How Many Times Is Normal To Urinate At Night
Not everyone is the same, and there are factors that determine what is normal for most people. For example, nighttime urination is more common if you have something to drink right before bed, and is also more common in older adults. Most people without nocturia can sleep for 6 to 8 hours without having to urinate, but getting up to go to the bathroom once during the night is still within the realm of normal. If you have to use the restroom two or more times per night, it is a good idea to talk to your urologist about nocturia.
How Is Nocturia Classified
Nocturia is classified into 3 types that may overlap:
- Global polyuria
- Defined as production of urine volume more than 40 ml/kg per 24 hours
The bladder diary is crucial in helping define the type and cause of nocturia. The bladder diary determines:
- Total 24 hour urine output
- Nocturnal urine volume
- Proportion of total urine output that occurs at night
Diagnosis Of Overactive Bladder
To thoroughly diagnose overactive bladders, tests should be conducted by highly expert urologists. Diagnostic tests include medical history, physical exam, which may include a rectal exam and a pelvic exam in women, urine sample to test for infection or other abnormalities and focused neurological exam that may identify sensory problems or abnormal reflexes. Overactive bladder assessments include:
- Frequency and quantity of urination in each day starting from morning time after waking up and before going to sleep at night
- Frequency and quantity of urination during nighttime starting from sleep at time to morning time.
- Number of urination with inability to hold the urine
- Number of urination with a sudden urge to urinate and that is difficult to control
In addition, tests might also involve measuring urine left in the bladder, measuring urine flow rate and testing bladder pressure. Individual patients might need different tests and procedures depending on their medical conditions and personal factors.
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How The Urinary Tract Works And What Happens With Oab Your Browser Does Not Support Html5 Audio Playback You May Download The Audio File Directly Here
The urinary tract is the important system that removes liquid waste from our bodies:
- kidneys: two bean-shaped organs that clean waste from the blood and make urine
- ureters: two thin tubes that take urine from the kidney to the bladder
- bladder: a balloon-like sac that holds urine until it’s time to go to the bathroom
- urethra: the tube that carries urine from the bladder out of the body. The urethra has muscles called sphincters that lock in urine. The sphincters open to release urine when the bladder contracts.
When your bladder is full, your brain signals the bladder. The bladder muscles then squeeze. This forces the urine out through the urethra. The sphincters in the urethra open and urine flows out. When your bladder is not full, the bladder is relaxed.
With a healthy bladder, signals in your brain let you know that your bladder is getting full or is full, but you can wait to go to the bathroom. With OAB, you can’t wait. You feel a sudden, urgent need to go. This can happen even if your bladder isn’t full.
Nocturia: Frequent Night Urination Causes & Treatment
Nocturia is a condition that causes sleep disruption as a result from frequent urination at night. Learn more about its causes and treatment options.
Bladder leakage at night can happen whether or not you feel the urge to go, so you may not always know beforehand that you have to use the bathroom. This means you may even wake up to wet sheets. Use this guide to better understand Nocturia, what causes those frequent urges to use the restroom at night, and how to prevent or treat the symptoms of nocturia.
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Three More Possible Causes Of Nighttime Overactive Bladder
Dr. Greenleaf explains, Low-level infections that linger can cause inflammation in the pelvic organs.
Typically urgency, frequency and nocturia may be the only symptoms.
Sensitivities any chemicals that can irritate delicate pelvic tissue can present as irritative urinary symptoms such as nocturia.
Sensitivities to dyes, perfumes and detergents are widespread.
Dehydration 75% of Americans are chronically dehydrated.
Thirst isnt always a symptom. But check the color of your urine. A dark yellow, yellow-orange or even pure orange indicates dehydration.
Shutterstock/gritsalak karalak
Dehydration concentrates the urine, which is more irritating to the lining of the bladder or urethra, adds Dr. Greenleaf.
Youll need to balance rehydration with making sure not to drink too much water or juice close to bedtime.
This will require experimentation as far as amount and when you drink it relative to going to bed.
Here is a study on nocturia prevalence.
Dr. Greenleafis board certified in obstetrics/gynecology, female pelvic medicine and reconstructive surgery, and procedural medicine and aesthetics. She is host of Some of Your Parts Podcast and owner of the Pelvic Floor Store. Follow her on Instagram.
Lorra Garrick is a former personal trainer certified by the American Council on Exercise. At Bally Total Fitness she trained clients of all ages for fat loss, muscle building, fitness and improved health.
What Are Bladder Storage Disorders
In bladder storage disorders the ability of the bladder to store urine is reduced causing nocturia . The night-time volumes of urine passed are often small as well as frequent in bladder storage disorders.
