10 health concerns that explain why you wake up to pee every night, and when it may be something less serious

• Midnight bathroom trips can disrupt sleep, cause daytime fatigue, and affect your health over time.
• Nocturia has many different causes, so it's essential to pay attention to other health symptoms.

You're tucked into bed, sound asleep and enjoying sweet dreams, when you wake with a pressing urge to pee — for the second time that night.

If you have to urinate in the night, you have nocturia, says Dr. Jeffrey Weiss, board-certified urologist, and professor of urology at SUNY Downstate University. It doesn't matter why you have to pee, or the number of times you get up.

In the United States, about 50 million people live with nocturia. Roughly one in three adults above the age of 30, and about half of all adults older than 60, wake up at least once per night to pee.

Nocturia doesn't just disrupt your own sleep, it can disturb anyone you sleep with — making it tough for either of you to get the rest you need. This lack of sleep can then have a number of consequences, from daytime drowsiness and difficulty focusing at work to accidents, falls, and other sleep deprivation issues.

Read on to learn more about nocturia's causes — from drinking too much liquid before bed to underlying health conditions — potential consequences, and treatments.

Causes of nocturia

Factors that may contribute to nocturia include:

• Age: As you get older, you're more likely to wake up at night for a trip to the bathroom. This happens due to natural bodily changes related to the aging process.
• Pregnancy: During pregnancy, your uterus grows and presses against your bladder, reducing its ability to hold large volumes of urine. As a result, you're likely to pee more frequently during pregnancy, both day and night. Current research suggests about 56% of pregnant people experience nocturia.
• When — and what — you eat and drink: If you eat or drink large amounts of food or fluids close to bedtime, you will make more urine at night. Drinks containing alcohol or caffeine are more likely to make you pee, as are salty or watery foods like soups and fruits.
• Medication: Some drugs can increase the amount of urine you make, increasing your bathroom trips at night. Examples include diuretics, lithium, antidepressants, phenytoin, and cardiac glycosides.
• Difficulty storing urine: Overactive bladder and other conditions that affect your bladder's ability to store urine can increase the number of times you pee at night.
• Trained behavior: If you have a habit of waking up at night to pee, that could affect your sleep — leading you to wake up even when your bladder isn't full.
• Physical inactivity: A small study involving 35 older women linked a sedentary lifestyle with low levels of physical activity to an increased need to pee at night.

Nocturia can also happen as a symptom of many different health conditions, including:

1. Urinary tract infections (UTIs)

When bacteria get trapped in your urinary tract, you may develop a UTI, which can cause frequent urination at night and during the day.

Other common UTI symptoms include:

• A constant urge to urinate, even if you've just gone
• Pain while peeing
• Cloudy or discolored urine
• Fever

2. Type 2 diabetes

Diabetes causes high blood sugar. The excess sugar is removed in your urine and draws more fluid from your body, making more urine than normal.

Other signs of unmanaged diabetes include:

• Extreme hunger
• Increased thirst
• Sudden weight changes

3. Sleep disorders

Conditions like sleep apnea and insomnia can make it harder to fall asleep and stay asleep. If you're lying awake in bed, you may feel the need to make a bathroom trip — even if your bladder isn't full.

High blood pressure

Experts have linked high blood pressure with getting up to pee at night.

High blood pressure often causes no symptoms, but you may also experience:

• Headaches
• Ringing in your ears
• Blurred vision

Note: Uncontrolled high blood pressure can cause stroke and sudden death, so it's important to get treatment right away for these symptoms.

4. Bladder diseases

Any conditions that cause changes in your bladder function can lead to nocturia.

Examples include:

• Overactive bladder
• Bladder infections
• Bladder obstruction
• Bladder cancer

5. Venous insufficiency

If your veins don't function as they should, blood will collect in them instead of returning to your bloodstream. When you lie down, the blood returns to your bloodstream, increasing urine production.

Other symptoms include:

• Swollen legs
• Skin discoloration
• Wounds on your legs

6. Congestive heart failure

With this type of heart disease, your heart can't pump blood efficiently, causing blood to pool in parts of your body.

At night, your body tries to improve your circulation as you rest, which may lead to frequent urination.

Other symptoms of heart failure include swollen legs and fatigue.

7. Prostate diseases

Health conditions that affect your prostate can make it harder to empty your bladder fully. These conditions include prostatitis, enlarged prostate, and prostate cancer.

Common symptoms of prostate issues include:

• Straining to pee
• Feeling like you can't hold your urine
• Dribbling when you pee

8. Pelvic organ prolapse

Your pelvic muscles and ligaments can weaken due to age, childbirth, or connective tissue disease.

As a result, organs like your uterus and bladder may slip out of place. This can make it harder for you to empty your bladder, causing frequent urination.

Other symptoms may include:

• Feeling your uterus bulge from your vagina
• Urine leaks
• Heaviness in your groin

9. Obesity

If you have obesity, you may make more frequent bathroom trips during the night.

Some research suggests this may happen due to:

• Increased urine production
• Increased pressure in your abdomen
• Nighttime eating and drinking

10. Depression

If you have depression, you may be more likely to wake up to pee at night.

But having nocturia may also increase your chances of developing depression symptoms — which may relate to the effects of disrupted sleep on your mood.

How to get a diagnosis

If you frequently wake up to pee at night, a good next step involves reaching out to a healthcare professional.

