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How Often Do You Get Up to Pee at Night?

This woman has to get up to pee every 2 hours. It disrupts her sleep! Does she have "nocturnal polyuria"? Another reader says raisins work!

Do you have to get up to pee several times a night? Many people report that this is a problem, especially as they grow older. Having to urinate several times during the night is a major factor interfering with sleep in older adults (Desjadins et al, Sleep, Feb. 15, 2019). Doctors call it nocturia (“peeing at night”), but they don’t have magical solutions for it. They do recommend drinking less liquid toward the end of the day (Oelke et al, International Journal of Clinical Practice, Nov. 2017). Some readers think that sounds sensible. Others say it isn’t good enough!

Waking Every 2 Hours To Get Up To Pee:

This reader could have a medical condition that gets her up every 2 hours:

Q. I have trouble sleeping more than two hours before having to get up to urinate every night. Is there a remedy? Melatonin pills don’t help, nor does soft music.

Is there a patch that would help me sleep through the entire night instead of getting up every two hours?

A. Sleeping pills or patches may not solve your problem. Getting up every two hours to go to the bathroom suggests a medical condition called nocturia. This condition can be caused by several factors. You will need to consult a physician for a clear diagnosis.

One possibility is “nocturnal polyuria,” an overproduction of urine at night. A healthcare professional will also need to test for a urinary tract infection, diabetes, heart or kidney problems. You may be asked to monitor urine output over 24 hours. If you are over 65 and nighttime production is greater than 33 percent of your daily urine output, that could signal nocturnal polyuria.

One possible treatment for this medical problem is the drug desmopressin (Central European Journal of Urology, Nov. 2, 2020). When dissolved under the tongue an hour before bedtime, this hormone-like medication (Nocdurna) may be helpful. Your doctor will need to monitor your sodium levels very carefully and make sure your kidney function is normal.

Drinking Water All Day Long Means You’ll Have to Get Up to Pee:

Q. We have heard for years that we are supposed to drink eight 8-ounce glasses of water every day. Yet, no one has ever bothered to tackle the other side of that equation. That is 64 ounces of liquid with perhaps many more from other sources throughout the day.

So just how many times am I going to go to the bathroom during the day and night? I don’t think that all this liquid can be eliminated before bedtime. Some inevitably filters through and causes nighttime bathroom jaunts. The doctors and health experts say do this and do that and seldom tell us what to expect after following their advice.

A. There has been a great deal of confusion about the “8 x 8” (eight ounces of water, eight times a day). Some researchers call this recommendation unscientific. Others point out that you get liquid from other sources besides drinking plain water (Nutrients, Oct. 31, 2020).

Older People Should Beware of Dehydration:

Older people may be vulnerable to dehydration if they don’t drink enough fluid, especially during hot weather. While younger people can often rely on thirst to tell them how much water they need, that mechanism starts to fail in the elderly (Physiology & Behavior, Sep. 1, 2017). Since dehydration can be dangerous, we don’t want to discourage people from drinking. On the other hand, your point is pertinent that drinking a lot of water will result in a lot of nighttime trips to the bathroom.

Can You Avoid the Need to Get Up to Pee?

Doctors don’t have a standard approach to this common problem. Occasionally, they may prescribe desmopressin nasal spray, sometimes used to prevent bed-wetting as well.  Several readers have found, however, that eating a small handful of raisins before bedtime can help. Another wonders if spending time with legs elevated might cut down on nighttime bathroom trips.

Does Resting With Your Legs Up Make a Difference?

Q. I watched a documentary about a simple remedy for nighttime urination. It suggested elevating the legs for at least half an hour in the afternoon or early evening. Is there anything to this? It seemed to work for a couple nights but then I wasn’t sure.

A. This is an old-fashioned approach to treating nocturia. A summary in the BMJ (May 1, 2004) recommends compression stockings or taking an afternoon nap with the legs elevated. This reduces the amount of fluid building up in the lower legs. As a result, you shouldn’t have to get up to pee quite so often. We haven’t been able to find any controlled trials of this approach, but it certainly can’t hurt to try it.

Doctors sometimes prescribe diuretics, but taking a water pill too late in the day might actually increase nighttime urination.

Testing the Idea of Putting Your Legs Up:

Q. When I read your idea about elevating the legs to cut down on nighttime trips to the bathroom, I thought it sounded ridiculous. I am a skeptic by nature and home remedies don’t appeal to me.

Then again, I don’t like it when I have to get up to pee three times during the night. So I figured what the heck. It is a low-risk proposition.

