it’s normal to wake up to use the washroom once in a while, but more frequent trips may be a sign something else is going on.

“It’s really common to wake up, but two or more times is what we would consider abnormal,” he said in an interview with CTV Your Morning Tuesday.

The key distinction, Elterman said, is that nocturia involves being awoken from sleep specifically because of the need to urinate, then having to fall asleep again.

Roughly 30 per cent of adults wake up at least once a night to pee, he said, noting that the number rises with age, with about half of people over “60 or 70″ affected, but it’s equal between men and women.

What causes nocturia?

There are many possible reasons, ranging from daily habits to medical conditions.

“Certainly, it could be that you’ve drunk too much fluid late into the evening,” Elterman said. “There could be an underlying medical condition, a sleep disorder ... we really need to dig into why.”

As people age, the kidneys may become less efficient at concentrating urine, leading to increased nighttime urine production. Other possible causes include sleep apnea, diabetes, fluid retention and heart or lung conditions.

In men, prostate enlargement can prevent the bladder from fully emptying, leading to more frequent nighttime urges.

Why it matters

Elterman says the problem isn’t just interrupted sleep.

“The big thing about nocturia waking up at night isn’t that you’re waking up at night,” he said. “It’s the consequence of waking up at night.”

He noted that fragmented sleep can lead to daytime fatigue and reduced productivity.

What can help prevent it?

Elterman recommends cutting back on fluids two to three hours before bedtime, saying people who retain fluid in their legs may benefit from elevating their legs in the late afternoon or wearing compression stockings.

Monitoring diet, including salt and alcohol intake, can also help.

“And last, but not least, you want to speak to your doctor if you may have an underlying medical condition that’s either not being treated properly, or it hasn’t even been diagnosed,” he said.

When to see a doctor and how it’s treated

Occasional nighttime washroom trips aren’t usually a cause of concern, Elterman said, but persistent or worsening nocturia should be checked out.

“There’s always one or two nights when you had something too salty, you drank too much alcohol. Those are going to get you up at night,” he said. “But if this is a long-term recurring thing, you really need to see your doctor.”

Treatment depends on the cause, Elterman explained, saying lifestyle-related nocturia may improve with changes to fluid intake. Diabetes may require better sugar control. Overactive bladder and prostate enlargement can often be treated with medication. Sleep apnea may be addressed with a CPAP machine.

The goal, Elterman said, is to identify what’s driving the nighttime awakenings and address it directly before sleep and overall health suffer.