Urge To Urinate In The Middle of the Night: Expert Urologist Explains
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- čas přidán 5. 11. 2012
- Dr. Blaivas explains that getting up in the middle of the night to urinate is called nocturia. Reasons for nocturia include the bladder not holding enough to allow the patient to sleep through the night, and the patient's kidney potentially making more urine than the bladder can hold. Nocturnal polyuria is when too much urine is produced overnight, therefore causing the patient to get up in the middle of the night to urinate.
Jerry Blaivas, MD: Getting up in the middle of the night to urinate is called nocturia. Nocturia is very very common, in fact most people get up once or twice at night to urinate starting in the teenage years even.
If you think about it, there is only two possible reasons why someone would get up in the middle of the night to urinate. One is that their bladder does not comfortably hold enough to allow them to sleep through the night, and, two, you make more urine, that it is to say your kidney is making more urine then your bladder cannot comfortably hold overnight.
The second condition, we called nocturnal polyuria. The nocturnal means nighttime and poly means too much and uria means urine. So nocturnal polyuria means that you make too much urine overnight and that is probably the commonest cause of nocturia.
The most common cause of that even is just drinking too much before you go to sleep. So if you have a couple of beers or you have wine before dinner and then you take a glass of water with some pills, all of that fluid that you ingest will then overnight be converted by the kidneys to urine and then if you make more urine overnight than your bladder can hold, then of course you have to get up to urinate.
So nocturnal polyuria is the commonest cause and the other cause, the bladder not holding enough urine, has many many many causes. Probably the most common one is, temporary problem is, urinary tract infection. It can be caused by blockages by the prostate. It can be caused by bladder cancer, by all kinds of other irritable kind of conditions so thinking back then we have these two different causes, making too much urine at night or the bladder not holding enough at night. So, then what to do about it.
Well the first thing you need to do about it is to diagnose it. How do we diagnose it? Very - very simply! We have you keep a bladder diary, that is to say you record the time and amount of urine, time and amount of each urination that you make in a 24-hour period, then we simply see how much you urinate at night, how much you urinate for the 24-hours and through some mathematical formula, we can figure out if you are making too much urine at night.
Generally, people make less than a third of their urine during sleep hours. If you make more than that then you have this nocturnal polyuria and we look for the causes of that. I briefly alluded to what they were in the beginning but now to get more complete, the most common cause is simply drinking too much.
Probably the second most common cause is people that take medications at night that can have a diuretic like effect. Another cause is anything that causes your legs to swell up, so people with varicose veins or from prior surgery, if your leg swell up during the day that the swelling is actually fluid and when you lie down at night, your body resorbs that fluid, that fluid gets into your system and the kidneys make more urine.
Another common cause is something called sleep apnea, people who snore, best diagnosed by going to a sleep lab and if you have sleep apnea, then that is what causes the problem and the treatment of the sleep apnea is the problem.
The bladders that do not hold enough urine, again we first determine that by the bladder diary and then we look for the common causes, common causes of urinary tract infection, prostatic obstruction, dropped bladder in women, overactive bladder, sometimes bladder cancer, bladder stones, no matter what they cause though, once the diagnosis is clearly understood then treatment of the underlying condition that is causing the nocturia is very often effective, it is usually effective.
However, just having nocturia, just getting up at night to urinate by itself does not demand any treatment.
So if you get up once or twice at night or three times and you are not bothered by it, there is no need for any treatment at all. If there is a need for treatment, if you are bothered by it, rest assured there just about always an effective treatment.
Learn more about Dr. Blaivas: www.urologysite.com/Meet_Our_D...
Of course it does bother you to get up twice or more during the night---particularly when you are old--and for a very small quantity which is often one tenth of what one could hold when up during the day;most common case.
When you finally wake up in the morning, you are far from fresh and energetic due to sleep interruptions.
Thank you, Doctor. Your Explanation is very helpful and has helped me not to get worried about Unwanted fear about urinating at night.
Thanks, wonderful, to the point and helpful video.
Thank you. Very informative.
Bless you Dr Jerry thank you for this lesson.
Thankyou for your expertise and coverage in explaining so clearly this common topic.
