Needing the lavatory in the middle of the night

Being awakened by the sensation of a full bladder can be useful. On the other hand if we then struggle to get back to sleep it isn't. How do people manage this problem.

Posted 14 Dec 2012 at 3:35 PM
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  • Sleepio Member

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    I have this problem but it seems only at night. During the day I have my usual 1 cup of wake me up coffee and then a continuous flask of 500mls herbal tea, peppermint during the mornings and camomile from about 4ish. (I am desperate to beat this problem). During this time I have timed myself that I need only twice and max 3 times to visit the loo. And totally stop drinking from 9.30 pm. And I always go to the loo before going to bed. Yet I still have to get up at least once every night. If it is a habit that needs to be broken, how – without having accidents.

  • Sleepio Member

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    Hi folks… one of the major causes of me waking up at night (and hence the reason for beginning the Sleepio course just last Monday) is having to use the damn toilet like many of you. I thought maybe I had Overactive Bladder, but my doctor said she highly doubts it…as it affects mostly older people and mostly women. I'm 44 years old and I'm male. But what I've just read is that if you have allowed yourself to go to the loo during the day at the slightest urge, your bladder then develops a “habit” of alerting you when it isn't even full. That's what I think has happened to me… an average person with normal health is supposed to be able to hold at least a couple pints, easily through the night. There are exercises called Keagal exercises (google that) where you can strengthen your bladder muscles. Personally I haven't tried them yet so I can't comment on how effective they are, but it seems plausible. Right now I just do like many of you… I try not to drink a drop of liquid at least an hour before bed time. Sometimes it works, sometimes it doesn't.

  • Sleepio Member

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    Hi Eat it or Else, I've got a friend who saw her doctor about needing the toilet frequently all day and all night. She was referred to a specialist nurse who prescribed pelvic floor exercises like the Kegel ones you mentioned. They were very effective and she can now last all night and for hours during the day. So I hope they work for you too. Good luck with this and the rest of the Sleepio course.

  • Sleepio Member

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    Yes the Keagle exercises do work. You need to get into the habit of doing them every day though just like all good habits.

  • Sleepio Member

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    Kegel exercises strengthen the muscles of the pelvic floor. They are used mainly for women who leak a little when laughing, coughing, sneezing, or after childbirth to “rebuild” the strength of the pelvic floor. The urge to go to the loo has little to do with these muscles, but is a nerve reflex due to stretching of the bladder as it fills. “Bad habits” eg going to the loo as soon as you feel it “full” can lead to the reflex starting sooner and sooner long before the bladder is full. What is needed is bladder retraining – see eg http://www.ouh.nhs.uk/patient-guide/leaflets/files%5C121213overactivebladder.pdf

    As men get older, they often have an additional problem. The prostate enlarges and prevents complete emptying of the bladder – thus it appears the bladder holds less, as bladder is not emptied. Bladder exercises can also help here to increase bladder capacity. Treatment for prostate enlargement is possible depending on the severity, but both medical and surgical treatment can affect fertility and the ability to get an erection.

  • Sleepio Member

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    I don't know what level of “workout” you do, but a high-protein diet causes a greater production of urine, as the excess protein is broken down and peed out in the urine. This means that more water is pulled from the blood to help the urea (main breakdown product from protein) removal. Excessive peeing while following a high-protein diet can lead to dehydration – hence your thirst!.
    I am not into bodybuilding but i doubt you need a very high protein intake. See http://goaskalice.columbia.edu/do-bodybuilders-and-other-weightlifters-need-more-protein.

  • Sleepio Member

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    I rarely drink anything after about 4pm, but still need to go to the loo usually twice during the night. Eating an evening meal that contains a fair amount of liquid, such as a stew, has the same effect as drinking, so makes me get up more too. I can 'hang on' all day without going, if necessary, so don't think it is an oversensitive bladder. For me the answer has to be in solving the problem of not being able to go back to sleep once I have gone to the loo, which I am pleased to say is hugely improved due to Sleepio sleep restriction. For the last 4 weeks I have been able to go back to sleep within 5 mins of going back to bed, whereas before I could be awake for an hour or more. So although I would rather not have to get up, it is no longer such a worry (and the worry about it kept me awake too, no doubt).

  • Sleepio Member

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    I still get up 2 or 3 times a night – sometimes pre Sleepio it would be more! I have tried not drinking but still wake up – not necessarily to go to the loo but then if awake I think I must go or I won't get back to sleep. It is a problem/habit I don't seem able to break no matter what I do. The only difference is post Sleepio I am less anxious about it – just accept it and then on that basis I tend to go back to sleep.
    However, any ideas would be welcomed

  • Sleepio Member

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    One of my original goals when I joined sleepio was to sleep through the night as I always got up at least once to go to the toilet. That's the only goal I still haven't hit, and I have come to the conclusion that it a rainbow I'm chasing.
    All my friends who are good sleepers (and my husband who is a championship sleeper usually) get up in the night to urinate. The BIG difference between them and me is that they aren't anxious about it, and don't obsess about whether they will be awake all night afterwards like I used to!!! I have decided just to live with that one, which I can do now because I do get back to sleep often within about 10 minutes, and if I haven't then I use the relaxation download and that usually works. If it doesn't I just shrug my shoulders and think that at least this is only one occasional bad night, whereas they all used to be like that.
    I have adjusted my expectations from aiming to have solid sleep every night to having a decent block of 5 or 6 hours and feel that has helped me.

