Waking up in the middle of the night with the sudden urge to pee is annoying. You have to climb out of your warm bed and attempt to get to and from the bathroom while in that foggy half-asleep state. And then you just have to hope you can fall back to sleep quickly!There's no question that having to get up to pee at night is bothersome. But is it something to worry about? According to urologists, sometimes it is. Keep reading to learn the most common reasons for having to pee in the middle of the night, when it’s worth seeing a doctor about and what you can do about it.
Is Having to Pee in the Middle of the Night Normal?
If you tend to wake up once during the night to pee, you can rest assured that this is normal. “Most people would consider getting up once during the night normal. But having to get up two or more times [to urinate] may be considered excessive,” says Dr. Christopher Chermansky, MD, a urologist with the University of Pittsburgh Medical Center.
Dr. Chermansky explains that regularly having to get up multiple times during the night to pee is called nocturia. Dr. Maheetha Bharadwaj, MD, a urology resident at the University of Washington Medicine and an MD candidate at Harvard Medical School, says that there are two types of nocturia: urologic nocturia and non-urologic nocturia. She explains that a urologic cause of nocturia means there’s something related to the bladder, prostate or urethra that is causing someone to need to urinate during the night. Non-urologic nocturia is due to a cause outside of the bladder.
For example, Dr. Bharadwaj says that diabetes, drinking a lot of liquid in the evening and eating spicy foods that irritate the bladder are all causes of non-urologic nocturia.
If the cause of frequent nighttime urination is urologic, Dr. Bharadwaj says the next step is identifying if it’s due to incomplete bladder emptying or due to an overactive bladder. She says that not emptying the bladder can happen in men with large prostates. “Naturally, as men age, their prostates grow in size. For some men, the prostate grows so large and constricts the prostatic urethra that it makes it hard for urine to pass through. These men end up not emptying their bladders completely,” she explains.
In both men and women, Dr. Bharadwaj says that bladder weakness can also prevent the bladder from emptying completely. “In these cases, the bladder never empties all the way, and therefore gets fuller, quicker. Subsequently, your bladder will feel the urge to pee more frequently,” she explains, adding that both men and women can also experience an overactive bladder, a condition where the bladder contracts more frequently than usual. This, she shares, can cause someone to feel a strong urge to urinate even though they don’t have a full bladder.
In addition to these reasons related to urologic nocturia, both urologists say there is a wide range of reasons for non-urologic nocturia that could also be causing someone to have to pee at night. Dr. Chermansky explains it may be as straightforward as drinking a lot of liquids in the evening, adding that coffee and alcohol can especially be irritating to the bladder, increasing the likelihood of having to get up in the middle of the night to pee.
What To Do if Getting Up to Pee Is Getting in the Way of Getting Enough Sleep
If you’re only waking up once in the middle of the night to pee and you’re able to fall back asleep pretty quickly, Dr. Chermansky says this isn’t a cause for concern. But if having to get up to pee is preventing you from getting enough sleep, both doctors say it’s worth troubleshooting. After all, getting enough sleep is vital for physical and mental health.
Dr. Bharadwaj says that it’s pretty tricky to pinpoint if the reason for having to pee at night is urological or not. For this reason, the first step both doctors recommend is restricting liquids three hours before you go to bed—especially alcohol. Dr. Bharadwaj also recommends nixing spicy foods since they can irritate the bladder. And you probably do this already, but she says to pee right before you head to bed.
If none of these steps do the trick, that’s when it’s best to book an appointment with your doctor—ideally, a urologist. A doctor can help pinpoint the exact cause and you can work together to find a solution.
“Last but not least, if you are experiencing frequent urge to urinate, even during the night, that is accompanied by a burning sensation while you pee, blood in the urine, pain in your lower belly, with or without fevers and chills, you may have a urinary tract infection or even something more serious, such as bladder cancer,” Dr. Bharadwaj says. For this reason, if you’re experiencing any of these symptoms, she says to go to urgent care right away.
It’s important to get enough sleep at night, so if anything is getting in the way of that, it’s worth figuring out. If you’ve tried restricted liquids in the evening and you’re still waking up to pee frequently, see your doctor. With their help, you’ll sleep sounder—and longer—than before.