I was annoyed and a little alarmed by your article on nocturia (Staying awake in the middle of the night to pee? Here’s why – and what to do about it, March 11). Now they medicalize getting up to pee! Of course, I realize that if there is a dramatic change in someone’s urination behavior, that can be a cause for concern. But even your article points out that “one leading study” found that “69% of men and 76% of women over age 40 experienced nocturia episodes that woke them at least once a night.” . Doesn’t that mean that this is actually, statistically speaking, normal?
I’m female in my late 60s, and I’ve been getting up to pee at least twice, often three times, a night since I can remember – at least since I was 30. I don’t drink too much alcohol, have never smoked, am not obese and haven’t spent most of my working life sitting and staring at screens. I also never followed the relatively recent trend of carrying a water bottle everywhere and drinking 1.5 liters a day.
On the rare occasions when I sleep most of the night, this seems to be related to eating atypically salty foods during the day. I usually try to minimize my salt intake.
A nonagenarian neighbor of mine found it so difficult to get up at night after falling that after about 2 p.m. he couldn’t be convinced to have a drink at all. As a result, he became dehydrated and so confused that he was (wrongly) thought to be suffering from dementia.
I fear that problematizing urination may increase cases like this. Is nocturia really a “worrying new trend” or just what most of us do anyway?
Name and address provided
This was a very interesting article and I thought the advice on when to take fluids made a lot of sense. However, I was surprised that there was no mention of the effects of motherhood on the need to urinate at night.
My own anecdotal evidence certainly suggests that childbirth, and the subsequent broken nights, sets something of a pattern for women. In my 30s, it was common to meet other mothers who almost all had to pee at night, years after the kids needed attention. Even now, several decades later, it’s quite a surprise (and joy) when I don’t have to go to the bathroom half asleep.
I wholeheartedly endorse the recommendation to keep light to a minimum when you need to go to the bathroom, and to avoid additional disruption from phones or other gadgets so you can fall back asleep quickly.
Kate Enright
Weymouth, Dorset
I’m surprised there is no mention of the effect of caffeine, which is a diuretic. Because it takes about 10 hours for caffeine to be processed from the body, cutting back on caffeine reduces the urge to urinate. So if you’re peeing more than you should, try going caffeine-free for a month.
Simon Hopper
EcclesGreater Manchester
Your article omits one critical piece of advice that my father gave me decades ago: men who get up to urinate at night should do so while sitting on the toilet to avoid fainting due to postural hypotension or increased vagal tone. As an emergency physician, I regularly saw patients who fainted while urinating in the middle of the night, often sustaining serious injuries.
Marc Salzberg
Stony Brook, New York, USA
For the past three years, I have been required to set a night alarm every three hours to help my wife, who is disabled, with her frequent medication needs. I have also been treated for an enlarged prostate. These frequent forced awakenings often lead to a “spike” in the bladder and the inevitable desire to urinate during the night, often several times. Worse yet, lately I found myself waking up in between this enforced schedule also with a desire to pee. This article was a real eye-opener and I will definitely apply some of the recommendations.
More worrying is the potential impact on the development of dementia later in life due to the frequent interruptions in my sleep. That said, despite frequent awakenings, I don’t seem to have any trouble getting back to sleep at all. As a retiree, I can also compensate for this during the day with at least one power nap, and I walk a lot.
Andrew Savage
Vista, California, USA