  • Sleepio Member

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    Session 1

    Hi, I have a rare medical condition that causes me to need to drink six liters of water a day and that means peeing a lot. I think I must have super sphincter because my bladder can easily hold two liters before I go to the bathroom. So every time I go I fill up the toilet with up to a half gallon of pee. I am not sure how many times in the night I go. I put it off for a long time when it is cold in the house. I can't restrict fluids or I will become dehydrated. I have never been incontinent luckily. If I ever am, it will be a disaster.

  • Sleepio Member

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    Session 1

    I dont see this issue raised on sleepio…is this medical and therefore outside sleepio remit?

  • Sleepio Member

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    Session 2

    I've noticed that if I drink tea of any sort (herbal or caffeinated) in the evening I'll need to get up to pee in the night. Drinking a mug of hot milk doesn't have this effect. (Coffee at that time of night is only for emergencies.) Normally I'll eat a late dinner, maybe 3-4 hrs before sleeping, with at least one glass of water, and I won't need to get up in the night. Obviously, I pee before getting into bed but it's not always last thing. So now I avoid tea and herbal infusions after dinner. Has anyone else experienced this?

  • Sleepio Member

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    Hi Nancy, that's been my ritual (and problem), for many years. If I don't get up and go to the bathroom (even if I really don't need to go), I used to toss and turn. I found it easier to get up, go to the bathroom, and then I'd fall asleep quickly on returning to bed.
    I've had this habit for many years and now can't break it!

  • Sleepio Member

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    Session 2

    Absolutely. Tea and coffee are diuretics and reducing my overall (not just in the evening) intake of these has led to a reduction of me getting up in the night to pee.

  • Sleepio Member

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    Hi – the leaflet mentioned by you is really useful – now available at https://www.ouh.nhs.uk/patient-guide/leaflets/files/14187Poveractivebladder.pdf

  • Sleepio Member

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    Session 1

    I'm disappointed that sleepio does'nt address Nocturia, this must be a very common reason for lack of sleep.

    Thanks for all of the comments will try them out!

  • Sleepio Member

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    Hi artesian,
    Do you have a particular problem at night getting up and going to the loo frequently?
    A few sleepios have commented on their profile pages that they were being disturbed by visits to the loo.
    I’ve managed to suppress the urge and don’t have huge amounts to drink in the evenings, just sips any time after 9.00 pm. My normal SR start time is 12.15 am.
    I do drink plenty during the day and visit the loo enough then.

    If you have more than one visit waking you up you possibly need to speak to your GP.

    I don’t know how old you are, but we produce less hormones as we get older and one of them leads to frequent toilet visits at night.

    Sugary drinks and caffeine are diuretics and can cause us to need the loo at night more. So limit your intake of sugary drinks and keep caffeine to mornings only.
    Hope some of this helps.
    Kurly :)

  • Sleepio Member

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    Hi Garry
    Welcome to Sleepio. Sorry you’re having a rough time of it isn’t he middle of the night. I have the almost the exact time waking up at 5.00 am…not for the loo though. Don’t know what it is that seems to disturb me, but I tell myself I’ve done well getting xyz amount of sleep then day I need more, roll over and relax back into the pillow.
    Now there maybe times when you can do this, but if you have a particular pee problem then you’ll need to go to the loo, regardless of what you tell yourself.
    Obviously you do need that sorting out with your urologist, as there maybe an underlying health problem.

    In the meantime, you need to work on things to help you get back to sleep after you’ve been on your loo visit. Make sure that when you get up to the loo you’re not using any lights to fully waken yourself up…feel your way to the loo, keeping your eyes almost closed, then go back to bed and try the technique I’ve suggested above.
    If you still haven’t gone back to sleep after quarter of an hour, then use the QHR rule and get up, go to your wind down place and do the quiet things you normally do in wind down, keeping all lights to a minimum so you don’t fully awaken your eyes. Listen to music, a podcast, a story, do some mindfulness meditation.
    I’m currently using a mindfulness body scan in the last half an hour of my wind down sessions. If you want it I can message you the details.
    Hope you can keep going on the programme, Garry, it’s worth persevering, but the rewards are better quality sleep even if you still have night time excursions to the toilet!
    Good luck with your appointment too and wishing you better sleepies <80)
    Kurly :)

  • Sleepio Member

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    Session 3

    Hi Franklin, you sound like me! I have Sjogren's Syndrome which makes everything dry. I have no saliva so have to drink constantly, but I've had this for nearly 30 years so it's not unusual to me. I do get up some nights, but not always. SS isn't a nice thing to have, but fortunately I only have it as a secondary condition and basically it's robbed me off all bodily secretions, (a nice way of saying it!) so everything is extremely dry. If this is similar to you and you think I can help in any way, please feel free to ask me.

  • Sleepio Member

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    Pre-course

    Hi I have a problem with needing the loo on average 3 times a night – I can go for 8 hours during the day though. My problem is that I have had a couple of ‘accidents’ where I have dreamt that I need the loo and dream I find a loo and have woken as I have started peeing. So now I am even more careful to go to the loo if I need it, has anyone else had this?
    Ido t drink alcohol but take ropinirole for restless legs and some other meds. Thank you

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