Help for excessive nighttime urination?
July 29, 2014 5:46 AM   Subscribe

I would like non-medical suggestions for reducing the number of times I need to get up at night to pee.

NB: I am NOT going to see a doctor and suggestions to do so are very unwelcome. Personal experience and non-medical suggestions are very welcome.

I'm a 41-year-old female. I've always woken from sleep to pee, but in recent months it's gotten ridiculous. I've been logging it lately, and I usually get up 4 times in about 2 hour intervals. Although I return to sleep quickly and sleep a normal amount, it is annoying and I am concerned that it is a factor in my daytime fatigue.

I've researched the possible causes online and I don't think it's any of them.

It does not appear to be a bladder infection. I have no pain or burning and my bladder is really full when I wake, not just irritated.

I have no reason to believe I have sleep apnea. No one has ever heard me snore other than when I have a cold or sinus congestion.

Also no reason to suspect diabetes. I have had blood sugar tests in the past, which were normal. I am not experiencing excessive or increased thirst.

The one pattern I do fit is that I wet the bed when I was a kid, until about the age of 7 or 8, so I gather that I may have had this problem my entire life, though I don't specifically remember how many times I used to wake from sleep to pee when I was young.

I am on no prescription meds.

I have tried limiting fluids in the past, even not drinking after lunch (!) with little result. My body just seems to think that the appropriate time to process fluids is when I am sleeping.

One idea for what has caused the recent worsening of this problem is that I have finally, after many years of having an irregular schedule, buttoned down and made my sleep schedule regular (I go to bed at 10 or so and wake between 6-6:30). Possibly my body got used to producing urine at night because I so often went to bed in the wee hours of the morning. The problem existed but was not as bad when my sleep schedule was irregular and I often ended up sleeping during the day.

I am interested in suggestions for what might be going on, and what might help, particularly from anyone who has experienced this and successfully improved.
posted by mysterious_stranger to Health & Fitness (24 answers total) 8 users marked this as a favorite
Best answer: Well, except for the current age plus or minus part of a decade, you and I sound about the same. Why I learned to do laundry at an early age.

How long have you been sleeping from 10 - 6 now?

Limiting liquids after lunch, for me worked if I staved it off after about 7pm and cutting out alcohol or other depressants completely. And stayed away from "watery" foods like fruit or soups or stews.

Do you have to pee when you get up, or can you hold it, try 'retraining' yourself that way as well? And make a habit of sitting on the toilet before you go to bed and again when you get up, not just because you have to go but to relax your bladder and get used to being there.

I do get up a couple of times a night (I have a sleep tracker and recently had a sleep apnea test, negative, so I'm back on some meds that help my sleep be restful as an off label benefit). I know you mentioned no meds, but what about a sleep aid to see if sleeping through the night by 'force' a bit might get you 'retrained'?

How is your weight (I could lose 80 pounds or so). Have you had children (mine were all c-sections after unproductive labor but over 9 pounds each for all that they came a few weeks early)? Is this all the time or when you are menstruating? I find that when I'm menstruating I get massively constipated and my "sensors" of when I have to go are off - I suddenly have to go quite urgently.
posted by tilde at 5:56 AM on July 29, 2014 [1 favorite]

Best answer: Oddly enough, Buteyko breathing and high intensity interval training (sprinting, elliptical, whatever) cured me of this. If I don't do interval training at least once a week, I start needing to pee at night again. I don't do Buteyko breathing anymore. Also, if I lose too much weight too fast it comes back.

It's got something to do with hormone concentrations in the blood that rise at night. And the kidneys work differently when you exercise regularly in certain ways. YMMV, but for me it was very clear.
posted by zeek321 at 5:56 AM on July 29, 2014 [1 favorite]

Two things that might help you: doing kegel exercises and pressing on your bladder with your fist after you fully urinate and kinda bending forward to make sure you have fully emptied your bladder. These are things they tell women with chronic UTIs to do to help manage the constant need to pee.

You might also try to think about whether you are peeing because you are awake or awake because you need to pee. There are other sleep disorders other than sleep apenea. I don't have a specific one to suggest, but it is something to consider.
posted by OrangeDisk at 5:58 AM on July 29, 2014 [3 favorites]

Best answer: It doesn't matter what I drink or don't drink, I have the same issue and always have. It amps up when I am anxious or if I have gone to bed too early. Try drinking a sleepy time tea before bedtime and getting plenty of exercise and some sunlight during the day. I'm kind of hyper and if I don't get a lot of exercise during the day then I'm not going to get to the deep sleep that keeps me in bed all night long.
posted by myselfasme at 6:26 AM on July 29, 2014 [1 favorite]

Response by poster: Hi, thanks for the feedback thus far. Wanted to answer a few questions and offer a clarification.

The new and improved schedule is only a few weeks old. For a long time I thought it would just revert back to irregular, and I've been pleased that it's stayed consistent (not so pleased at the nocturia, obviously).

