Why You’re Always Waking Up to Pee—and How to Make It Stop

Getting a good night’s sleep is hard enough without getting up to pee every hour.

Called “nocturia,” having to go during the night is actually incredibly common—and according to research in The Journal of Urology it happens more often to women than men. In fact, the research found that up to 44 percent of women ages 20 to 40 get up to pee at least once a night, while up to 18 percent pee at least twice a night.

“But just because something is common doesn’t mean it’s normal,” says Lauren Streicher, M.D., a clinical associate professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine and author of Sex Rx. That’s because not only is having to pee during the night super annoying, but by interfering with the quality of your sleep, it can zap your energy levels, smarts, and overall health. Plus, it could be a symptom of an underlying health problem.

Do You Really Have to Go?
Okay, we’re sure your immediate answer is an emphatic yes, but think about it for a minute. Oftentimes, women who pee frequently during the night aren’t actually waking up because they need to go, says Streicher. (Your brain actually has a mechanism that works to keep you from having to interrupt your sleep to pee.) Oftentimes, women just wake up during the night and figure they might as well go while they are up. If that’s you, insomnia may be a bigger issue than bladder control, she says.

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On the flip side, if you are actually doing the pee-pee dance in your dreams, how much are you letting out when you get up to go? If you only have a few little tinkles to give, you may be suffering from overactive bladder, she says.

Meanwhile, if your bladder is filled to the brim, you may be taking in too many liquids—including diuretics like caffeine and alcohol—close to bedtime. “Drinking caffeinated beverages in the afternoon and afterward, as well as alcohol intake prior to bedtime, is typically discouraged because it can interfere with your sleep,” says Eric A. Serrano, M.D., an internal medicine physician with MDVIP, a network of physicians. This can make you think you woke up because you need to relieve yourself—even if that’s not really the case. “Also, caffeine may trigger overactive bladder, which can lead to the need to urinate frequently during the day and night,” says Serrano.

He recommends cutting back on your fluid intake after 6 p.m. and limiting any caffeine intake to the morning. However, he notes that, in general, people who suffer from nocturnia generally have multiple underlying factors, so switching up your fluid intake may not be enough to help you make it ’til morning.

Is Your Middle-of-the-Night Peeing a Bigger Issue?
The list of conditions that can contribute to frequent urination—including during the night—are endless. But the big ones include diabetes that’s either new or poorly controlled and heart disease, says Serrano. Gestational diabetes also counts.

Any condition that alters the anatomy of the urinary tract, such as a prolapsed uterus, can play a role, too. So can other down-there issues, including urinary tract infections and pelvic inflammatory disease, says Serrano. Interstitial cystitis, an inflammation that occurs in the lining of bladder, can also cause frequent urination, but its intense pain is usually what brings people to the doctor for it, says Streicher. Some medications can also increase your need to go.

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And pretty much every woman could get some bladder benefits from strengthening their pelvic floor muscles, which contribute both to holding it and emptying your bladder when it’s full, says Benjamin Brucker, M.D., assistant professor of urology and obstetrics and gynecology at NYU Langone Medical Center. He notes that some women relieve their nocturnia through physical therapy exercises such as kegels that are aimed at strengthening the pelvic floor muscles.

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If you’re consistently getting up to pee more than one or two times during the night, Brucker recommends talking to your doctor. To prepare for your appointment, keep a diary detailing at least 24 to 48 hours of your symptoms, fluid intake, and bathroom schedule, says Serrano. If a simple exam and blood test don’t reveal the culprit, she may refer you to a urologist or urogynecologist who can help put your pee-pee problems to bed for good.

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