Thankyou, lots of information. God bless 😊
The most common cause is 'experts' telling us to carry a bottle of water around with us all day and keep drinking from it, to keep hydrated. Very fashionable, but guaranteed to keep you peeing all day and all night!
You better hydrate or else; particularly in Hot weather places like TEXAS.
This can be " The Very Best Thing " !
@@crayfish7542 6
;0m
Yes, peeing all day and all night. I always bring with me a bottle of water wherever I go. If I am dehydrated I got migraine. I am under medication for prostate problem, bph I think.
Thank you for sharing valuable helpful TIPS. I appreciate your precious time greatly!
Brilliant analysis. Thank you.
thank you Doctor for the info
Thanks good information 👍
Your advice on many issues sure helps out
Thank you for sharing this valuable vedio
Thanks for great information!
Thanks for helpful info...!
Thanks for the valuable information
great advice sir. thank you
Very well explained.Thank You Doctor.👏
DOCTOR thank you very much for your time and valuable information.
I used to think if I limited my fluid intake well before bedtime my problem would either go away or be lessened. We have to remember the solids will also fill our bladders as well. No Eating or drinking 4-5 hours before bedtime.
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@@johnbulljuliet3668 Me too, PLEASE!!
Exactly. Very soon after I began limiting food and fluid intake 2-3 hours before bedtime my quality and duration of sleep enhanced significantly.
Thank you Doc. Well explained.
I’ve had OAB for more than 13 years. And it seems I almost cured it just a month ago.
Was trying different doctors. It took multiple years until they set a proper diagnosis. I tried electrical stimulation, Mirabegron, Solifenacin. Medication helped a bit, but after I stopped taking it, the symptoms got back to what had.
In November here were my complains:
* I went to a bathroom about 15 times a day (60ml - 130ml per one time)
* 2-3 times during night
* During mastrubation I had to make a break to pee
* If I wanted to go to a bathroom then I had to do it ASAP.
So in November another doctor recommended trying a Bladder training. As a main treatment. I adjusted it a bit my way and unbelievably I got my first results in 2 weeks: first time for maybe last 10 years I didn’t go to a bathroom at night. Then I started to go to the bathroom more rarely.
Here is what I got now:
* I go to a bathroom 5-7 times a day (200 - 300ml per one time)
* Haven’t gone to a bathroom at night last 1 month
* I can easily wait if I need
So for some reason doctors didn’t recommend trying bladder training and hence I thought it wouldn’t help, so didn’t bother.
========
One important thing to mention. Those recommendations are for Overactive bladder, which is a diagnosis urologists made for my case. It’s not like I just decided that OAB is my case. Before starting OAB treatment I made blood, urine tests as well as Cystoscopy and Urodynamic testing to exclude other reasons.
========
Here is my modification of the bladder training which helped me to get cured from Overactive bladder which I suffered from for about 13 years:
With the help of pelvic floor physiotherapist learn how to achieve these things:
How to understand that your pelvic floor muscles are contracted. The doctor might use “biofeedback” device to help you with this
How to relax pelvic floor muscles
Keep a bladder diary. Record how many millilitres you urinate every time you go to a bathroom. While at home you can have a plastic bottle at the toilet with the volume marks. While not at home you can use a zip-bag which you also have to mark. Like 50 ml, 100 ml, 150 ml and so on.
Analyse the reason why you might want to urinate. Be aware that sometimes the reason is caused by some patterns. For example, here are some patterns that I have: when getting up from a chair/bed; when sitting with my legs bent underneath me; when coming back from outside to home; when feeling depressed; when taking shower; when pooping.
Then every time you want to urinate ask yourself: “Why do I want to urinate? Is it caused by a pattern? If so, what can I change? Can I wait a bit more?“. F.e. if the urge is caused by a body position like when sitting with my legs bent underneath me, then take a position when pelvic floor muscles are not contracted. If the urge is caused by a pattern like when you get up from a chair, then recognize that it’s just a pattern and try to ignore the urge for some time.
When you are already at the toilet and about to urinate. Do these steps:
Try to analyse how badly you want to urinate. Is it 10/10 or 5/10?