I'm peeing a LOT when I get up at night. My bladder is full. It's not that it's irritated or that I am not emptying it when I do use the bathroom. It's that my body seems to want to do all of its daily fluid processing at night. The idea that some kidney-related hormones are out of sync seems quite possible. :-(

I haven't had any kids.

I don't drink alcohol at all, and limit caffeine to the morning.

I am in the process of losing weight, have about 60 lbs until my personal target weight (which in itself is above the "should" BMI, but I'll be ecstatic if I make it).

I started exercising about 7 or 8 months ago in earnest. I do my version of HIIT 2-3 times a week. I also hike and walk frequently (yesterday was a 1 3/4 hour hike). Recently, I have done a decent job of getting natural light during the day, that was one of the things I did to try to get my sleeping schedule normalized.
posted by mysterious_stranger at 6:43 AM on July 29, 2014

Urinals are cheap. They're easy for men to use, but there are female adapters. Go to any surgical equipment store.
posted by KRS at 6:43 AM on July 29, 2014

Best answer: I went through a lot of this while pregnant (in my mid-thirties), and the thing that worked then was to not limit liquids but instead drink loads and loads, right before bed. It sounds counter-intuitive but it made me wake up fairly early on in the night, have a massive pee, and, then, having woken at an hour at which my body was still able to clearly understand 'go back to sleep,' nod back off easily, and not wake again.

Then I did not go back to normal postpartum until an irritable doctor said 'Just don't pee,' and I left irritated at this advice but followed it and... Yeah, it worked; I think it took about six weeks for my bladder to understand the new regime it was under. If you have any ability to fall back asleep without getting up to use the toilet, it could be worth trying, even if it is a bit more hassle to fall back asleep.
posted by kmennie at 6:44 AM on July 29, 2014 [4 favorites]

My wife had this problem. She got thoroughly checked by urologist — no problems could be found. But, he referred her to a sleep specialist; she got tested in a sleep lab; it turned out she had apnea, which wakes you up multiple times in a night, and each time, she would feel like she needed to pee. The difference with you is that in her case, it was just a little bit each time. Once diagnosed and fitted out for a CPAP machine, the problem disappeared immediately. You mention no snoring, but in some cases, apnea happens without snoring. Apnea can be life-threatening it should not be ignored. It is not usually included in possible causes o excessive nighttime urination, but in this case, it was the culprit.
posted by beagle at 6:52 AM on July 29, 2014 [3 favorites]

Best answer: You've addressed caffeine - that's good because the only thing I can contribute is that I saw on Oprah how excessive caffeine can have this effect on women. I guess the next step might be cutting caffeine out for a week (I know - hard!) as an experiment, and seeing if that makes any difference.
posted by joseph conrad is fully awesome at 6:59 AM on July 29, 2014 [1 favorite]

Sometimes this is the only warning your body gives you when your kidneys aren't working properly. That can't be determined without medical tests, though, so I'm not sure what you'll do with the information.
posted by sockermom at 7:22 AM on July 29, 2014 [9 favorites]

Best answer: I'm 37 weeks pregnant so getting up a lot at night. Obviously my root cause is different than yours but I have noticed over the last week or two that I'm getting up ~2 fewer times during the night than I was before...and it's glorious. the reason is two weeks ago I stopped being able to sleep on my back. Now that I'm exclusively on my sides, it seems that I'm able to ignore the urge to purge a lot longer. I keep myself propped on my side by tucking an extra comforter under my back/belly/where ever to keep me in position. While this doesn't address the reason for peeing more, perhaps it'll help.
posted by adorap0621 at 8:06 AM on July 29, 2014

If you would like to further investigate or try to rule out any diabetes issue, the cheapest blood glucose meters at a pharmacy will only cost a few bucks. There are probably ways to get them for free, too; the manufacturers make all their money off of "testing supplies", but a new one usually comes with the strips or cartridges to do several tests.

So, you could see if the times during the day when you have to urinate frequently correspond with a higher blood glucose level versus the rest of the day.
posted by XMLicious at 9:00 AM on July 29, 2014

FWIW, I have noticed a correlation between heightened levels of anxiety and needing to go multiple times a night. It's interesting that others have seen that too! Often I feel that it's not the urge to go that wakes me up, but that once I'm awake, I feel like I need to go. If this resonates with you, is there anyone/thing that might be waking you up? (Partner, pet, neighbor?)
posted by purple_bird at 9:41 AM on July 29, 2014

Best answer: One of my older female coworkers swears by raisins. She is not particulary hippie-ish or woo-woo, either.

I'm not typically a fan of the website I linked but hey! Raisins are good for ya anyway.
posted by leemleem at 11:33 AM on July 29, 2014

Response by poster: Thanks for the useful ideas. I will try eliminating caffeine. I may try the raisin thing, as wacky as that sounds. I may try just not ceding to my body's urge to pee, but I am afraid that might mess up my hard-won sleep schedule if I do. Might try that just once per night on the last go-round at 4 AM or so, when I've slept enough that if I can't back to sleep it won't put me right back on the path to an irregular sleep schedule.

