PeeFilter: Why can't I stop peeing in the middle of the night?

April 30, 2008 7:34 AM

I can't stop peeing in the middle of the night and its preventing my girlfriend from sleeping well. Is this normal? How do I stop this?

For the record, I'm turning 25 later this month. I've been to my doctor about it who said nothing was wrong with me and that I just need to make sure I don't eat/drink anything several hours before I go to sleep.

I've tried this and I still can't stop getting up to pee in the middle of the night! Sometimes its more than once...like once at 4am or so and again at 6am.

My girlfriend is very understanding but at the same time its causing her to not get a full nights sleep and this has been taking its toll on her so I want to figure out how to put an end to this.

When I wake up with the urge to pee, its not like if I don't go I'll wet the bed, however it is uncomfortable enough that I can't continue sleeping. This only started happening after college when the real stresses of the world fell upon my shoulders so I've considered it being job stress, however I was recently let go from an extremely stressful job and it continued despite me not having much stress about being unemployed due to knowledge that my family would support me should my funds run out.

Any suggestions?

posted by Elminster24 to health & fitness (50 comments total)

It could be that maybe you've trained your body to hit the toilet at about the same time every night. Which, in that case, you'll probably need to just suffer through it and force yourself to stay in bed. Re-train the body to want to go about the time you usually get up.

I'd try pushing back even further the time when you consume liquids. But also, even if you don't even feel like going, use the toilet before you hit the bed. Even getting the bladder emptied a little bit, from my experience, can assist in keeping it from screaming for attention later in the night.
posted by Atreides at 7:48 AM on April 30, 2008

I don't think it has anything to do with stress. It's more likely have to do with, er, getting older. The timing is a coincidence.

You're a guy. You have to get up and the night and pee.

How's the hairline holding up?
posted by cptnrandy at 7:48 AM on April 30, 2008 [1 favorite has favorites]

Sleep in another room until you get the problem solved? That is a considerate thing to do, if it wouldn't be upsetting to your girlfriend / make sleeping difficult in its own way.
posted by By The Grace of God at 7:49 AM on April 30, 2008

Is it possible that you're waking up in the middle of the night for another reason (sleeping badly due to stress, maybe?), and that if you hadn't awakened for that other reason you would have held your water fine until the morning? I have to go to the bathroom anytime I wake up in the middle of the night, whether it's due to a loud noise outside or a bad dream or whatever. But if nothing else wakes me up I'm fine until morning. It's like the urge is there all along, but it will bide it's time until you wake up, whenever that is.

Not that I'm advocating taking sleeping pills, but as an experiment, maybe try taking a Tylenol PM tonight before bedtime and see if you sleep through the night. If you do, that might show that it's more of a sleep issue than a pee issue.
posted by amro at 7:51 AM on April 30, 2008

You obviously have the most understanding girlfriend of all time, and you probably owe it to her (if not to yourself) to bring this up to a therapist. In the absence of physical causes, and in light of your having mentioned stress as a possible cause above, the only thing I can guess is it's a physical reaction to unease you're not otherwise dealing with.
posted by kittens for breakfast at 7:54 AM on April 30, 2008

Getting up to pee in the night is perfectly normal.

Isn't the problem here that your girlfriend is a light sleeper, not that you have to get up to pee? I'd suggest she tries earplugs and a sleep mask, and see how that goes.
posted by essexjan at 7:57 AM on April 30, 2008 [15 favorites has favorites]

Seconding Atreides. I had the same problem once upon a time, and working my way through it was the way to go.
posted by puritycontrol at 7:58 AM on April 30, 2008

I had the same thought as amro, stress may just be making you a lighter sleeper, you wake up after one REM cycle or when your body temp hits rock bottom and then you're like "oh huh, time to pee" so in addition to the decent stuff like drinking less water late in the day [and I always find that less caffeing/sugar/alcohol generally helps this] you might try something that will take the edge off anxiety-wise like benadryl (ok for pretty frequent use and the soporific of choice for old people everywhere) right before bed and see what that does for you. Other stress-relievers like exercise, not right before bed, or possibly meditation may help with the stay asleep thing.
posted by jessamyn at 8:00 AM on April 30, 2008

