I was irritated and a little alarmed by your article on nocturia (Keep waking in the middle of the night to pee? Here’s why – and what to do about it, 11 March). Now they’re medicalising getting up to pee! Of course, I realise that if there’s a dramatic change in someone’s urinary habits, that might be cause for concern. However, even your article points out that “one leading study” found that “69% of men and 76% of women over the age of 40 lived with nocturia episodes that woke them at least once in the night”. Doesn’t it mean that this is actually, statistically speaking, normal?
I’m female and in my late 60s, and I have got up to pee at least twice, often three times, a night ever since I can remember – at least since my 30s. I don’t overindulge in alcohol, have never smoked, I’m not obese and most of my working life has not been spent sitting staring at screens. I have also never subscribed to the relatively recent trend of carrying a water bottle everywhere and consuming 1.5 litres a day.
On the rare occasions when I do sleep through most of the night, it seems to relate to eating atypically salty food during the day. I usually try to minimise my salt intake.
A nonagenarian neighbour of mine found it so inconvenient to get up during the night after he suffered a fall that he couldn’t be persuaded to drink anything at all after about 2pm. As a result, he became dehydrated and so confused that it was (erroneously) thought that he had dementia.
I fear that problematising peeing might increase these kinds of occurrences. Is nocturia really a “worrying new trend” or just what most of us do anyway?
Name and address supplied
This was a most interesting article and I thought the advice about when to take in fluids made a lot of sense. However, I was surprised to see no mention of the effects of motherhood on the need to pee at night.
My own anecdotal evidence certainly suggests that giving birth, and the subsequent broken nights, sets something of a pattern for women. In my 30s, it was very normal to meet other mothers who nearly all needed to pee in the night, years after the children needed attention. Even now, some decades later, it’s quite a surprise (and joy) if I don’t need to make my way to the bathroom half asleep.
I heartily endorse the recommendation to keep lights to a minimum if you need the bathroom, and avoid any extra disturbance from phones or other gadgets for a swift return to sleep.
Kate Enright
Weymouth, Dorset
I’m surprised that there’s no mention of the effect of caffeine, which is a diuretic. Since it takes around 10 hours for caffeine to be processed out of the body, reduce caffeine and the urge to pee is reduced. So if you’re peeing more than you think you should, try going caffeine-free for a month.
Simon Hopper
Eccles, Greater Manchester
Your article left out one piece of critical advice that my father gave me decades ago: men who get up at night to pee should do it sitting down on the toilet to avoid passing out due to postural hypotension or increased vagal tone. As an emergency physician, I regularly saw patients who passed out while peeing in the middle of the night – often sustaining serious injuries.
Marc Salzberg
Stony Brook, New York, US
For the last three years I have been obliged to set an overnight alarm every three hours to help my wife, who is an invalid, with her frequent medication needs. I’ve also been receiving treatment for an enlarged prostate. These frequent enforced awakenings often lead to a “surge” in the bladder and the inevitable desire to pee overnight, often multiple times. Worse still, more recently, I have found myself waking up in between this enforced schedule, also with a desire to pee. This article was a real eye-opener, and I will certainly be applying a number of the recommendations.
More worrying is the potential impact on the development of dementia in later life due to the frequent interruption in my sleep. This having been said, in spite of the frequent awakenings, I seem to have no trouble at all in getting back to sleep. I am also, as a retiree, able to compensate during the day with at least one power nap, and I do a lot of brisk walking.
Andrew Savage
Vista, California, US