Bladder storage can be affected by conditions that reduce bladder capacity, cause an overactive bladder or that cause bladder irritation.
Incomplete bladder emptying due to an underactive bladder or bladder outlet obstruction is another potential cause of more frequent night-time urination.
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Precautions And Proper Diagnosis
The main symptoms of OAB can also occur in other health conditions like bladder cancer, urinary tract infection and enlarged prostate. Seeing blood in your urine is not a symptom of OAB.
A sudden and frequent need to urinate is common in both OAB and a UTI. How can you tell the difference between these two urinary health issues? Unlike OAB, a UTI also comes with other symptoms such as discomfort while urinating. In addition, OAB symptoms are continuous while UTI symptoms are sudden and may also include a fever.
Overflow incontinence is characterized by the involuntary release of urine from an overfull urinary bladder, often in the absence of any urge to urinate. This condition is not associated with OAB. It typically occurs in people who have a blockage of the bladder outlet, which can occur with benign prostatic hyperplasia, prostate cancer or a narrowing of the urethra. Overflow incontinence can also occur when the muscle responsible for removing urine from the bladder is too weak to empty the bladder in a normal way.
It is very important to see a doctor to ensure a proper diagnosis if you experience any changes in your urine and/or urination habits.
Treatment Of Global Polyuria
Global polyuria due to excessive fluid intake can be managed with fluid restriction. There is no health benefit in drinking excessive volumes of fluid beyond the bodys requirements. Metabolic conditions such as poorly controlled diabetes mellitus or diabetes insipidus benefit from further treatment by an Endocrinologist.
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Your Overactive Bladder In Menopause Especially During The Night
It wasnt only the hot flushes and night sweats that were waking up Romany night after night. It was needing to pee as well.
I know that this affects many of you too. Because exactly one year ago before the world when into chaos, I was travelling throughout New Zealand, Australia and the United Kingdom, sharing my live Masterclass on Menopause with you, and hundreds of hands would shoot up in the air when I asked who was waking up because they needed to pee in the night. Perhaps this is you as well.
Discovering that our nerves become more irritable during menopause was another aha lightbulb moment for me you see, your bladder has thousands of nerves that help to control its functions. Our irritable bladder and urge to pee more frequently, is another symptom of menopause, however, a word of caution too it can also be a sign of Urinary Tract Infection too. Hence, if you are experiencing any burning pain on urinating or if you have any pelvic or back pain, then head to your Doctor right away.
The changes to our urinary system during menopause can be such a challenge for many, especially those of us who aspire to continue to stay active as we age. So, lets take a look at whats going on.
The Mystery of your Ageing Bladder in Menopause:
What can I do about it? Here are my 5 pointers to help you:
Use Herbal Remedies To Relieve Symptoms And Promote Sleep
Herbs offer many benefits for sufferers of OAB. Marshmallow root and cornsilk soothe the urinary system, and while they may be consumed in many forms, I suggest drinking one quart of herbal tea daily, during the daytime.
If you suffer from frequent urinary tract infections, cranberry, blueberry, pipsissewa, buchu and uva ursi are excellent choices for relieving and preventing them. Consult with a qualified practitioner who is skilled about herbal therapies if you suspect that you have a urinary tract infection.
Valerian, hops, linden and passionflower are just a few of the many herbs that promote relaxation and sleep. Herbal remedies are generally very safe and well-tolerated. See which ones work best for you.
Photo Credit: monkeybusinessimages /
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Nocturia Or Frequent Urination At Night
Millions of Americans are affected by a frequent need to urinate during the night. This is known as nocturia, and it is often cited as a cause of sleep disruptions. Though frequently thought of as a problem in elderly people, it can impact people of all ages.
Trips to the bathroom can cause fragmented sleep, excessive daytime sleepiness, and an elevated risk of dangerous falls. Nocturia has numerous potential causes and can be connected to a range of serious health issues.
Although nocturia is common, it shouldnt be accepted as inevitable. In many cases, steps can be taken to reduce bathroom trips and improve sleep. Understanding the basics about frequent nighttime urination, including its causes, consequences, and treatments, can be a first step for people of any age to sleep better and with less bothersome nocturia.
Pearls And Other Issues
Guideline and Quick Summary of Nocturia Treatments
Although nocturnal polyuria is the most common etiological finding in patients with bothersome nocturia, mixed causes are very common, usually requiring combination therapy.
Unfortunately, for most cases, there is no specific cure for nocturia. Establishing a reasonable patient expectation for partial resolution is important as complete eradication of significant nocturia is uncommon but most patients will be quite satisfied with a 50% reduction in their nocturnal voids.