I’ve done my own clinical trial on this question now. If I spend an hour or so with my legs elevated before bedtime, I have not had to get up as much during the night. Why does this work?

A. As far as we can tell, there haven’t been scientific studies on this low-cost, low-tech technique. Putting your legs up is supposed to help keep fluid from collecting in them. Compression hose might offer a different means to the same end. Doctors suspect that this allows you to get rid of excess fluid before bedtime rather than overnight.

You can read more about these and other approaches in our eGuide to Favorite Home Remedies. Some readers maintain that eating a handful of raisins before bedtime can help with this problem. Others suggest beets or beet juice to reduce urinary frequency. Here are a few testimonials about these options.

Exercise to Reduce Bathroom Trips:

As men age, they frequently have to get up during the night to urinate as result of prostate enlargement. One study suggested that the most physically active men are less likely to wake up for a bathroom run (Medicine & Science in Sports & Exercise, March 2015).

The analysis included roughly 30,000 men with benign prostatic hypertrophy or BPH. Those who exercised at least an hour a week were 13% less likely to report nighttime urination and 34% less likely to have problems with nighttime urination. Since regular exercise has long been recommended as a way to promote better sleep, this sounds like a no-lose proposition.

Will Raisins Reduce the Number of Times You Get Up to Pee?

Q. I have had nocturia for many years. I tried numerous treatments, including two surgeries. My sleep was frequently interrupted, sometimes five or six times a night. I didn’t know what it would be like to get a good night’s rest.

Nothing helped until I tried eating a handful of raisins before bed.

The first night, I only had to get up to pee one time. The second night I got up one time and last night I didn’t have to get up a single time. I only hope that this continues. Thank you for sharing this inexpensive and safe remedy.

A. We are glad this worked to help you sleep better. We don’t know if the benefit will persist, but you are not the only one to have noticed a difference. One person has compared nights on which he consumes some raisins in the evening and doesn’t need to get out of bed at all to other nights when he skips the raisins and has to trek to the bathroom at least once and usually twice during the night. Here is another visitor’s story:

Making Fewer Bathroom Visits Overnight:

Q. I am going in for simultaneous knee replacements soon. I had to find something to stop the nighttime trips to the bathroom so I don’t fall.

Your idea of eating raisins seems to be working. I eat 10 in the morning and 10 at night and I’ve slept better than I have in years.

Raisins Reduce the Number of Bathroom Visits Needed:

A. We have heard from a surprising number of readers that eating raisins in the evening can reduce bathroom trips at night. We have no idea why this might work.

However, you can read more about this and other remedies for nocturia (excessive nighttime urination) in our Guide to Favorite Home Remedies. Access to this online resource can be purchased at PeoplesPharmacy.com.

Beets May Also Help You Not Get Up to Pee:

Some people report that beets are also helpful for reducing urination at night. That might be because compounds in beets help relax smooth muscle, but we really do not have a scientifically proven explanation. On the other hand, doctors don’t have many effective treatments for nocturia (Dani, Esdaille & Weiss, Nature Reviews. Urology, Oct. 2016). If munching a few raisins or sipping beet soup before bedtime can help, why not try it?

You will also find other ideas on improving sleep in our online Guide to Getting a Good Night’s Sleep.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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Citations
  • Desjardins S et al, "Factors involved in sleep efficiency: a population-based study of community-dwelling elderly persons."
  • Oelke M et al, "A practical approach to the management of nocturia." International Journal of Clinical Practice, Nov. 2017. DOI: 10.1111/ijcp.13027
  • Stookey JD & Kavouras SA, "Water researchers do not have a strategic plan for gathering evidence to inform water intake recommendations to prevent chronic disease." Nutrients, Oct. 31, 2020. DOI: 10.3390/nu12113359
  • Begg DP, "Disturbances of thirst and fluid balance associated with aging." Physiology & Behavior, Sep. 1, 2017. DOI: 10.1016/j.physbeh.2017.03.003
  • Marinovic SP et al, "Managing nocturia." BMJ, May 1, 2004. doi: 10.1136/bmj.328.7447.1063 PMCID: PMC403853
  • Wolin KY et al, "Physical activity and benign prostatic hyperplasia-related outcomes and nocturia." Medicine & Science in Sports & Exercise, March 2015. DOI: 10.1249/MSS.0000000000000444
  • Dani H et al, " Nocturia: aetiology and treatment in adults." Nature Reviews. Urology, Oct. 2016. DOI: 10.1038/nrurol.2016.134
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