That nagging urge to pee at 3 a.m. is one of the worst ways to wake up. Nearly everyone experiences this disturbance at some point, but sometimes frequent urination may be a sign of health problems.
According to a new study, presented at the annual Scientific Meeting of the Japanese Circulation Society, people who woke up at least once per night to use the restroom were 40 percent more likely to have high blood pressure. And those who woke up multiple times each night were at an even greater risk.
Of course, this doesn't mean that your nightly bathroom visits are a sure-fire sign that you're at risk for high blood pressure. But if you're already at risk of hypertension, due to smoking, alcohol abuse, or genetics, then you may want to see your doctor if you wake up several times a night to urinate.
In fact, most people get up to pee at night occasionally, and it’s no big deal. But it becomes a problem when you experience daytime fatigue as a result of interrupted sleep, says Matthew Rutman, M.D., associate professor of urology at Columbia University Medical Center.
Nocturia, or frequent nighttime urination, is generally defined as getting up at least once a night to pee. While getting up even once a night can be considered nocturia, it's generally considered more bothersome to your quality of life when your nighttime bathroom breaks reach two or more times, according to Reviews in Urology.
Nocturia can result from one of three possible reasons: your bladder is having a hard time holding urine, you’re producing more urine than usual during the day, or you’re producing more urine during the night.
Sometimes, the latter is just a function of growing older, says Dr. Rutman. But if it’s happening consistently more than once a night or interfering with your ability to function the next day, the problem goes beyond normal aging.
While getting up to pee is annoying, it could also point toward a bunch of other underlying health problems. Here are a few potential issues behind the constant need to pee at night. Talk to your doctor if nighttime urination is disrupting your sleep to see if you might be dealing with any of them.
Cause of nocturia: unrelated sleep problems
The more you wake up, the more opportunities you’ll have to notice you have to pee—and to empty your bladder. So, it may not actually be the urge to urinate that’s waking you up, says Dr. Rutman. You might just be waking up anyway.
One possible reason? Sleep apnea, a condition in which your breathing pauses while you sleep, can wake you up throughout the night. One recent study, for example, found that treating sleep apnea also treated nocturia. If you’re dealing with any other sleep issues, addressing them might help stop the peeing.
Cause of nocturia: bad drinking habits
Caffeine and alcohol are both diuretics, which increase your urine production, so drinking either late in the day could lead to excessive nighttime urination. Drinking too many fluids at night, regardless of what type, can also lead to nocturia.
Jason M. Phillips, M.D., a urologist with North Coast Urology, recommends cutting out all fluids two to four hours before bed and steering clear of caffeine and alcohol in the evening to prevent late-night bathroom trips if you've been bothered my nighttime peeing.
Cause of nocturia: certain medications
Some common medications, including Lasix and hydrochlorothiazide, which are used to treat edema (swelling) and high blood pressure, are also diuretics, says Dr. Phillips. If you’re on one of these, take it six hours or more before bed.
It's possible other meds can be the culprit too, so your doctor if nocturia is a side effect of any medications you’re on.
Cause of nocturia: untreated diabetes
When you have diabetes, the excess glucose, or blood sugar, rushes to your kidneys, leading water to enter as well, says Dr. Phillips. So you might find your bladder filling up more quickly than usual.
If your constant peeing happens throughout the day as well as at night, and large amounts of fluid come out each time, you might want to get a urinalysis test, which will reveal how much sugar is in your urine, says Dr. Phillips.
Cause of nocturia: an enlarged prostate
As men grow older, something called benign prostatic hyperplasia—or an enlargement of the walnut-shaped prostate gland responsible for urinary continence—can occur. This can be due to changing levels of hormones, including less testosterone production or an accumulation of dihydrotestosterone.
An enlarging prostate gland can cause pressure on your bladder, making you think it needs emptying more often than it does, says Dr. Phillips. An enlarged prostate can also cause other urinary symptoms, like issues starting or stopping your flow, a weak stream, or the feeling you didn't complete empty your bladder after peeing.
An enlarged prostate can be treated with drugs like Flomax, Myrbetriq or anticholinergics that relax the bladder muscles, as well as the UroLift procedure.
Cause of nocturia: an irritated bladder
Similarly, irritants like spicy food, alcohol, and urinary tract infections can trick your bladder into thinking it’s full, says Dr. Phillips. Bladder problems will also likely show up as frequent urination throughout the day, not just at night.
Cause of nocturia: bladder infection
You may thing that men don't get bladder infections, but that's a myth. Although less common, guys can get infections, particularly if they have an enlarged prostate, kidney stones, or their urethra narrows in size due to sexually transmitted infections, or injuries. Other signs of a bladder infection including burning or tingling, fever, and bloody or cloudy urine.
Bottom line on waking up to pee
How often you pee is affected by many factors, like fluid consumption, so there's no need to automatically panic. According to the Cleveland Clinic, most people urinate about four to eight times a day. Urinating more than eight times a day could be a sign of a larger problem.
If you frequently hit up the bathroom, and there’s a lot of pee coming out each time, then drinking habits, medications, or diabetes may be the culprits, says Dr. Phillips. If there’s just a little, your bladder is more likely experiencing nerve overactivity due to pressure or irritation. And the good news is these problems are all treatable once you identify the cause.
Suzannah Weiss Suzannah Weiss is a freelance writer and editor whose work has appeared in New York Magazine, The Washington Post, Playboy and more.
Melissa Matthews is the health writer at MensHealth.com and has written for Newsweek, Men's Fitness, Inc.