
Peeing frequently at night? Here's what that could mean, according to health experts.
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It's 2 a.m., and you know the blinding light you just flickered on to use the bathroom is about to ruin your sleep. But when you've got to go, you've got to.
Nocturia, known colloquially as frequent nighttime urination, is common. More than 50 million people in the U.S. suffer, according to the National Institutes of Health's (NIH) National Library of Medicine. And roughly half of adults over the age of 65 have reported getting up at least once every night to use the bathroom.
"Waking up to urinate can either be a warning sign or an actual sign of a health issue you may not be aware of or a health issue that is not being properly treated," Dr. Justin Dubin, a urologist and men's health specialist at Memorial Healthcare System in South Florida and a co-host of the Man Up podcast, tells USA TODAY.
First, let's be clear about how nighttime urination is actually counted. Nocturia refers to urinating after a period of sleep, so simply heading to the bathroom after sundown doesn't count. Nocturia can be caused by a number of factors, including sleep disorders, excessive urine production, problems with bladder capacity and hormonal issues, per NIH.
Sometimes, waking up to go to the bathroom is just waking up to go to the bathroom. But how do you know when it's an issue worth bringing up to a doctor? Here's what medical professionals say.
Is your pee cloudy? Here's what medical experts say that could mean.
How many times is it normal to urinate at night?
Waking up once a night every once in a while is usually OK, Dubin says. But you should generally be able to sleep six to eight hours without having to do so.
"Consistently waking up two or more times every night? That is considered abnormal," he adds.
If you feel like you fit the description of nocturia, it may be worth it to take stock of how much fluid you're consuming two hours before bedtime, "especially alcohol and caffeine," which are both diuretics, meaning they make you urinate more frequently, Dubin notes.
Hmm: Certain foods can cause changes in urine, but so can medical conditions. Know the signs.
Why am I peeing so much?
Frequent nighttime urination can sometimes be an indicator of further health issues, experts say. Sometimes it isn't; Certain medications that are classified as diuretics, such as water pills, some heart medications and lithium can be the culprit. If that's the case, you can ask your doctor if you'd benefit from taking the medication in the morning, rather than right before bed.
But even if your nocturia isn't a warning sign for other health issues, the loss of sleep is likely enough reason to seek help.
"It is worth bringing up to your doctor, especially if it bothers you," Dubin says. "There are a lot of possible causes for you to be waking up at night and talking to your doctor will allow them to appropriately evaluate your history, your lifestyle and your overall health to see what is causing you to wake up at night. If you have specific health issues like diabetes, high blood pressure or prostate issues, the solution to your problem is treating your health issues."
Health experts will typically recommend patients try a mix of behavioral therapy, lifestyle changes and medication to relieve significant nocturia, according to the NIH.
"Like anything with your health, if something feels off or bothers you, it's important you go talk with a doctor," Dubin says. "Remember, we can't help you if you don't come in to talk with us."
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However, the FDA doesn't require trial plans to include procedures for long-term device follow-up and maintenance, although the spokesperson stated that the agency has requested those in the past. While some informed consent forms say devices will be removed at a study's end, Lázaro-Muñoz said removal is ethically problematic when a device is helping a patient. Plus, he said, some trial participants told him and his colleagues that they didn't remember everything discussed during the consent process, partly because they were so focused on getting better. Brandy Ellis, a 49-year-old in Boynton Beach, Florida, said she was desperate for healing when she joined a trial testing the same treatment Seeger got, which delivers an electrical current into the brain to treat severe depression. She was willing to sign whatever forms were necessary to get help after nothing else had worked. 'I was facing death,' she said. 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'I can't count on any coverage because there's nothing that says even though I've had this and it works, that it has to be covered under my commercial or any other insurance,' said Ellis, who advocates for other former trial participants. Even if companies still make replacement parts for older devices, she added, 'availability and accessibility are entirely different things,' given most people can't afford continued care without insurance coverage. Seeger, whose device was implanted in 2012 at Emory, said she went without a working device for around four months when the insurance coverage her wife's job at Emory provided wouldn't pay for battery replacement surgery. Neither would Medicare, which generally only covers DBS for FDA-approved uses. With her research team at Emory advocating for her, Seeger ultimately got financial help from the hospital's indigent care program and paid a few thousand dollars out of pocket. She now has a rechargeable battery, and the device has been working well. But at any point, she said, that could change. Federal cuts stall solutions Lázaro-Muñoz hoped his work would protect people like Seeger and Ellis. 'We should do whatever we can as a society to be able to help them maintain their health,' he said. Lázaro-Muñoz's project received about $987,800 from the National Institute of Mental Health in the 2023 and 2024 fiscal years and was already underway when he was notified of the NIH funding cut in May. He declined to answer questions about it. Ellis said any delay in addressing the thorny issues around experimental brain devices hurts patients. Planning at the beginning of a clinical trial about how to continue treatment and maintain devices, she said, would be much better than depending on the kindness of researchers and the whims of insurers. 'If this turns off, I get sick again. Like, I'm not cured,' she said. 'This is a treatment that absolutely works, but only as long as I've got a working device.'