If you do take a sleeping pill like amro suggests, try to pick one that is supposed to last for 8 hours. The issue with Tylenol PM or Benadryl, I've found, is that you might wake up when they wear off. For me this is usually about 4 hours after going to bed. If waking up is causing the need to pee, then this won't really help.
posted by cabingirl at 8:01 AM on April 30, 2008

IANAD, but I am a man, and I do sometimes get up to pee in the night. I think it is a mix of getting older and habituation. Whatever the changes are as you age (prostate? bladder less stretchy? something else?), needing to pee a little more often seems to be a really normal part of that. It's been true for me, and true for most of the men with whom I've shared living quarters. (I slept once in a big gymnasium full of older male church volunteers; people were walking back and forth to the bathroom all night long -- I think some of those guys should have just moved their cots into a bathroom stall for convenience. So expect this to get worse, not better, with time.) And if you drink a lot of things that irritate your bladder, this problem increases -- for me, cutting caffeine made the difference between peeing two or three times in a night, and peeing once -- the better sleep made up for the caffeine withdrawal headaches, mostly.

But it's also habituation or training. If I go three nights in a row waking up at 3am to pee, chances are pretty good that I'll wake up the fourth night at the same time even if I had a lot less to drink the previous day. So you can work on retraining yourself -- it is actually possible (although difficult) to fall back asleep with a semi-full bladder, for example. And if waking up once a night is inevitable, you can work on timing it at around your girlfriend's sleep patterns -- she might find you getting up at 5am a lot more disturbing than at 3, for example.

But mostly it's just normal, and just as you need to work on minimizing its impact on her, she will need to learn how to sleep given the reality of how your body works. If you are peeing every hour (or are wetting the bed), then yes, she has good cause for complaint. But if you get up once a night on most nights, and are quiet and well-behaved about it, that seems pretty unobjectionable to me.
posted by Forktine at 8:02 AM on April 30, 2008

(On review: Boy, did I misunderstand the central premise of this question. On second thought, your girlfriend isn't necessarily that superhuman in her understanding...um...ness, and talking to a therapist is probably not an urgent need. Atreides and jessamyn are both much more on point.)
posted by kittens for breakfast at 8:04 AM on April 30, 2008

Yeah, I agree about the habituation thing. I find that if I do happen to wake up in the night, even if I don't have to pee, if I get the thought into my head, then I can't fall back asleep without going to the bathroom because I'm thinking about it. So some re-training or a mild sleep aid to get you through it might do the trick.
posted by gaspode at 8:10 AM on April 30, 2008

Drink a lot more water from waking up til 5:00 pm. Hold it as long as you can. Pretty soon, you'll be able to hold it all night. Every couple years, I get on a water-drinking kick (4-5 quarts/day) and the first week *sucks* for getting up in the middle of the night.
posted by notsnot at 8:11 AM on April 30, 2008

It's unusual for a 25 year old man to wake up more than once at night to pee.

Your doctor should have sent off a sample of urine to exclude infection, and done a basic check for diabetes.

If behavioural changes like fluid restriction aren't helping, consider an anticholinergic medication, rather than a sleeping tablet. Medications like oxybutynin, tolterodine, and solifenacin relax the bladder muscle, and reduce sensation from the bladder, so you can hold a greater volume without waking up.

If your doctor isn't taking you seriously, and it's really impacting on your quality of life ask for a referral to a urologist.
posted by roofus at 8:12 AM on April 30, 2008

A few years back, I was peeing very frequently, tired and otherwise not-feeling-great. I went to the doctor and he told me I had breathing problems and handed me a couple of sampler inhalers.

Turns out I actually have diabetes and he completely missed it.