Do you feel that sometimes your stomach is a bit stretched when you want to urinate and sometimes the urge is just in the head?
If the urge is not that intense, can you try to not to urinate and postpone it a little bit? Like 15 minutes?
After you urinate, write down in the diary how many millilitres you urinated.
Next time you at the toilet play a game: Based on your feelings and urge evaluation, try to guess how many millilitres you are going to urinate. This was the key technique for me. After some time you’ll learn to understand by your feelings/sensations how many mls you’re going to urinate. Use this prediction skill and when you feel that the volume is going to be below 200 ml, try to relax the pelvic floor muscles and just ignore the urge. Go to the bathroom only when you think it’s going to be above 200 ml.
The only exception when you go to the bathroom to urinate and you feel it’s going to be less than 200 ml is before going to bed at night.
During the night try not to go to the bathroom right away. Try to resist as much as you can, but don’t torture yourself. Just make a bit of effort.
Don’t drink like 3 hours before bed. Try to see if reducing the coffee intake helps.
Don’t bother with how often you go to urinate. For me if I drink a litre of cola then at the very beginning of the training I can urinate within a 15 minutes interval. That doesn’t matter. What matters is to be above 200 ml.
The doctor advised me to try the bladder training for 1 month and if I don’t see any changes, then we can add the medication like Mirabegron to help following the training.
After 2 weeks of the training I didn’t go to urinate at night. Probably that was the first time in the last 10 years. Then later I went to urinate less and less at night. Last month I didn’t urinate at night at all. Wish you all luck!
I am so thankful that you wrote all these in order to help other who have the same problem and can't go to sleep is that still working?,have a nice day
@@johnp4301 Thanks! Yes, it still works for me
Thank you! I appreciate this! I can relate and will try some of your recommendations
Wow, during masturbation you had to STOP & pee ....
Mind over matter didn't work, eh ?!?
Can u I help me from overactive bladder. I am suffering now. My doctor told I must have tot pee everyhour and holding pee is bad for pelvic muscles .I am in confused
Thanku so much. Very helpful.
Surprised he didn’t mention enlarged prostate. That makes it very hard to completely empty your bladder effectively making it much smaller than it actually is.
at about 4 minutes in he does mention it
Women do not have prostrates.
@@fionagregory9376 Why not? some women have balls.
He did but he said that there could be many other reasons!
@@paulmitford5189 They have eggs & smaller bladders than men!
The most important is to know what's causing it. Like several diseases since an infecting, severe infections, kidney problems, prostate, brain diseases, kidney damage, bladder damage (but why there should be an investigation), diabetes.
Sadly many doctors don't want to do any research and will tell you that's "only" a common Urine infection.
Thank you very much.I take care of several oldsters and now I have answers.
Thanks good explanation, it does Vader me BECOUSE interrump my sleep.
Stress definitely makes a person get up and urinate. I have been running races for 40 years and the night before the race is always a bit spooky so I might use the bathroom more. The day after the race I might only get up once in the middle of the night. I actually have had doctors tell me that if I got up to use the bathroom I probably had prostate cancer. I just looked at him and thought WOW! I’ve had cancer since I was 5 years old! I quit going to him.
Spot on! Stress , negative stress, unfortunately wrecks havoc on one's physical, psychological and spiritual health, it's a real killer! Why it's so vitally important to embrace one's life, not only physically, but emotionally/psychologically and spiritually, i.e. holistic health! The body, mind and spirit connection! Far too many allopathic conventional doctors just deal with our health on a physical level! They forget we also have feelings, a mind and a spirit/soul! smdh Remind them!
I had the problem and after 8 weeks went to the doctor. After numerous tests he discovered using Ultrasound a growth, after a MRT scan I was diagnosed with cancer, morbus hodgkin. The growth pushed against the bladder when I lay fown. Hence the problem was only at night. It was aggressive and doubled in size within 10 days. A Chemo was given to me over 5 months called BEACOPP and I am now in total remission 11 years. So please get problem checked out. Do not wait.....
@@pauledwards4333 Hello how many times were you getting up at night to pee???
Thanks doctor for information.
Thank you very much.
Excellent
Thank so much Doc..