Initial evaluation includes a history and physical , a blood test to rule out diabetes and check serum sodium, a post void residual urine volume and a 24-hour voiding diary. The importance of a properly done voiding diary cannot be overemphasized as it guides diagnostic differentiation and optimal treatment selection which usually involves a combination of therapies.
Simple behavioral and lifestyle measures should be tried first, for example, limiting fluid intake in the evening, increasing daytime physical activity, minimizing bedroom distractions to enhance sleep, using a bedside commode or urinal, performing regular Kegel and similar pelvic floor exercises, decreasing caffeine ingestion, avoiding high salt intake late in the day and elevating the lower extremities for several hours before bed.
Alpha-blockers can be useful in male patients with benign prostatic hypertrophy and other lower urinary tract symptoms besides nocturia.
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What Are The Specific Symptoms Of Overactive Bladder
Overactive bladder represents a collection of symptoms that can include:
- Urinary urgency: This is a failure to be able to postpone the need to urinate. When you feel you need to urinate, you have a limited amount of time to get to a bathroom.
- Frequency of urination: People who experience this symptom need to urinate very often. Typically its an increase in the number of times you urinate compared to what you previously experienced.
- Urge incontinence: In this case, there can be a leakage of urine when you get the urge to urinate.
- Nocturia: This symptom is characterized by the need to get up and urinate at least two times each night.
Getting Up At Night To Urinate
Drinking too much liquid before bed especially diuretics like alcohol can make anyone visit the bathroom in the middle of the night. However, if you find that most nights youre waking up more than once with an urge to empty your bladder, you should see your doctor about a potential problem. This issue is known as nocturia, and although it may seem like a minor inconvenience, the longer you allow your bladder to interrupt your sleep, the more likely you will begin to suffer the consequences of poor sleep patterns.
Photo Credit: kone /
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Making Too Much Urine
Your childs kidneys may make too much urine overnight, leading to an overfull bladder. If your child doesnt wake up in time, a wet bed is likely. Often this excess urine at night is due to low levels of a natural substance called antidiuretic hormone . ADH tells the kidneys to release less water at night.
What Causes Overactive Bladder
An overactive bladder can be caused by several things, or even a combination of causes. Some possible causes can include:
- Weak pelvic muscles: Pregnancy and childbirth can cause your pelvic muscles to stretch and weaken. This can cause the bladder to sag out of its normal position. All of these factors can cause leakage.
- Nerve damage: Sometimes signals are sent to the brain and bladder to empty at the wrong time. Trauma and diseases can cause this to happen. These can include:
- Pelvic or back surgery.
- Stroke.
Often, there may be no specific explanation for why this is occurring.
How Can Nerve Stimulation Help Overactive Bladder
There are several treatments that involve stimulating your nerves to help improve overactive bladder. Your nerves help communicate the message that your bladder needs to be emptied to your brain. By treating the nerves, your healthcare provider can improve your bladder control. Nerve stimulation is a reversible treatment that is considered when conservative treatments have not worked or have not been tolerated. Conservative treatments include behavioral therapies and medications.
There are several types of nerve stimulation treatments. These can include:
Do Not Let Your Life Be Disturbed Stop Worrying About Overactive Bladder
6 minute read
Urinary abnormalities such as frequent urination and feeling a sudden urge to urinate might be frequently overlooked. In fact, these symptoms potentially indicate overactive bladder or OAB. Overactive bladder is a chronic medical condition which has tremendous impacts on the quality of life in both men and women. Overactive bladder affects performance of daily activities and social function such as work, traveling, physical exercise, sleep and sexual function. If this condition is left untreated, it leads to impaired quality of life accompanied by emotional distress and depression.
Bladder Has Two Distinct Roles
What Causes Daytime Wetting In Children
Daytime wetting in children is commonly caused by holding urine too long, constipation, or bladder systems that dont work together smoothly. Health problems can sometimes cause daytime wetting, too, such as bladder or kidney infections , structural problems in the urinary tract, or nerve problems.
When children hold their urine too long, it can trigger problems in how the bladder works or make existing problems worse. These bladder problems include:
How Does Frequent Urination At Night Or Nocturia Affect Quality Of Life
People generally find nocturia most bothersome when it occurs more than twice per night. The severity of the effects of nocturia on quality of life relates directly to the number of times a person has to wake to pass urine at night.
Nocturia can have a significant impact on a persons quality of life by:
- Disturbing sleep
- Affecting the quality of sleep
- The effects of reduced sleep such as daytime tiredness, effects on memory and work performance
- Increasing the risk in elderly patients of falls and injuries
- Affecting the sleep partner of the person suffering from nocturia whose sleep can also be disturbed