I always hesitate to use the word “normal”, as there are so many factors that go into how often you pee.  If you typically get up once in the night, then that is probably normal for you.  If your sleep is disrupted because you’re getting up more frequently, then possibly something needs to change during the day while you’re awake.

1. Are you drinking too much after dinner?  Assuming you’ve been drinking fluids through the day and your kidneys are working properly, stopping all fluid intake 2-3 hours before bed will reduce waking up at night.
2. Are you drinking alcohol or caffeine?  Both are diuretics, meaning they make the body produce more urine. Enough said.
3. Are you pregnant?  There is a pregnancy hormone called human chorionic gonadotropin (hCG), which will increase blood flow to the kidneys and uterus—this will put pressure on the bladder.
4. Do you take medications for high plod pressure, muscle relaxants or sedatives? Some of these drugs can make you pee more.
5. Are you over 60?  As you age, the bladder tends to not hold as much, so if you’re drinking the same amount as when you’re younger, then you may have to pee more often. As well, menopausal women can have changes in the urethral tissue—the tube from the bladder that urine flows out—that make the urge to pee more prominent in the brain, so women may want to keep less in the bladder and empty more often.
6. Do you have a UTI or prostate issue? If peeing in the night is also associated with burning or urgency, it could be due to a UTI or enlarged prostate.  A larger prostate can lead to thickening of the bladder tissue, and the prostate can make the urethra smaller, so the bladder holds less and is less elastic, and then has to push against the obstruction of the prostate. This equals more peeing, day and night.

When should you get it checked?

If you are up a few times in the night, try to keep a bladder diary for two 24 hour periods and see if there is a pattern—track how much you take in, what you are drinking, how often you pee, and how long is the flow of pee in seconds.  If you’re peeing more than 8 times in any 24 hour period, that is likely too much. If frequent peeing is also associated with increased thirst, weight loss or increased appetite, you should get checked by your family doctor. If you notice the frequency of peeing in the night getting worse, if you see blood in your urine, it is painful to pee, or if you’re going to pee often but only in small amounts, then get checked by your doctor.

Really, the pelvic floor?

If you’re peeing often, or have real urgency to pee through the day or night, then sometimes the brain and the pelvic floor can be the cause. If other things, like UTI or prostate issues, have been ruled out, sometimes having a pelvic floor that is too tight or too weak (or both) can be an issue.  The pelvic floor is often ignored by most until they have a problem.  At Elevation Physiotherapy & Wellness, we are your pelvic floor specialists who can help with bladder frequency and urgency due to pelvic floor issues—there is much that can be done, let’s start now!