Night-Time Bathroom Trips After 50: What's Common and When to Get Checked

If you're over 50 and you get up at night to use the bathroom, you're in large company. Doctors call waking to urinate "nocturia", and it becomes more common with every decade. Being common doesn't mean you have to accept it without a second look, though. The reasons vary from man to man, and several of them are within your control.

Why it happens more with age

Several everyday changes add up:

• The body makes more urine at night. With age, the hormone signal that normally slows urine production overnight tends to weaken.
• The bladder holds less comfortably. It may signal "full" sooner than it used to.
• The prostate changes. In many men the prostate gradually gets larger with age, which can make it harder to empty the bladder fully, so it fills again sooner.
• Sleep gets lighter. Lighter sleep means a mild urge that wouldn't have woken you at 35 now does.
• Other conditions and medications. Diabetes, heart and kidney conditions, sleep apnea and some medicines, including certain blood pressure pills taken in the evening, can all play a part.

Habits that make a difference

1. Move your drinks earlierKeep drinking enough during the day, but taper off in the two to three hours before bed.
2. Watch caffeine and alcohol after dinnerBoth increase urine production, and alcohol also makes sleep lighter.
3. Raise your legs in the eveningIf your ankles swell by the end of the day, fluid that collects there is reabsorbed when you lie down. Raising your legs for an hour in the early evening lets some of that happen before bed.
4. Go twice before bedEmpty your bladder, wait a few minutes, then try again.
5. Ask about medication timingSome medicines are better taken in the morning. Don't change anything on your own; ask your doctor or pharmacist.

Keep a simple diary for a week

Before your appointment, write down for seven days: what you drink after 6 p.m. and when, the time you go to bed, how many times you get up, and roughly how much you pass each time. It takes a minute a day, and it turns "I get up a lot" into something your doctor can work with.

Questions to ask at your checkup

1. Could any of my medications or their timing be part of this?
2. Should my prostate be checked, and what would that involve?
3. Could my sleep be the problem rather than my bladder?
4. Is there anything in my diary that stands out to you?