To help determine whether your nocturia may relate to an underlying illness, your doctor will ask some questions, such as:

• How long have you experienced this symptom?
• What do you drink in the evenings?
• How much do you drink each day, and when?
• Do you pee a lot or just a little?
• Do you feel pain or a burning sensation when you pee?
• Do you take any medications?
• Have you recently changed your diet?
• Do you ever wake up wet?
• What other symptoms do you have?
• What treatments have you tried?

They may also ask you to keep a bladder diary. This record of your sleep, urine, fluid intake, and current medications can help you notice things that trigger symptoms — and how your symptoms affect your sleep and daily life.

Your doctor will typically also conduct a physical exam to check your:

• Blood pressure
• Heart and lung function
• Nervous system function
• Legs and abdomen for signs of swelling or tenderness

They may also recommend specific tests to detect any underlying conditions. Examples of these tests include:

• Blood tests: A blood test can help your care team detect conditions like diabetes, kidney disease, and infections.
• Urinalysis and urine culture: These tests help detect abnormalities in your urine and identify any bacteria present so your doctor can prescribe antibiotics to treat them.
• Cystoscopy: This test involves looking into your bladder with a small camera to identify signs of disease.
• Bladder scan: This test involves an ultrasound to check how well your bladder holds urine when it's full and whether you can empty it completely.
• Urodynamic testing: This series of tests can measure your lower urinary tract function, including any leaks, nerve damage, and obstructions to urine flow.

Treatment

Waking up at night to pee repeatedly can lead to a number of unwanted effects, including falls, traffic accidents, and difficulty concentrating at work or school.

Experts have also found a link between nocturia and increased risk of poor health and higher death rates.

That's why it's a good idea to get prompt treatment for nocturia.

Treatment generally begins with pinpointing the cause or triggers — since identifying and addressing the underlying cause may relieve your symptoms without the need for additional treatments, according to Dr. Fenwa Milhouse, a board-certified urologist in Chicago.

The right treatment for you may depend on why you have to pee so much — but treatment will generally aim to reduce your symptoms, address any underlying conditions, and improve the quality of your sleep.

Common treatment options include:

Medication

Your doctor may prescribe:

• Diuretics: Medications like furosemide and spironolactone can help regulate your blood pressure and the way your body produces urine, so you pee less at night.
• Topical vaginal estrogen: This medication may help improve nocturia that happens after menopause.
• Botox injections: If your overactive bladder doesn't respond to other medications, Botox injections may help ease your symptoms.
• Hormones: Drugs like desmopressin and vasopressin act like hormones naturally produced by your body, and they may help your body make less urine at night.
• Anti-spasmodics: Medications like darifenacin, oxybutynin, and tolterodine can help reduce spasms in your bladder and may help treat overactive bladder symptoms, including nighttime urination.
• Alpha blockers: Drugs like prazosin and doxazosin can help reduce the urge to pee at night, especially for men.

Your care team may also prescribe medications to help treat any underlying conditions, such as diabetes, high blood pressure, heart failure, or any infections. Treating these conditions can help reduce nighttime urination.

Important: If you believe one of your current medications is causing your nocturia, let your doctor know. They may recommend switching to another medication or changing your dose.

Lifestyle changes

Before you make an appointment with a doctor, you might consider a few modifications that could reduce how often you pee at night, Weiss says.

Changes that may help reduce your symptoms — or help you adjust to them — include:

• A last bathroom trip before bed: If you empty your bladder before you sleep, you're less likely to pee during the night.
• Limiting drinking, especially in the evening hours: Limiting your consumption of liquid or water-rich foods in the evenings can decrease the amount of urine you make, thus reducing your need to pee at night.
• Limiting salt in your diet: A high salt intake can make you pee more at night. The World Health Organization (WHO) recommends consuming no more than 5 grams (g) a day, or just under a teaspoon, to ease nocturia.
• Exercising regularly: If you can, aim for 150 minutes of exercise a week. Exercise has many potential health benefits, including helping cut down on nighttime urination.
• Managing your medication: Aim to take any medications that cause increased urination at least six hours before bedtime.
• Relieving fluid buildup in your legs: If you have swollen feet, try elevating them or using compression socks to help fluid return to your bloodstream. This may help reduce nighttime bathroom trips.
• Taking brief naps: Brief naps can help you feel more rested if your sleep is regularly disrupted. Just keep in mind that taking long or frequent naps can compound the problem by making it harder to sleep well at night.
• Improving sleep habits: Improving your sleep hygiene could help lower your chances of waking up at night. A few helpful changes include sleeping at a set time each night, avoiding electronic devices at bedtime, turning down the thermostat, and using blackout curtains.
• Consider Kegels and pelvic floor muscle training: If your nocturia is associated with weakness in your pelvic floor, you may benefit from exercises that strengthen those muscles, such as Kegel exercises.
• Reduce your fall risk: Using a bedpan, opting for low-level lighting in your bedroom and hallway, and removing rugs or obstacles that can trip you can lower your risk of falling during nighttime bathroom trips.

Insider's takeaway

Nocturia can disturb your sleep — but it can also increase your risk of work and traffic accidents, falls, and poor health overall.

But there's a lot you can do to address nocturia on your own, including limiting fluids at night, getting regular physical activity, and improving your sleep habits.

If these changes don't seem to make any difference, it may be time to reach out to your doctor. A healthcare professional can help you determine if your need to pee during the night stems from an underlying health condition or natural changes in your body. They can also offer more guidance on steps to ease your symptoms.