Waking up more than twice during the night to urinate is called nocturia. While it can negatively affect your overall well-being, nocturia is actually not a disease or illness. It is the result of another underlying problem that needs to be identified and treated. Memorial Hermann-affiliated urologists are highly trained in finding the cause of nocturia and developing a plan to ease the symptoms.

What is Nocturia?

If you wake frequently (more than twice) during the night to urinate, you are probably suffering from nocturia. Healthy adults should be able to remain asleep for six to eight hours each night without waking to urinate.

Excessive nighttime urination affects both men and women, and can occur at any age. It is more common among older adults. Men over the age of 60 have a high incidence of nocturia, and about 80% of elderly people (over age 75) are affected. 

Nocturia can be caused by sleep disorders, bladder conditions, or even something simple like drinking too much liquid right before bed.

Having to wake to pee can be more than just a hassle. Without quality, uninterrupted sleep you may have difficulty doing the things you need to do during the day. Visiting the bathroom multiple times during the night is not normal and should be evaluated by a physician.

Symptoms of Nocturia

People who suffer from nocturia may show some common symptoms:

  • Waking more than twice during the night to pee
  • Urinating a larger amount than usual each time you go to the bathroom
  • Daytime sleepiness and general fatigue after waking

In addition, nocturia is a common symptom of men with benign hyperplasia (BPH) or enlarged prostate and can be treated with medication or other minimally invasive procedures.

Nocturia is also a common symptom of obstructive sleep apnea.

Causes and Risk Factors of Nocturia

Older adults and people who have underlying conditions that affect urinary function are at a higher risk of developing nocturia.

Frequent urination at night can be caused by diseases of the urinary tract. This can include infections in the bladder, kidneys, ureters (tubes that connect the bladder to the kidneys) or urethra (urine passes through this tube before exiting the body).

Other causes can be divided into three main categories:


This occurs when your body creates too much urine. It is often due to drinking excessive amounts of liquid during the day, or it can be caused by medical conditions like diabetes.

Nocturnal polyuria

If your body makes excessive urine at night, but makes a normal amount of urine during the day, you may have nocturnal polyuria. A common cause is fluid retention in your legs, ankles or feet that may be connected to certain medications. Fluid builds up in your lower extremities during the day, and when you lie down to sleep at night, that fluid travels through your body and contributes to urine production.

Bladder storage disorders

When the bladder cannot store urine appropriately, or cannot release the urine effectively, you may urinate more frequently, in smaller amounts.

How is Nocturia diagnosed?

Nocturia is diagnosed when you have to urinate more than twice during the night, on a regular basis.

To understand your urinary habits, your physician may recommend keeping a record of the liquid you drink and the number of times you urinate. This is called a voiding diary. In some cases, physicians may want to collect a urine sample and have it examined in a laboratory (urinalysis) to check for certain infections.

Treatment for Nocturia

Because nocturia is a sign of another underlying condition, treatment is aimed at reducing symptoms for that specific condition. If the underlying condition is controlled, nocturia should improve or go away.

In addition to treating the underlying condition, your physician may recommend medication to treat your nocturia symptoms. These may include medication to relax the bladder muscles or control bladder spasms, or medication to reduce the amount of urine produced by the kidneys.

Lifestyle changes

Some simple changes in your daily habits can have a big impact on reducing your need to urinate at night. Your physician may recommend these strategies:

  • Reduce the amount of liquid you drink before bed. You should limit all evening beverages, especially those that contain caffeine or alcohol, as they can worsen your symptoms.
  • If you take medication to reduce water retention or swelling (diuretics), be sure to take it in the afternoon instead of at night. This will allow you to urinate more before you go to bed, instead of during the overnight hours.

Scheduling an appointment

We are committed to using a multidisciplinary approach to provide exceptional urological care. Our highly skilled practitioners utilize leading-edge treatments for a full range health concerns.

Memorial Hermann-affiliated primary care physicians or urologists can identify the right treatment to help you get a better night’s sleep. Find a doctor today to schedule an appointment.