Urinating frequently at night is fairly common, with 1 in 3 adults over 30 making at least two trips to the loo each night¹. Nonetheless, an overactive bladder at night, known in medical circles as nocturia, can be bothersome, particularly if it’s preventing you from getting sleep. So, we’ve gathered all the facts and our top tips for managing this issue.

What constitutes an overactive bladder at night?

Technically speaking, an overactive bladder at night means getting up at least once a night to urinate². However, by this definition, most people experience this condition to some extent. Therefore, it’s generally considered a “problem” when you’re getting up two times a night or more to go to the toilet and/or have difficulty getting back to sleep.³

Nocturia differs from bedwetting (also known as nocturnal enuresis), which typically involves the involuntary passing of urine⁴ and is more common in children⁵.

What can cause nocturia?

While an overactive bladder at night is most common in adults aged 60 years and older, it can occur at any age. It can be caused by a variety of things from lifestyle factors to more serious medical conditions, ⁶ including:

• drinking a lot of fluids, particularly drinks with caffeine in them or alcohol
• eating a lot of salt
• certain medications and supplements⁷
• behavioural patterns (i.e. you’ve trained yourself to need to pee at night)⁸
• untreated diabetes
• swelling in your legs (also known as oedema)⁹, as the fluid retained in the lower body needs to go somewhere¹⁰
• sleeping disorders, such as sleep apnoea (where breathing is interrupted while you sleep)
• bladder obstruction
• urinary tract infections (or UTIs)¹¹
• pregnancy
• obesity
• bladder infections
• menopause
• kidneys problems, such as stones¹²
• restless leg syndrome
• decreased bladder capacity
• vaginal or pelvic floor issues      
• nocturnal polyuria (where your bladder produces too much wee at night).¹³

How can you manage an overactive bladder at night?

While unpleasant, an overactive bladder at night is controllable. Tips for managing the symptoms of nocturia vary from home remedies and lifestyle changes to medical interventions (which should be guided by a doctor). When initially seeking advice from a medical professional, it can be useful to keep a voiding diary beforehand. This is a record of how much liquid you drink and how often you go to the toilet, which can help a doctor diagnose your issue. It may also include:

• how much wee comes out when you go to the loo
• which medications you take
• UTI symptoms
• other symptoms, such as fatigue.¹⁴

Medical interventions

Should your doctor recommend it, there are various medical treatments for an overactive bladder at night, including:

• removing or reducing any regular medications that can worsen symptoms of an overactive bladder (under the direction of your healthcare provider)
• treatments for prostate problems, such as surgery
• medications to relax your bladder, if you experience urge incontinence
• anti-diuretic hormone (ADH), which helps to regulate water balance in the body¹⁵
• medicines to block particular nerve impulses to the bladder that tell it to contract when it shouldn’t¹⁶.

However, it’s unlikely that medication alone will completely remove all symptoms, so you might wish to try changing some lifestyle factors¹⁷.

Home remedies and lifestyle changes

In addition to medical options, you could consider changes to your day-to-day life to improve your nightly urges to go to the loo. These include:

• limiting how much your drink right before bed
• avoid certain foods and drinks that can irritate your bladder, including:
  • caffeine
  • alcohol
  • citrus juices and cranberry juice (though this can be useful for other bladder issues)
  • spicy foods
  • acidic foods, such as tomatoes
  • chocolate
  • artificial sweeteners
• double-void before sleep; this means going for a second wee before you get into bed, even if you don’t need to
• pelvic floor exercises¹⁸
• if you experience swelling in your legs, make sure to elevate them during the day or wear support stockings
• improve sleep hygiene by making your bedroom the right temperature and dark enough¹⁹
• quit smoking, as this can cause frequent urination²⁰.

In addition, appropriate continence products, such as iD Pants Maxi, can help capture any leaks. These unisex comfortable and discreet incontinence pants have odour control and are super absorbent, meaning you can put concerns of overnight leaks to bed.

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Sources

¹ “How to Treat an Overactive Bladder at Night”, Mary Ellen Ellis, 17 September 2018, Source: https://www.healthline.com/health/overactive-bladder/overactive-bladder-night
² “Nocturia or Frequent Urination at Night”, Eric Suni, 11 March 2022, Source: https://www.sleepfoundation.org/physical-health/nocturia-or-frequent-unrination-night
³ Ibid.
⁴ Ibid.
⁵ “Bedwetting in children”, NHS, 27 April 2020, Source: https://www.nhs.uk/conditions/bedwetting/
⁶ “How to treat an overactive bladder at night”, Jon Johnson, 22 December 2020, Source: https://www.medicalnewstoday.com/articles/316869
⁷ “Nocturia”, Cleveland Clinic medical professional, 1 June 2020, Source: https://my.clevelandclinic.org/health/diseases/14510-nocturia
⁸ “What is Nocturia?”, Urology Care Foundation, n.d., Source: https://www.urologyhealth.org/urology-a-z/n/nocturia
⁹ “Nocturia”, Cleveland Clinic medical professional, 1 June 2020, Source: https://my.clevelandclinic.org/health/diseases/14510-nocturia
¹⁰ “Warning: Here’s Why Waking Up To Urinate At Night Is NOT Always Normal!”, Times of India, 7 December 2017, Source: https://timesofindia.indiatimes.com/life-style/health-fitness/photo-stories/warning-waking-up-to-pee-at-night-is-not-always-normal/photostory/61942025.cms
¹¹ “Nocturia”, Cleveland Clinic medical professional, 1 June 2020, Source: https://my.clevelandclinic.org/health/diseases/14510-nocturia
¹² “How to treat an overactive bladder at night”, Jon Johnson, 22 December 2020, Source: https://www.medicalnewstoday.com/articles/316869
¹³ “What is Nocturia?”, Urology Care Foundation, n.d., Source: https://www.urologyhealth.org/urology-a-z/n/nocturia
¹⁴ “How to Treat an Overactive Bladder at Night”, Mary Ellen Ellis, 17 September 2018, Source: https://www.healthline.com/health/overactive-bladder/overactive-bladder-night
¹⁵ “Nocturia”, West Suffolk NHS Foundation Trust, n.d., Source: https://www.wsh.nhs.uk/CMS-Documents/Patient-leaflets/Gynaecology/6497-1-Nocturia-getting-up-at-night-to-pass-urine.pdf
¹⁶ “Overactive bladder syndrome (OAB)”, North Bristol NHS Trust, March 2018, Source: https://www.nbt.nhs.uk/sites/default/files/attachments/Overactive%20bladder%20syndrome_NBT002734.pdf
¹⁷ Ibid.
¹⁸ “Putting an Overactive Bladder to Bed”, Gina Shaw, 11 July 2013, Source: https://www.webmd.com/urinary-incontinence-oab/features/putting-an-overactive-bladder-to-bed
¹⁹ “Nocturia”, West Suffolk NHS Foundation Trust, n.d., Source: https://www.wsh.nhs.uk/CMS-Documents/Patient-leaflets/Gynaecology/6497-1-Nocturia-getting-up-at-night-to-pass-urine.pdf
²⁰ “7 Urologic Conditions Impacted by Smoking”, Urology Care Foundation, 17 March 2018, Source: https://www.urologyhealth.org/healthy-living/care-blog/2018/7-urologic-conditions-impacted-by-smoking