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Nocturnal Urination: Some Basic Symptoms and Causes

When you have a good night’s sleep, then it will help you to feel rested and refreshed in the morning. But, when you have a frequent urge to use the bathroom at night, then a good night’s sleep can be hard to achieve. You may have a condition called nocturnal urination if you find yourself waking up to urinate more than twice each night. This is a very common condition for people who are over the age of 60 [1]. Nocturnal urination is not the same condition as the condition called enuresis (it is also known as bedwetting).

Nocturnal Urination
Nocturnal Urination

The bed-wetting is characterized by the inability to control your need to urinate at night. Nocturnal urination usually results in sleep loss, but it can be a symptom of an underlying condition. If you believe that you suffer from nocturnal urination, then you should drink your normal amount of liquid, but do so earlier in the day. You should cut down on any drinks in the last two hours before you go to bed, especially tea, coffee, or alcohol because they are stimulating urine production.

You should keep a diary of how much you drink, what you drink and when. This can help you to identify the situations which can worsen the symptoms of nocturnal urination.

Nocturnal Urination: Symptoms

It is a known fact that most people can get 6 – 8 hours of sleep without the need to urinate. But, nocturnal urination can cause you to get up several times at night to use the bathroom. When nocturnal urination is in its most severe form, then it can cause you to get up 5 – 6 times at night. Some of the most common symptoms of nocturnal urination include feeling the urgent need to urinate, but producing little urine; urinating too frequently, and overproduction of urine.

Nocturnal urination can cause you problems. You cannot feel rested when you are constantly using the bathroom. Also, nocturnal urination can increase the risk of falls and injuries in the elderly. If you think that you have the nocturnal urination, then it is very important to talk with your doctor before you try some medications or home treatments for this condition. Your doctor will evaluate your symptoms and he or she will make you a physical exam to be sure that you suffer from nocturnal urination.

Also, your doctor will ask you important questions to determine the potential cause of this condition. Your doctor can make tests to determine the nocturnal urination, such as urine concentration and urinalysis. If your doctor suspects that the underlying condition is cause for the nocturnal urination, then he will order to make additional tests. Your doctor will help you to choose the right treatment for your condition, so do not risk on your own.


One of the biggest contributing factors to nocturnal urination is aging [1]. As we are getting older, our bodies are producing less of the antidiuretic hormone which can help us to retain fluid. Also, this is resulting in increased urine production, especially at night. Also, the muscles in the bladder can become weak over time, which makes it more difficult to hold urine in the bladder. [2]

But, aging is not the only contributing factor to nocturnal urination. There can be other common causes for nocturnal urination, such as medications that encourage urination (known as diuretics) [3], a bacterial infection in the bladder [4], drinking excess fluids (especially caffeinated and alcoholic ones) [5], and chronic urinary tract infections. Also, women can experience frequent urination due to childbirth or pregnancy. These conditions can weaken the bladder and the pelvic floor muscles.

There are some cases when nocturnal urination is a symptom of an underlying medical condition. Some of the most common diseases and conditions which are associated with frequent urination include enlarged prostate; diabetes; congestive heart failure and chronic kidney failure. In some cases, nocturnal urination can be a symptom of sleep disorders, such as restless leg syndrome, insomnia, or obstructive sleep apnea [6].


[1] Duffy JF, Scheuermaier K, Loughlin KR. Age-related sleep disruption and reduction in the circadian rhythm of urine output: Contribution to Nocturia? Current Aging Science. 2016;9(1):34–43.

[2] Kujubu DA. Chapter 19: Nocturia in elderly persons and nocturnal polyuria. American Society of Nephrology. 2009. Retrieved from

[3] Oelke M, De Wachter S, Drake MJ, et al. A practical approach to the management of nocturia. International Journal of Clinical Practice. 2017;71(11):e13027.

[4] Najar MS, Saldanha CL, Banday KA. Approach to urinary tract infections. Indian Journal of Nephrology. 2009;19(4):129–39. doi:10.4103/0971-4065.59333

[5] Noh JW, Yoo KB, Kim KB, et al. Association between lower urinary tract symptoms and cigarette smoking or alcohol drinking. Translational Andrology and Urology. 2020;9(2):312–21. doi:10.21037/tau.2020.03.07

[6] Raheem OA, Orosco RK, Davidson TM, Lakin C. Clinical predictors of nocturia in the sleep apnea population. Urology Annals. 2014;6(1):31–5. doi:10.4103/0974-7796.127019

Elene Jordanova
Elene Jordanova
Elena Jordanova is a medical researcher from Macedonia with specialization in Internal Medicine


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