I don't mean to scare you (and maybe your doctor is actually competent), but don't end up like me - make sure they've checked your blood sugar and all that too.
posted by juicedigital at 8:20 AM on April 30, 2008

I can't believe no one's mentioned benign prostatic hyperplasia (BPH) yet. Very common, totally not a big deal. We think of it as a disease of older men, but it can certainly start in younger men, even as young as you are. As the prostate grows larger, urinary symptoms like what you describe show up. There is a simple blood test to rule out cancer (prostate-specific antigen, or PSA), and it's treatable with medication. Flomax is a common one. If you tell your doctor the symptoms are interfering with your quality of life because you can't get a full night's sleep, he or she should take you seriously.
posted by selfmedicating at 8:22 AM on April 30, 2008

As others have mentioned, frequent urination is a symptom of diabetes. Increased urination during the day, increased consumption of high-carb items (e.g. non-diet soda), decreased exercise, and weight gain would all point to diabetes as well. If that sounds at all like you and your doctor didn't already check your blood or urine for excess sugar, you should probably ask about it. It's very helpful to catch type 2 diabetes early.
posted by scottreynen at 8:23 AM on April 30, 2008

I used to wake up in the middle of the night all the time, and got up to pee when that occurred. I thought I was waking up because I had to pee. Turns out I was just sleeping poorly due to untreated sleep apnea. Once I started treatment for apnea, I stopped having to pee at night, because I was sleeping far better. Get a sleep study. May not be apnea, but you likely have something wrong with the way you sleep.
posted by BigLankyBastard at 8:26 AM on April 30, 2008

You said that the doctor told you nothing was wrong, but did the doc examine your prostate?
posted by yqxnflld at 8:26 AM on April 30, 2008

I hate to be the only one taking this track, but have you considered treating the actual problem instead of its causes? It sounds like you're getting up to go to the bathroom once or twice but it's not hurting your sleep. The real problem here isn't that you're getting up, it's that it's bothering your girlfriend. Is it because she hears you get up, or because it disrupts the bed? Looking into a mattress that doesn't transmit as much movement to where she's sleeping, putting a rug on the floor so it doesn't creak when you get up, or sleeping in a position where you won't bother her when you get up might be good ideas.

There will always be times when one person in a bed needs to get up during the night. Is she just easily disrupted, or is she not used to sleeping with someone and she might adjust?
posted by mikeh at 8:40 AM on April 30, 2008

Since I've started training myself to breathe through my nose at all times (whenever I remember, anyway!), I've slept better and need to get up to urinate a lot less often.
posted by tomcooke at 8:40 AM on April 30, 2008

I have been doing this since I was a boy (I'm 50 now). I wake up in the middle of the night and I go. Simple as that. But if this is something new for you it's worth having checked out.
posted by tommasz at 8:41 AM on April 30, 2008

I agree with roofus that you should find out what your doctor did and get him to follow up or get a referral.
posted by sero_venientibus_ossa at 8:42 AM on April 30, 2008

I'm not sure that this is such a big deal for you (you girlfriend is another matter). This often happens to me, and normally when I wake up in the middle of the night I go to pee and most of the time I don't really need to. It's just that I know that I'll get back to sleep faster if I do. Honestly, I think it's a guy thing. I have only anecdotal evidence on which to base this, but I think that men are not as good at 'holding it' than women. If you're worried then you should get this checked out, but I think that what you're describing is not unusual.
posted by ob at 8:57 AM on April 30, 2008

I can't believe no one's mentioned benign prostatic hyperplasia (BPH) yet.

The reason it wasn't mentioned is because it doesn't affect 25 year old men. Figure 1 in this paper demonstrates that the rate of histological BPH (i.e. not even necessarily associated with symptoms yet) is basically 0% in men in their twenties.
posted by roofus at 9:00 AM on April 30, 2008

You drinking gatorade?
posted by cashman at 9:01 AM on April 30, 2008

Yeah, getting up to pee in the nighttime is just a thing dudes have to do. If you have to go A LOT, you could have diabetes but that certainly isn't something to focus on unless you're getting up constantly.

Making a big deal about you having to get up to pee is no different than you making a big deal if she gets cramps from her period or something. It's something pretty normal that you can't control.
posted by Justinian at 9:01 AM on April 30, 2008

ob, men actually hold a greater volume, and go less often. From this paper:

"Men had higher total fluid intake and mean voided volume than women (p <0.001 and 0.04, respectively). Women voided more frequently than men (p = 0.006) and had more voids per liter of fluid intake (p <0.001). CONCLUSIONS: This analysis suggests that there are significant gender effects on 24-hour diary variables, with females tending to void more often and at lower mean volumes."
posted by roofus at 9:03 AM on April 30, 2008

Leptin, a hormone produced by your fat cells when they are 'full', is a diuretic.

