Some of the ways the body changes with age are obvious. Wrinkles, gray hair and age spots may not exactly be welcome, but they aren’t all that surprising.
Then there are the bodily changes that happen with age that are less talked about. Maybe you’ve noticed hair sprouting up in new places, like your chin, ears or nose. Or maybe you’ve had changes to your vision, making it more challenging to drive at night.
Another change that is common with age, yet many people don’t talk about, is having to pee more frequently. You may no longer be able to sit through an entire movie without having to visit the restroom, and long car rides now require a few bathroom breaks. Having to pee more frequently can also happen at night, which can be especially frustrating because it interferes with sleep.
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Sometimes, having to pee more frequently during the night is related to getting older, but it can also be a sign of an underlying health condition. Here, urologists share what they want all adults 60 and older to know about having to get up to pee more frequently during the night, how to prevent it from disrupting your sleep and when to see a doctor about it.
Why Getting up To Pee at Night Becomes More Common With Age
Even if you’re in perfect health and don’t have any underlying health conditions, you still may find yourself having to use the bathroom more frequently, including at night. “As we get older, our bladder becomes more sensitive overall. This leads to increased urinary frequency during the day, and increased ‘nocturia,’ which means increased urinary frequency overnight,” says Dr. Lawrence Dagrosa, MD, a urologist with Dartmouth Health in New Hampshire.
In addition to having a more sensitive bladder as we get older, Dr. Dagrosa explains that sleep quality declines with age and can lead to waking up during the night more easily. “When our sleep is disturbed, it is normal to go to the bathroom once we wake up,” he says.
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According to a survey of more than 4,000 U.S. adults ages 65 and older, roughly 50% reported experiencing nocturia, or having to pee during the night. “Nighttime urination, called nocturia, becomes very common after 60. As we age, the brain releases less of the hormone that normally slows urine production overnight, so the kidneys make more urine at night. The bladder also becomes less elastic and more easily irritated, fluid that pools in the legs during the day gets processed once we lie down and sleep becomes lighter, so we wake and notice the urge more easily,” explains Dr. Justin Houman, MD, FACS, a urologist specializing in men’s health.
When Having To Pee More Frequently Is Due to More Than Aging
As both urologists explained, it isn’t unusual to have to pee more frequently at night as you get older. But sometimes, having to pee more often is caused by something other than just getting older.
For men, it’s important to know that having to pee more often could be a sign of an enlarged prostate. “As the prostate enlarges with age, it squeezes the urethra and keeps the bladder from emptying, so it fills again sooner. The bladder muscle also becomes thicker and overactive from pushing against the blockage,” Dr. Houman explains. He says that men may notice a weak stream, hesitancy or a feeling of incomplete emptying.
Both doctors say that diabetes—which affects 33% of adults 65 and older—can also lead to having to pee more frequently. Dr. Dagrosa explains that elevated blood sugar leads to increased sugar in urine, which is a bladder irritant and can make someone have to pee more often, including at night.
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On top of that, he says that diabetes can lead to increased urinary production. This, he says, causes someone to become thirsty and increase their fluid intake, which then leads to having to pee more frequently. “Later stages of diabetes also lead to nerve damage that can affect the nerves of the bladder in particular and exacerbate the problem,” Dr. Dagrosa adds.
Both doctors say that sleep apnea, heart failure, kidney disease, overactive bladder, urinary tract infections, neurologic conditions like Parkinson’s or stroke, menopause-related changes in women and certain medications can all contribute to having to pee more frequently at night.
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How To Minimize Having To Pee at Night and When To See a Doctor About It
As you can see, there are a lot of underlying health conditions that can lead to having to pee during the night; sometimes it’s not just a symptom of getting older. If you’re regularly getting up to pee more than twice during the night, it’s a new change that suddenly occurred or getting up to pee is preventing you from getting enough sleep, Dr. Houman says that these are all good reasons to see a doctor.
“Seek care promptly for blood in the urine, pain or burning, a weak stream, excessive thirst or unexplained weight loss, leg swelling, shortness of breath or loud snoring with daytime fatigue. Being unable to urinate at all is an emergency,” Dr. Houman adds.
There are some ways to minimize having to get up during the night to pee, if it’s due to getting older and not a symptom of an underlying health condition. As you might expect, Dr. Dagrosa says that minimizing fluid intake after 6 p.m. can help.
Dr. Dagrosa says that sensitivity to spicy or acidic foods and drinks also increases with age, so cutting back on them is something else to try. “Caffeine and alcohol are particularly bad because they are not only direct bladder irritants, but they also affect sleep quality and the combined effects are more pronounced as we age,” he says.
Though having to get up to pee at night does become more common with age, Dr. Houman says it’s not something anyone has to learn to live with. “Once we identify the cause, it’s usually very treatable,” he says. If it’s something that’s getting in the way of you living your best life or getting enough sleep, see a doctor about it. Together, you can figure out a solution that works.
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Sources
- Dr. Lawrence Dagrosa, MD, urologist with Dartmouth Health in New Hampshire.
- Seop Kim, J, Soo Chung, H., Myung Yu, J, et al. (2018). Analyzing the Factors Associated With Nocturia in Older People in the United States. Annals of Geriatric Medicine and Research. 22(4):184-188.
- Dr. Justin Houman, MD, FACS, urologist specializing in men’s health.
- Diabetes and Older Adults. Endocrine Society.