Written and clinically reviewed by Mr Daniel Swallow, Consultant Urologist (GMC 6128674). Last reviewed: .
Is it normal to get up at night to pass urine?
Needing to pass urine once during the night becomes more common with age and is often not a problem. It becomes worth looking into when you are woken two or more times a night, when it is getting worse, or when it is leaving you tired through the day.
Why does it happen?
- The prostate. In men, an enlarged prostate can stop the bladder emptying fully, so it fills up again sooner. Look out for a weak stream, hesitancy or dribbling as well (see enlarged prostate).
- An overactive bladder, causing sudden urgency and frequency by day as well as night.
- Making more urine at night (nocturnal polyuria). Common reasons are drinking a lot in the evening, caffeine or alcohol, water tablets taken late in the day, and fluid that collects in the legs during the day and returns to the circulation when lying down.
- Other medical conditions such as diabetes (including undiagnosed diabetes), sleep apnoea and heart or kidney problems.
- Poor sleep. Sometimes you wake for another reason and then notice the need to pass urine.
See your GP promptly, or call NHS 111, if you notice blood in your urine or pain when passing urine. Also get checked if you have a fever, unexplained weight loss, or extreme thirst and tiredness. Most causes are benign and treatable, but these features need to be checked rather than put down to age.
If you are suddenly unable to pass urine at all, or have a painful, swollen lower tummy, you need urgent help the same day (this is called acute urinary retention). Call NHS 111 or go to A&E rather than waiting for an appointment.
What you can try first
- Keep a simple bladder diary for three days (what you drink, when, and how much you pass). It is the single most useful thing to bring to an appointment.
- Cut down on caffeine and alcohol, and drink less in the hours before bed, while still drinking enough during the day. Cutting fluids too far can lead to problems such as urine infections.
- If you take a water tablet (diuretic), ask your GP or pharmacist whether it can be taken earlier in the day.
What an assessment involves
A review of your symptoms and medicines, the bladder diary (ideally covering at least three days), an examination, a urine test, and, where appropriate, a simple flow test and a bladder ultrasound to check that you are emptying properly. Blood tests may include kidney function, blood sugar and, after discussion of the pros and cons, a PSA. Treatment depends on the cause and ranges from lifestyle changes and medication through to procedures such as HoLEP or Aquablation where the prostate is the problem.
Common questions
How many times a night is too many?
There is no single cut-off. Two or more visits a night is usually considered bothersome enough to look into, particularly if it disturbs your sleep or is getting worse.
Is getting up at night always a sign of a prostate problem?
No. Fluid intake, medicines, sleep apnoea, diabetes and an overactive bladder are all common causes, in men and in women. Assessment sorts out which one applies to you.
Can it be treated?
In most people, yes. Depending on the cause, treatment can be as simple as changing when you drink or take your tablets, or may involve medication or prostate surgery.
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Further reading from trusted sources
Information on this page follows patient guidance published by the British Association of Urological Surgeons (BAUS). External links open on the NHS and NICE websites, which are not run by Mr Swallow.