If you are eating most of your food in the evening, I'd try to shift that consumption to earlier in the day, and I would try to reduce the fat content of what I did eat at night.

Melatonin (produced by your brain in the absence of light) and insulin working together appear to enhance the production of leptin, whereas by itself melatonin seems to reduce leptin, so I would try avoiding anything with a high glycemic index at night, as well.
posted by jamjam at 9:08 AM on April 30, 2008

You can buy a generic meter to test your blood sugar for something like 10 to 20 bucks. You may have an issue with morning sugar so a test when you first wake up is in order, and then some tests prior to and after meals. It will come with instructions to let you know if the readings are high. It is not as definitive as a fasting blood glucose test ordered by a physician, but if it actually gets you to test rather than waiting it can be useful. The variations in sugar levels are also good to know.
posted by caddis at 9:10 AM on April 30, 2008

I don't understand how this is completely disturbing your girlfriend's life. So you get up once or twice in the middle of the night. Lots of people do that, whether it's to pee or shake yourself out of a bad dream or a sudden bout of insomnia. Hell, my cats run all over our bed at random times, and we sleep fine.

I'm assuming you're quiet and just slip out and slip back in. Do you have to crawl over her or something? Are you turning the light on? If not, she needs to look into earplugs or a sleeping mask or something, because it shouldn't cause such problems for her.
posted by heatherann at 9:25 AM on April 30, 2008 [1 favorite has favorites]

If you and your girlfriend just started sleeping together -- I mean actually sleeping -- then she's going to be a lighter sleeper now than she will be in a little bit. If she's not used to sleeping next to someone, every little thing you do will disturb her sleep.

My husband's bathroom trips woke me when I was getting use to having him in bed with me - now I can sleep through his sleep talking, the bathroom breaks and almost any kerfuffle he conjures up.

Also, if you're fretting about things, even if you're sleeping, you're sleeping lightly, so you're not sleeping through the urge to go to the bathroom. You may also be tossing and turning, which is keeping your girlfriend's sleep lighter than it needs to be to sleep through bathroom trips. Solving the root emotional cause - worrying, fretting, etc. - might help you sleep deeper. Combined with forcing yourself to go right before bed and cutting back on liquids before bed, it should help.

If you've been sleeping together for a long time, I agree that you two need to figure out a way to get both of you sleep better - whether it's a night mask or repositioning the bed so you can slip out unnoticed.
posted by Gucky at 9:37 AM on April 30, 2008

Not every man needs to get up in the middle of the night and pee. Not only is this disturbing your gf's sleep, but it's almost certainly negatively affecting your sleep as well, although you may not recognize the affects yet.

I went through a period where I had trained myself to wake up and pee around 3am. Super-annoying for me. I started peeing right before bed, and ignoring any urge less than "OMG I'M GOING TO EXPLODE". Now, I sleep through the night.

Also, any doctor that poo-poo's your concerns as "nothing to worry about" without at least discussing what the cause COULD be is a rather bad doctor, IMO. It's obviously something that you're concerned about, and therefore it's not nothing.
posted by muddgirl at 9:43 AM on April 30, 2008

ob, men actually hold a greater volume, and go less often.

Well I never! That's fascinating. Of course it just goes to show that anecdotal evidence is no evidence at all, but it is exactly opposite to my experience. I'll bring this up the next time that women that I know make fun of us boys when we're out drinking. Thanks roofus!
posted by ob at 9:45 AM on April 30, 2008

Have you tried disposable adult undergarments? Seriously, it sounds like it's your girlfriend's problem, not yours. How long does it take you to do your business? 2 minutes?

Also, do you drink alcohol by any chance? The whole "problem started in college" thing kind of suggested that to me.
posted by tjvis at 9:47 AM on April 30, 2008

Yeah I don't think your girlfriend is being particularly understanding. What are you going to do? Hold it until she wakes up? Geez. If you have to go, you have to go. Do you sleep on the outside? Slip out of bed and be quiet about it. That's the best you can do.

I and every male in my family usually has to pee once a night. If I don't actually get up and do it, it's because I'm too lazy, but I always wish I would. My problem is that it's always accompanied by a totally unwanted hard on.