Thank you doctor, that was right on time for me. Wish you were in eastern North Carolina.
I don't want to scare anyone here but if this happens frequently it could be a symptom of DIABETES and KIDNEY DISEASE. This is not the end of the world but if you have other symptoms or risk factors (high blood pressure, family history etc.) better get checked before things get worse. I've made a video on my channel recently explaining exactly what you should be on the look out for. God bless.
Op0
Op0
Welp I can't get check out because the coronavirus
Hi there , having a small Cyst on my left kidney after doing Ultrasound , it’s about 5 cm ,can it cause Frequent Urination ? How about also the Prostate Enlargement on the top of that ?
Is it a dangerous thing having that small cyst ? And what causes it ? What is the best treatment to solve this problem ?
Thanks .
when I read the title , I wanted to write a post to add to it, but just realized you beat me to it. BRAVO.
how can i empty my bladder get help with any pills with no said effect thank you
Thank you Doc.!
Thank you doc
I reduced getting up 3-4 times at night to just once by not drinking anything 4 hours before going to bed and intermittent fasting - two meals, one in the morning and one 4pm. No snacking either.
Is it hard not to drink anything for 4hrs?
one should eat both meals within 8 hrs and balance 16 hours without food if calorific value. This 8 hours could be further reduced to 6 hours or 4 hours for better results out of intermittent fasting.
Thanks a lot, you are really the Best Doctor.
c.
Thank you Dr.
Thank you Doctor
thank you.
A good inforation, thank you Best doctors
Thank you Doctor.
It's not the getting up that's my problem, it's that I cannot go back to sleep.
Ron Carpenter I have the same issues have you found a resolution?
@@anarchyxtra7795 hello . when you get up to relieve yourself use lighting that's not led / but Amber orange yellow low watts .
As the light will keep you from falling back to sleep. Hope this helps
@@aik9lifestyle589 that doesn't help unfortunately
@@anarchyxtra7795 & Ron Carpenter >> " _I have the same issues have you found a resolution?_ "
@@Antares8491 ok but it's my urination issue that makes me get up if I could solve that then I would probably be ok
Thank you.
No mine is all day and during the night
Do you have a office near Cornell and number to make a appointment.
I’m 59 had prostate surgery and still get up 4 times per night . And need melatonin to get back to sleep. I also take Flomax . Being diabetic doesn’t help either . I use to drive a Transit bus . Retired now , thank God . Take Care. Small bladder and loosing weight is very important.... go on a diet !!!! Thank The Doctor for this video.
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You should try eating keto( low carb, low sugar). I was just watching a video discussing insulin and this exact problem of peeing too much. If you weren't aware eating foods that spike your insulin makes you pee more. Just food for thought, but go watch that video.
Hi doc I was diagnosed with fibroids an The doctor says it sit on my bladder so that cause me to pee very often sometimes four times I have to get up to pee am really tired of this I can't get a good night sleep cause I have to go to the bathroom can u help me
what is the treatment?
Thank you ! ...
Sir, journey during cold times like Night times might also cause Nocturia. Whats your opinion ?
Not sure if this is what you were asking but I have read that being in the cold temperatures makes us have to pee more .
Thank you doctor
Always be aware off what your doctor prescribes!; it can kill you; seriously!
tripping at the veins thing. I got those after having my son and my legs ache all day. by night they feel heavy and achy. wonder if that may be causing it to
Me too; Michelle Kenway has a good video and she also mentions veins. I think it's time for compression stockings.
Doc hi the right side of my back hurts alot what is the cause
thanks doc...very helpful....good explanation,starting with the simplest.
Thanks
Nocturne
@@knutsolvang1902 。。。。妈妈。没。妈妈。 ，
Last night was a bad night. I had to get up to urinate every 15 minutes for at least two hours. Then 4 times the rest of the night.
Thank you
Since I learned about the ‘second sleep’ it doesn’t matter anymore that I wake up once in the night. I adjusted my sleep pattern, and read a book at night. Already kept trace of the intervals during 24 hours. And at day there is always one long period of 5 hours or longer. So my bladder can hold enough urine.
