Last updated: April 2023
Going to the bathroom is one of those inevitable things in life. A shared human experience. But it’s really, really, really annoying when an urgent need to go wakes you from a deep sleep.
For those of us who struggle with insomnia, after hours of finally getting to sleep, to wake a short time later with an urgent bladder call is very frustrating. Particularly if it happens more than once.
4 types of night-time urination
There is a name for frequent night-time urination – nocturia, from the Latin ‘Nox’ (night) and ‘Uria’ (urination). And it can have an enormous impact on sleep quality and duration. Normal hormone fluctuations cause our urine output to decrease and become more concentrated overnight, hopefully reducing the need to wake for the toilet. This process is disrupted with nocturia.
There are 4 types of nocturia:1
- Polyuria: when your body makes too much urine in a 24-hour period
- Nocturnal polyuria: when your body makes too much urine during the night
- Bladder storage problems: when your bladder doesn't store or release urine well
- Mixed nocturia: when more than 1 of these problems are happening
A single trip to the bathroom causes hours of wakefulness
While I am sure that all of these are disruptive to anyone impacted, the reality for insomniacs is that a single trip to the bathroom can mean hours of wakefulness. And when sleep finally descends, the bladder call can interrupt sleep soon after.
By the time we reach the age of 30, approximately a third of us are having issues in the wee hours, and as we age, that number increases. It may be caused by a lifestyle habit or an underlying health problem.1
What causes nocturia?
There is a big, long list of potential reasons for nocturia.1
- Lifestyle habits might include drinking too much fluid before bed, too much alcohol or caffeine, a behavioural pattern whereby you’ve trained your body to go to the bathroom during the night, timing and/or dosage of medications.
- Sleep disorders such as restless legs syndrome, insomnia, and sleep apnoea can lead to frequent bathroom trips. Insomnia can be a result of frequent bathroom breaks, or frequent bathroom breaks can lead to insomnia.
- Nocturia may also be a result of underlying health conditions such as diabetes, high blood pressure, cardiac disease, bladder or prostate obstruction, enlarged prostate, overactive bladder, vaginal or pelvic prolapse, menopause, oedema, interstitial cystitis, or nocturnal polyuria (overproduction of urine during the night).
How I solved my night-time bathroom break problem
Frequent trips to the bathroom used to be a major issue for me. I effectively had bladder storage problems, which came from an overactive bladder, a sudden, uncontrolled need or urge to urinate.2
After years of frequent and urgent toilet stops, I finally decided to mention it to my doctor. She put me onto a very low dose of oxybutynin, and half a little blue pill each night has changed my life. I am no longer the person who knows the location of every public toilet in every location I ever visit. And I almost never wake to go to the bathroom during the night.
Talk to your doctor
If frequent night-time urination is impacting you, it is worth having a conversation with a doctor. You may be asked to keep a bladder diary to track fluid and dietary intake along with bathroom breaks. This information can be used to assess lifestyle considerations and potentially retrain your bladder to sleep through the night. While hydration is very important for all of us, it makes sense to drink more during the day and less at night.
A physiotherapist can sometimes assist with bladder retraining. And of course, the trip to the doctor is always important to rule out other medical conditions.
Bathroom breaks are something we take for granted in life, but when frequency and timing impact the quality of your sleep, it could be time to mention bladder habits to your doctor. Any little thing that improves the quality and duration of sleep is worth its weight in gold.
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