SERIOUSLY THOUGHT LISTEN HERE TO THIS COUNTERINTUITIVE ADVICE:
For a while I was trying to not drink fluids late in the evening so that I wouldn't have to pee. When I got up to pee I would feel really dry and I wouldn't really have much pee in me. It would be just a tiny bit. It was the hard on that woke me up.

Then I tried drinking a fair amount of water in the evening. At least a pint. Sometimes more. And I slept a lot more soundly. I think there is some part where being dehydrated gives you some painful bladder action, and drinking some water in the evening has helped me sleep. YMMV,definitely, but it's worth a try.
posted by sully75 at 10:09 AM on April 30, 2008

I think you really need to ask yourself why this is such a big deal. Is it a big deal because your girlfriend has complained about it a lot? Or, is it a problem because you don't wish to inconvenience your girlfriend? In the first instance, I would say she's pretty out of line complaining about one of your bodily functions (which is operating within normal parameters).
If it's your anxiety about it, you should ask yourself why you feel the need to change the way your body works in order to please another person. Either way, your doc said it's ok, it's what your body does, and this is not really a problem.
posted by The Light Fantastic at 10:27 AM on April 30, 2008

What mikeh and others have said, about the problem being mainly that your girlfriend's sleep is disturbed. It's perfectly normal to get up during the night to pee, I wouldn't worry unless you're getting up A LOT, 3 or more times a night. If you had diabetes, like someone suggested, you'd be peeing a lot, not just at night, and you'd be thirsty all the time and losing weight.

Are you touching each other when you sleep? She might sleep more soundly if you're not touching. One of those special motion-control mattresses might help, as well as trying to reduce how much noise you make, and she might try ear plugs. Is the bathroom right next to the bedroom? If it's yellow, let it mellow!
posted by Koko at 10:37 AM on April 30, 2008

WOW - alot of good stuff here. I agree with Atreides that your body is doing what you've programmed it to do. Every now and then I'll get in the same rut and I really think it is b/c I let myself pee so than I have to pee.
So hold on on the liquids (I actually intentionally stop drinking water around 3:30-4:00 and take it easy at at home (unless i'm hitting the bottle;-)
posted by doorsfan at 10:40 AM on April 30, 2008

A lot of people are saying to hold off on the liquids later. Yeah I don't really agree with that. When you go with out liquids at any time that just makes your bathroom habits all funky. What you can do is drink water all through out the day but drink it in small quantities. Even smaller at night. Limit the caffiene, alcohol and any soda, and any liquids in large quantities.
posted by 85 celica at 11:41 AM on April 30, 2008

Honestly, I think it's a guy thing. I have only anecdotal evidence on which to base this, but I think that men are not as good at 'holding it' than women.

I'm female and I have the same problem as the OP, and I have reason to believe it is unrelated to my prostate. There have been times when I've literally gotten up to pee ten times before falling asleep, and then ten more times throughout the night. I went to the doctor and was tested for diabetes, infections, tumors. No smoking gun.

For me, I think it's a combination of anxiety and diet-related bladder irritation, and of course habit. I read about interstitial cystitis, which you might find interesting. When I cut out the foods listed as common irritants - particularly coffee, tea, carbonated beverages, tomatoes, and most vitamins - I noticed an immediate difference. The anxiety is a whole different thing, but benadryl is a good short-term solution (those drugstore-brand OTC "sleep relief" pills are actually just benadryl.). Best of luck!
posted by granted at 11:46 AM on April 30, 2008

Not your problem. Surely you toss and turn while asleep, like everyone else does. Doesn't this wake up the GF? Surely you are creating MORE of a disruption by moving while asleep, than when you gently ease yourself off the bed and tiptoe out of the room.

I think you have to consider whether the GF, for unknown reasons, is way too focused on your toileting life.

This assumes you don't have an excessively creaky floor, that you don't bump her every time you go out, that you don't turn any lights on, and that you don't flush. You're NOT turning on lights and flushing, are you?