This video convinced me that drinking in the evening has effect. So that’s where I can take some measurements to keep it to once a night.
Thanks for this video.
Good information from medical expert.What medicine can one take to overcome the problem of the bladder not holding enough urine to disturb the night's sleep?
Helpful
Thanks needed that extra info
God bless you Sir
I am T2Diabetic . I go 3 or 4 times at night. What the good Doctor did not say is most people in USA are diabetic and the kidneys are trying to get rid of the high blood sugar . So you need to pee a lot. The other one is enlarged prostate . The bladder never gets empty,only partly. So you go more often .
I am 62yo and have been experiencing the exact same issue. Five weeks ago I started a strict Keto diet. Sleeping much better and only peeing once through the night. Amazing transformation!!! Reduced prostate issues as well. I highly recommend ketosis as a lifestyle.
@@woodroofguy same here. it's too much sugar/carbs and stop drinking liquds in the evening. hydration hysteria is silly.
I am so suprised that this doctor never once mentioned the word Diabetes. Diabetes or Pre Diabetes is the #1 cause or insulin/ Sugar issues. Yet he never mentions that at all.
Thank you Dr., very valuable information, greeting you from Accra, Ghana, West Africa
buu
6
Thank god even ghamand pissing frequently proves frequent pissing is an universal phenomena hail the frequent pissers
I am epileptic who need take meds before bed what do I do? Can green tea with honey in morning help?
Thank you doctor.
Lower back injury (to the spine) can also cause it.
Thanks Doc
I get up 4 times a night to pee. I've tried Vesicare and Myrbetrique combined, all to no avail. One urologist examined me and said I have a flabby bladder. So with a flabby bladder, I wouldn't think Vesicare and/or Myrbetrique would work, as they are bladder relaxants.
Ingesting high levels of erythritol for a long time can increase the urine volume and the number of times you urinate. Caffeine can promote urgency and frequency of urination as well as nocturia symptoms. L-arginine causes a significant increase in urine flow, urinary excretion.
Hello
I stopped drinking tea/coffee about 1hr, or 1.5 hrs before going to bed, and that seems to help quite a bit. Also, if you are genuinely tired after being active all day, you will sleep it out. Losing weight and eating healthy will reduce your prostate size, as happened in my case. I'm 66 soon.
Good In formation but i peeh Lot my doctor give me a prescription for removing fluids from my body and i peeh lot. Maybe I am consuming a lot of sugar i am not a diabetic.
I switched to a small cup of coffee per day.
Coffee beans evolved caffeine as an anti-mold agent.
Eating healthy does NOT shrink the prostate. Don't know where you got that nonsense from.
@@Person-mh6xqYour right about that.
Thank you doctor that was so helpful. I was so worried cuz every test I took came back negative. You explained it so well. Thank you again!
Very sensible
Hello Robert
I wish I had a Doctor like you.
Because its ramadan, this happens to me alot, is it a bad thing or normal
pl siggest some methods or medicine so tht 2 time urination during night can be avoded?
What is your. Reply
I
I'm 40 years old and have to get up to pee about 25 times in a period of 8 hours. I'm literally getting up every 15-20 minutes. I'm guessing that's to much?
Hello
Perfect!
I am a diabetic so Drink about a quarter glass of water before retiring. I then urinate only once during the night. Any problems with this? Also have sleep apnea.
Thanks
This is the second video on this topic that mentions varicose veins which I have. I am going to try compression stockings. Even if they just help with the aching legs it will be worth a try. Maybe I'll even get a good nights sleep. See also Michelle Kenways' video.
did it help
@@praba991ify too soon to tell; will check back in a week or so.
Thanks Doc very helpful informative greeting from Somalia 🇸🇴
I sleep with Airconditioning turned up very cold. I notice if I sleep without aircon, ie room is warm with fans, I don't urinate at night. So the room temperature affects how much your urine is produced. Also if I take meat for dinner, seems I dont urinate at night. Perhaps high protein with more salts is better, as I took rice high carbohydrate mostly at dinner. Makes sense?
Last night was bad... after urinating I would need to go 12 minutes later and that happened several times. Finally got a huge jar and put by bed... luckily I fell asleep and now I’m trying to figure it out.
