Updated: Feb 9
A healthy young bladder should let you sleep for six to eight hours without demanding to be emptied.
With age, two things happen:
1. We produce less of a hormone that slows urine production during the night.
2. Our bladder gets less stretchy.
If you are 70 and you get up to the toilet once or twice every night, that might be normal for you. Getting the most good sleep you can is important, so you should still aim for as little overnight disturbance as you can - there are tips below that can help regardless of age and what’s ‘normal’.
There are some health conditions that can increase nocturia – diabetes, sleep apnoea and heart conditions are prime candidates. Actively managing those conditions can have the side effect of letting you sleep longer without needing to empty your bladder.
Why worry about how many times you get up? Because sleep is really important to your mood, your energy levels, your immune system, your brain health, and your general wellbeing.
And because getting up in the night leads to tripping over things in the dark. This is no joke. Going to the toilet in the night is a major, common cause of falls and injuries. I don't want to scare-monger here, but really it is best everyone to avoid these toilet trips if they can. Not just people who use walking aids, but everyone - even those who are fit and mobile.
Here are five things to consider that may reduce your need to empty your bladder when you should be getting your beauty sleep instead.
If you have swelling (often of the lower legs) that goes down overnight, then that fluid has to go somewhere. Where it goes, as you might have guessed, is your bladder. And of course you DO want that fluid out of your legs (or whatever other area), so that process is important! The simplest option for improving sleep is to try to get a head start on the process before bedtime.
Try to get some fluid moving before you go to sleep by spending time sitting or lying with your feet elevated, and do some gentle movement of your feet while they are up. You can do this in front of the TV, just try to get your feet as high as you can (perhaps add a pillow to your footrest) and your heart as low as you can (recline your chair). Maybe you could raise the TV up so you can still see it when you are lying back!
Most people already sit in front of the TV for a while before bed, but don’t brush this off without seriously considering it. Are you elevating your feet (or arm as the case may be) as much as you could? Are you lowering your torso as much as you could? Are you gently moving, flexing, rotating the swollen region so that muscle movement helps shift the fluid? You need to do that over and over again, not just for ten seconds when you first sit down. (This is much easier to do once it becomes a habit - it can seem very annoying at first!)
If you are on medication to reduce your fluid retention (or any medication with the side effect of making you pee more), don’t change anything without talking to your doctor or pharmacist. But if you are taking the tablets at night, they will be making you pee a lot at night. Many people are allowed to change to taking them earlier in the day, so the extra urine is made earlier and you get to sleep better.
Everybody has a different sensitivity to caffeine, so there is no clear rule. There has been loads of research into the effects of caffeine, but a lot of the ‘results’ are fairly loosely interpreted by people who love coffee. We know it can effect our bodies, making us need the toilet sooner and more frequently, for as long as six hours after we consume it.
Caffeine is in coffee and tea, and in chocolate and some soft drinks. Green tea has similar caffeine to black tea, which surprises some people! Consider putting an early afternoon curfew on your caffeine. (It would be best to try this for a couple of weeks, since we are creatures of habit and at first we will probably wake and get up to the loo just because we are used to doing it.)
Alcohol definitely causes increased urination, and alcohol can be detected in your system even longer than caffeine, but there isn’t as much research on whether it effects your bladder for all of the time that it’s in your system. (Dare I suggest that there is far more research into caffeine because of the number of caffeine-addicts working in research.) All science can currently generalise is that the less alcohol you drink, the happier your bladder will be.
Stay hydrated on a schedule
It takes about 3 hours to process a drink of water - in one end and out the other.
You can safely drink during the day, and stay hydrated. Once you are within three hours of bed-time, reduce your fluid intake to smaller amounts. Take sips to keep comfortable, but avoid whole glasses of water or the traditional mugs of warm milk.
This ‘staying hydrated’ has a two-part effect.
Getting plenty of fluids during the day will result in your bladder being less irritable, so it will happily hold a little more for a little longer.
Reducing fluids for just the last three hours before bed will result in less filling of the bladder during the night.
Are you getting the urge to pee at night, but none of the tips mentioned above seem to address your situation? You may have Urinary Urgency rather than Nocturia. Check out 8 Ways to Reduce Bladder Urgency for some tips that might help you.
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