Not your problem.
posted by JimN2TAW at 12:05 PM on April 30, 2008

Do you drink soda or coffee? Caffeine makes me pee alot.
posted by Avenger at 12:05 PM on April 30, 2008

And, by the way, your fear of having to pee during the night may be waking you up. And, also by the way, unemployment may well be as stressful as anything. So again, I think it's your GF's complaints that are the problem, not anything that you're doing.
posted by JimN2TAW at 12:09 PM on April 30, 2008

(I'm a doctor.) You need to be checked for diabetes. A random, daytime (esp. if fasting) blood sugar test is inadequate to rule it out. A simple & expedient way might be to have your doc give you a couple of urine dipsticks to use at night.

Also, consider obstructive sleep disorder, which may be the most common cause of nocturia. There is no easy way to rule it in or out, but you might start with the Epworth Sleepiness Scale. If you score 8 or more, testing may be warranted.
posted by neuron at 1:42 PM on April 30, 2008

I second BigLankyBastard.
Have you gained alot of weight lately? Do you snore? I had sleep apnea, and was getting up to pee atleast once a night. Once I got a sleep machine, I sleep through the night no matter when or what I drink.

When you sleep, your body should slow unrine output. If you never reach a deep sleep, your body keeps producing urine like you were awake and you have to pee more often.

Daytime sleepiness, heavy snoring or gasping for air are all symptoms. Your girlfriend should watch you sleep a few times and see if you are having problems breathing. Take that info to the Dr. and they can recommend a sleep study.
posted by wrnealis at 3:56 PM on April 30, 2008

Wow, didn't expect to get this many amazing answers for my first Ask MeFi question. Thanks everybody!

The job situation may be getting better (pretty sure I'm getting a good offer tomorrow for a good company) but until I am certain of my employment situation I want to avoid going to the doctor as I haven't opted in to COBRA yet and need to find out how that works if I get new employment but have an existing claim.

Neuron, thanks for the medical info...I'm going to try Atreides suggestion for the next couple of nights while I'm getting job stuff figured out and if that doesn't help at all I'll be sure to make another appointment. I guess in the meantime I can call my doc and see if the blood/pee tests she did when I was last in (Feb or March I think) would have caught anything like diabetes.
posted by Elminster24 at 6:25 PM on April 30, 2008

One: in general, men do have larger bladders and a consequently lower need to frequently urinate than women (not to mention that womens' uteruses lie atop their bladders, increasing pressure). Two: in general, as men age their prostates normally enlarge, frequently resulting in a newfound need to urinate in the middle of the night. Three: in general, this usually doesn't manifest until the thirties or later.

Conclusion: this may or may not be the sign of an important medical condition. If you were older, it would be entirely normal. But you are in your mid-twenties, so it is unusual. You should follow-up on this. However, it's quite likely that eventually—even if it's not until your sixties—you'll be needing to get up and urinate at night. And there's no guarantee that your partner(s) will always be a through-the-night sleeper who never disturbs you. Your youth (and that of some commenters) is showing here in not seeing this is as an example of the sorts of accommodations couples must make with each other when they share a roof and a bed.

It's considerate of you to be concerned about disturbing her—and I wholeheartedly believe that it is the responsibility of the partner who gets up to be as unobtrusive as possible—but the issue about it bothering her really is more about her than it is you, assuming you are being considerately quiet when you get up and do your business.
posted by Dances with Werewolves at 8:51 PM on April 30, 2008

I gave this a little thought, and I think troublesome nocturia at your age is a little unusual. I would probably suggest you have it checked out by another doc, one who will take your complaint a little more seriously.
posted by ikkyu2 at 11:43 PM on April 30, 2008

Seconding the recommendation to consider interstitial cystitis/painful bladder syndrome. This could be a mild case of IC. It is well known that IC is often initially triggered by stressful events, but does not require stress to maintain it.

"When I wake up with the urge to pee, its not like if I don't go I'll wet the bed, however it is uncomfortable enough that I can't continue sleeping."

This is an important fact; mention this to your doctors. This is the difference between overactive bladder and interstitial cystitis. See a urologist; he might recommend urodynamics for you.

Another highly overlapping disease: chronic prostatitis/chronic pelvic pain syndrome.

To alleviate these conditions, you should reduce stress, eliminate dietary triggers, and try various medications that are known to help. A site with good information is ic-network.com.
posted by wireless at 6:34 AM on May 1, 2008