Adora: Good idea, unfortunately I already sleep on my sides (mostly left, but flip back and forth).

KRS: Thanks, but a urinal would not address the fact that I am waking up and that I believe this disruption in sleep may relate to my daytime fatigue.

To reiterate: I don't wake up because of a noise or because of anxiety. I wake up because I have to pee. My bladder is very full and I pee a LOT. I guarantee you after hearing how much I pee you would understand that I have woken up because I need to go.

To those who posted medical suggestions: I don't know how I could have been clearer that this was unwanted. I really resent your violating my explicit request, which is also a violation of Metafilter guidelines. Your answers are derails and I have flagged them as such.

I am especially irked at the suggestion I have Tumors! On my bladder! Oh noes!! If I have tumors on my bladder, they have been there since I was a child and no doctor ever has caught them despite multiple tests for kidney and liver function, and having seen doctors for my bed-wetting as a kid. You don't know my medical history and you are self-righteous and arrogant enough to want to steamroll right over my very clearly worded request for non-medical feedback. If you can't or don't want to answer the question on its own terms, don't answer at all.
posted by mysterious_stranger at 12:55 PM on July 29, 2014 [1 favorite]

You mentioned that you're not taking any prescription drugs, but are you taking any supplements or over-the-counter drugs? Multivitamins and various antihistamines (including pseudoephedrine) have a similar effect on me no matter when I take them during the day.

I also have kidney stones, which have a similar effect: even the slightest bit of kidney gravel -- the pain-free sizes -- can make one feel like they need to pee.

Another less likely factor: melons (including watermelons and canteloupe) can act as diuretics for some folks.
posted by Mo Nickels at 1:27 PM on July 29, 2014 [1 favorite]

Best answer: Tea makes me pee a lot and is a known diuretic - I don't drink it anymore, ever, for this very reason. Coffee isn't a problem for me.

Also, for some reason, corn - but that's more an irritant. Tea is definitely a volume issue.
posted by jrobin276 at 2:31 PM on July 29, 2014

Just take what you want from the answers and leave the rest. Those who reference medical issues are likely actually trying to be helpful or worried about your health, rather than being arrogant or self righteous. Your nighttime urination issue now may not have anything to do with your bedwetting as a child. Kidney function tests don't detect tumors, unfortunately, not that I think that is a likely cause of your problem. Most folks here really do write these answers because they care about helping people, in my experience, even if the answers aren't always the answers the asker wants - I've been that asker so believe me, I feel you. I really think you might find this online presentation about primary nocturia to be relevant to your question, for example, even though it does reference medical issues that could cause the problem. Not saying you have to see a doctor or get testing done - you have the right to make any choice you want about what to do with this information.

I would second Kegel exercises as a good idea - I noticed that you didn't mark that as a best answer, but it's easy, free, and has the potential to help.
posted by treehorn+bunny at 5:13 PM on July 29, 2014 [17 favorites]

Have you ever had a bacteria vaginal infection?

Sometimes when I get them the ONLY symptom is having to pee a lot. And it comes and goes, sometimes I will have to go constantly (and I have the same thing, my bladder would seem to be full when I pee), while later the same day I'm fine.

I did see a urogynocologist, who told me that irritation and infection in the vagina and vulva can cause frequent urination. You might just have irritation and not an infection, but it might be helpful to try to make sure you aren't using any harsh or scented soaps/detergents, wearing only cotton undies, and taking a good probiotic.
posted by inertia at 5:52 PM on July 29, 2014 [1 favorite]

intertia's comment reminds me; any intimate personal items should be cleaned properly after use and replaced as needed.
posted by tilde at 5:31 AM on July 30, 2014

Response by poster: I measured my pee volume last night, btw. 54 ounces. That is not "feeling the need to pee" or "irritation" and 54 ounces doesn't fit in a bladder no matter how many Kegel exercises one does.

posted by mysterious_stranger at 7:31 AM on July 30, 2014

I forgot to ask--how much water do you consume throughout the day? 54 ounces of urine is quite a lot.

Also, you say you're losing weight, are you doing any sort of keto/low-carb diet thing or taking any supplements?
posted by inertia at 8:05 AM on July 30, 2014

Mod note: Comment removed. Asker, it's totally understandable if you're frustrated by the situation you're in, but you need to stop using Ask threads as an opportunity to dress down people answering your question. Skipping answers you don't like is fine, but this is not a place to have an argument.
posted by cortex (staff) at 8:15 AM on July 30, 2014 [2 favorites]

Some people experiencing nocturia wear compression stockings during the day to avoid fluid accumulation in the legs. Sometimes nocturia is gravity-induced. Try this and see if it helps.

Restricting fluid at night does not generally help for nocturnal polyuria, or excessive production of urine at night. So you can and should continue to drink normally.

Limiting alcohol and caffeine can help.

I am not a doctor and this is not medical advice. I hope it resolves soon. It sounds very frustrating and uncomfortable. I'm sorry.
posted by sockermom at 8:21 AM on July 30, 2014 [1 favorite]

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