Urination - excessive at night

Alternative names
Nocturia; Nycturia

This symptom is a frequent need to urinate at night.

It is normal for urine to decrease in amount and become more concentrated at night. Most people can sleep 6 to 8 hours without having to urinate. Middle aged or older men may normally have to urinate once in the early morning hours.

With nocturia, it is common to awaken one or more times during the night to urinate.

Common Causes

  • Drinking too much fluid before bedtime - particularly coffee, caffeinated beverages, or alcohol  
  • Benign prostatic hyperplasia  
  • Diabetes  
  • Chronic or recurrent urinary tract infection  
  • Chronic renal failure  
  • Congestive heart failure  
  • Cystitis (acute urinary tract infection)  
  • Drugs such as diuretics, cardiac glycosides, demeclocycline, lithium, methoxyflurane, phenytoin, propoxyphene, and excessive vitamin D

Home Care
Keep a diary of how much fluid you drink, how often you urinate, and urine output. Record your body weight at the same times and on the same scale daily.

Call your health care provider if

  • Excessive nighttime urination continues over several days, and is not explained by medications or increase of fluids before bedtime.  
  • You are bothered by the number of times you must urinate during the night.

What to expect at your health care provider’s office
Your health care provider will perform a physical examination and ask questions about your nighttime urination, such as:

  • When did it start?  
  • How many times does this occur each night?  
  • Has there been a change in the volume of urine produced?  
  • Do you ever have “accidents” or bed wetting?  
  • How much urine is voided each time?  
  • What makes the problem worse? Better?  
  • How much fluid do you drink before bedtime? Have you tried restricting fluids before bedtime?  
  • What other symptoms are also present? Do you have increased thirst, pain or burning on urination, fever, abdominal pain, or back pain?  
  • What medications are being taken?  
  • How much caffeine do you consume each day?  
  • Have you had any bladder infections in the past?  
  • Is there a family history of diabetes?  
  • Does nighttime urination interfere with adequate sleep and rest?  
  • Do you drink alcoholic beverages and, if so, how much each day?  
  • Have you changed your diet recently?

Electrolytes and fluids will be monitored over a period of time.

Diagnostic tests that may be performed include:

  • Blood urea nitrogen  
  • Serum creatinine or creatinine clearance  
  • Fluid deprivation  
  • Osmolality  
  • Serum electrolytes  
  • Urinalysis  
  • Urine concentration  
  • Urine culture


Treatment options vary depending on the cause of frequent nighttime urination. If excessive nighttime urination occurs as a result of diuretic medications, you may be advised to take your medication earlier in the day.

Johns Hopkins patient information

Last revised: December 3, 2012
by Martin A. Harms, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.