Hello
up to pee 1 to 3 times a night has been ongoing for the last 12+ years. and has been
adapted to. a 'plus' is that the urge always follows a dream. so dreaming is not
interfered with. so this means it'll be an hour or more before feeling sleepy again.
thus the up-time , after taking a leak, is used in some manner that is productive.
along the way i come across videos like this one. that give a person ideas .
like watching your water intake and when. just yesterday i cut back from 3 x 500 ml
bottles of water/ day to just two. and none after 6 PM. and last night , for the first time
all month , did not wake during the night to pee.
How much would that be in fluid ounces?
I dealt with this for years and no longer experience it. For me it was anxiety related. If your symptoms are anxiety related they will go away once you reduce your anxiety, reduce your stress and learn to under react and even embrace the symptoms.
@Jibon Sarkar At my worst I was going about 40-50 times a day.
@Jibon Sarkar I did make a video about this a while ago. It's on my channel.
@Jibon Sarkar You're welcome.
Eswryokm.
Tks for your article Doc.I am a 73 yr old male with BPH and would like to seek your view reg PAE procedure .
Is this a proven way to get rid of prostate enlargement and has wide and proven efficacy of combating the above problem? Will be obliged yo seek your view on this.
Tks
My major cause is due to my having inherited gout! My back disks have dissolved to the point that I am three inches shorter than I used to be! The omly place that I can give in is my bladder itself! So that's where I have space to give up..in fact I believe that my bladder has even folded over as everytime I urinate when I seem to be finished I always wait a few seconds and a little more comes out as the upper (folded over) part as it finally drains itself.
Tqvm Sir, your explanation is so clear and helpful. God bless you and your family 🙏
Hello Susan
How are you doing?
@@thompsonsmith7798, Very well, thanks.
@@susanchin4117 You're welcome
Where are you texting from?
@@thompsonsmith7798
Malaysia
@@susanchin4117 I'm from Los Angeles California
Mind if we text on goggle chat..
I have always avoided any liguid after 5:30 pm during dinner for the very purpose to avoid getting up at night. So why do i still have to get up at least once during the night? Sometimes it just ruins getting back to sleep.
If someone has trouble sleeping, then eat something, Before you go to sleep !
Even " Cortege Cheese " works well " once your body starts " assimilating it " !
Failing THAT / Have you heard of Melatonin ?
[ Your body creates it, and it's sold over the counter ].
It could be inflammation of bladder. For this there is urine in the blood. The diagnosis called intestial cystitis.
@@crayfish7542 park 50thI
I just needed to know how to stop wanting to go pee at night cuz I’m going on a camping field trip (5th grade) on April 29th, and I’m not sure if there will be a bathroom in the cabin so~ I needed to find a solution myself
take a bucket.
Watch out for the bears.
No solution other than to piss in your under ware
I get up five to eight times every night. I have inspire therapy inserted for sleep apnea, it continues. I have had green laser treatment on my prostate. I am careful not to drink liquids after 7:00 PM. What do you think the problem is
I have type two diabetes however I have an A1C of 6.0 to 6.2.
My father used to say that he could sleep all night and day if he didn't have to pee. He died young at 92. I remember when I would visit him after my mother died we were both getting up at the same time every night to pee. At first I thought he was waking me up. But I often got up just before he did. I am now 68 and get up three or four times a night. The only thing that might be related in my case is that I was told from childhood that I have an enlarged spleen.
Overweight? I was!
Thanks doc much appreciated
I don't drink water before I go sleep,in fact I don't drink much water even during the day,but I get up during the night three four times
Do you drink pop that causes it too stay away from alchol in caffeine too drink milk or capri suns
A B u should drink water during the day
So, how about an enlarged prostate as a contributor?
Candida can also cause diabetes type 2 and infections like urine infections, this is why i kept on weeing frequently because of urine infection.
What about the NERVE that gives us the URGE to go being over active ? & When you do go you don't have much to pee but it still happening many times per night. STRESS & ANXIETY DISORDER ! my father & I have this problem. His is worse now that he has been diagnosed with Lung Cancer. His Stress =
NERVES has him up & down all night with this. !