Waking Up at Night to Pee: Causes to Check Before You Buy a Fix

How common is it?

Very. In a U.S. survey of nearly 9,900 adults, about one in three got up at least twice a night to urinate.¹ Doctors call this nocturia.

Is it always a bladder problem?

• Diabetes: a review of 29 studies found people with diabetes were more likely to have nocturia.²
• High blood pressure: in a survey of 29,505 adults, nocturia was linked with hypertension, and the link grew stronger as nighttime trips increased.³
• Heart disease and death: in the 9,900-person survey, nocturia was linked with higher death rates, including from heart disease, and the risk rose with more trips a night.¹

These surveys show associations, not cause.¹³ But they’re a good reason to treat frequent night trips as something to mention, not just put up with.

What should I track?

A 3-day bladder diary helps a clinician sort out the cause. Write down:

1. What and when you drink, especially in the evening.
2. Each time you urinate, day and night, and roughly how much.
3. Leaks or urgency.
4. When you go to bed and wake up.

Our guide to the bladder diary explains the details.

Is there a pill for it?

Desmopressin reduces urine production. Generic desmopressin tablets are approved for a rare hormone condition and for bedwetting, not specifically for adult nocturia.⁴ In a trial of 190 women with nocturia from making too much urine at night, a low dose let them sleep about 2 hours longer before the first trip, but it didn’t significantly cut the number of nighttime trips compared with placebo.⁵

The label warns that desmopressin can cause low blood sodium, which can be fatal. It calls for limiting fluids, extra caution in older adults, and watching for headache, nausea, confusion and muscle cramps. It isn’t used in people with low sodium or moderate to severe kidney problems.⁴

Who should I see first?

Start with your primary care clinician, who can check blood sugar, blood pressure, kidney function, medicines and sleep. A urologist or urogynecologist can help if the bladder is the main cause. Overactive bladder treatments are covered in our guides to beta-3 agonists and the oxybutynin patch. If you snore or stop breathing in your sleep, ask about sleep apnea testing.

Try: “I’m getting up three times a night to pee. Here’s my bladder diary. Could this be my blood sugar, blood pressure, a medicine or my bladder?”

Laugh, Sneeze, Jump includes an appointment prep sheet. Use it with your bladder diary to show your clinician your nighttime pattern.