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Waking up several times during the night because you have to urinate is a condition called Nocturia. This condition is more common as you age, but can be a sign of an underlying urologic condition that should be evaluated by a doctor.

Nocturia often becomes a problem for people who wake up two to six times during the night, causing extreme daytime fatigue and increasing the risk of cardiovascular disease and dementia.

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Causes of Nocturia

There are a number of different causes of nocturia that range from simple to complex. Some causes include:

  • Too much fluid intake right before bedtime, especially caffeinated beverages and alcohol
  • Certain medications such as diuretics (water pills) can cause increased urination at night
  • Certain medical conditions such as congestive heart failure, chronic kidney disease, and diabetes
  • Sleep apnea
  • Overactive bladder

Urologic Conditions and Nocturia

Urologic conditions that can be associated with nocturia include:

  • Enlarged Prostate (BPH), because of its effects on emptying and bladder muscle function.
  • Other causes of bladder obstruction
  • Overactive bladder, the frequency in this case usually occurring both day and night
  • Chronic Urinary Tract Infection (UTI)
  • Nocturnal Diuresis – a condition where the body uses nighttime to rid itself of excess fluid

Treating Nocturia

Once your doctor determines the cause of your nocturia, treatment options will be specifically tailored to any urologic condition you may have, which can include medications, behavioral modifications, and, less commonly, surgical intervention.



  1. Careful medical and family history and physical
  2. Urinalysis
  3. Review of medications
  4. Keeping a 24-hour diary of urination, documenting number of occurrences, times of day, and amount of output
Lifestyle Changes
  • Careful history to evaluate underlying medical issues such as diabetes, sleep apnea, and chronic cardiac or kidney conditions
  • Limit or restrict your fluid intake in the evening, especially alcoholic and caffeinated beverages
  • Don’t take certain medications such as diuretics (water pills) right before bedtime
  • Elevate the legs throughout the day and evening, which helps prevent fluid accumulation, if you notice swelling at the end of the day

Your doctor may prescribe medications that can be effective in alleviating nocturia based on your diagnosis and if other first-line therapies have failed.