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Written by

Dr.Masarat Jilani


Hey there, I’m Dr. Masarat. I'm passionate about smashing health taboos and tackling medical myths.

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Why is incontinence worse at night?

Waking up at night to go to the loo can ruin sleep and leave you knackered during the day.

There are many reasons why your bladder may bother you at night more so than in the day.

One is adult nocturnal enuresis - a fancy name for leaking at night. It can happen very commonly with 1 in 50 adults sometimes losing bladder control- as with many bladder issues this may be an underestimate as stigma prevents people from reporting symptoms. 

Nocturnal enuresis doesn’t always just happen at night -  it can also occur during naps in the day. Many factors can contribute to this including stress, urine infections, diabetes or overactive bladder. You should always share your nocturnal enuresis with your doctor so you can be investigated for underlying health conditions. One of the most common causes may be weak pelvic floor muscles - in this case pelvic floor exercises can be beneficial.

The second way your bladder can affect you at night  is called nocturia - this means you wake up multiple times at night needing the loo. This may happen due to overactive bladder syndrome or it could be due to diabetes, prostate issues in men and other conditions. Some lifestyle factors may also lead to nocturia such as drinking more fluids in the few hours before bed or consuming alcohol or caffeine just before bed. It may also be linked to other bladder irritants such as tomatoes or spicy food consumed at night.  To tackle this you can undergo bladder retraining and avoid bladder irritants.

Some people may suffer with incontinence or overactive bladder worse at night because they produce more urine at night rather than in the day - this is called nocturnal polyuria. This can be linked to other conditions such as heart failure, swollen ankles and snoring (sleep apnea). You may be retaining water during the day and hence need to expel at night. You should discuss solutions with your GP and may need to limit water intake in the evening by compensating with more intake in the morning. Otherwise your GP may need to check your hormonal profile including a hormone called ADH and then prescribe medication accordingly.

Another factor can be a poor sleep routine with regular waking or sleeping at different times every day. To tackle this you should practice sleep hygiene. 

Top Tips for preventing incontinence at night

Once you have addressed any medical issues with your doctor there are some lifestyle changes which may help.

Three hours before bed it is best to avoid:

  • Spicy foods

  • Caffeine

  • High water content foods such as fruit, vegetables, pasta, rice

  • Drinking most of your water content in this time period

Also if you are getting up at night it can be an effort to fully empty your bladder. But not fully emptying can lead to you getting up again only minutes later.

Tips for emptying your bladder fully when you pee:

Try a few of the different techniques for doing this and see what works for you:

  1. Shake it off: Leaning forward and shaking or rocking your hips from side to side while you pee can get rid of that extra fluid.

  2. Get tapping: Gently tap on your lower tummy when peeing to help the bladder empty.

  3. Get listening: Listen to running water while you pee. This is also a good way to stay focused and relax. A mindful pee is a good pee!

  4. Try warm and toasty: Pour some warm (not hot!) water over your pubic area as you pee. 

  5. Take a break: Once you feel that you’ve finished peeing, walk around for a few seconds and then try peeing again.

Perfect your peeing posture

Forget prim and proper. We may have been told to sit up with our back straight when we pee, but this is not the perfect posture. Instead, say howdy to your inner cowgirl! Lean forward with your legs apart and rest your elbows on your knees, keeping your feet flat on the floor. This is the best posture for peeing. Remember not to dangle your feet or keep them on tiptoe on the floor, because this stops your muscles relaxing.

Poor bladder health shouldn’t be a “normal” part of ageing or childbirth — that’s why we created the Bladder Care Handbook: our guide to life’s trickly moments. Download your free copy for expert tips on how to look after your bladder.

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