The Daily Observer London Desk: Reporter- John Furner
A leading urologist has revealed how men can stop themselves from waking up in the middle of the night to go to the bathroom.
More than 30 million men aged 50 and over have their sleep disturbed at least once a night to use the bathroom, suffering from a condition doctors call nocturia.
Dr Edward (Ted) Schaeffer, from Northwestern University in Chicago, Illinois, said this nighttime disturbance was being driven by the normal enlargement of the prostate, which puts pressure on the bladder.
To stop the habit and get an uninterrupted night of sleep, he suggested three hacks for reducing middle-of-the-night urination.
Speaking on the Peter Attia Drive Podcast, he said: ‘You can go from [urinating] two times at night to one time at night just by changing what you drink and wearing tight stockings.
‘It is maybe not true for everybody, but it certainly encourages people to do simple things without doing the polypharmacy.’
The hacks included not drinking water before bed because this can be quickly filtered out of the blood and fill the bladder leaving someone needing to use the toilet
Don’t drink water before bed
Dr Schaeffer urged men to avoid having a glass of water before going to bed in the evenings.
He said: ‘A lot of people come in with night-time urinary frequency and a lot of that you can just modify with education.
‘So, by saying; “Hey, don’t drink a glass of water right before you go to bed.”
Dr Edward Schaeffer revealed tips for avoiding urination at night
‘And, “if you get up in the middle of the night because you have to urinate, don’t drink another glass of water right when you get up to urinate” — [that can help].’
Drinking water just before bed boosts the amount of fluid in the bloodstream, which is then rapidly filtered out by the kidneys.
This causes fluid to build up in the bladder, leaving a man needing to use the toilet within hours.
Young men can avoid this because they have higher levels of an anti-urine production hormone — called ADH — in their bloodstream when they go to bed and a more elastic bladder, reducing the risk of needing to urinate at night.
But older men, particularly those over 50 years old, have much lower levels of this hormone at night and less elastic bladders.
Wear knee-high stockings
Dr Schaeffer also recommended men with any signs of fluid retention in their legs wear knee-highstockings to bed.
Fluid retention is more common in obese or overweight individuals who are at higher risk of edema, when the feet are swollen or there is a ‘ringing’ over the socks because of excess fluid in the body.
Dr Schaeffer said: ‘One of the behavioral modifications is knee high stockings for people who, if I see them at 8, 9, 10 o’clock and they have any edema… then I definitely strongly encourage them to do that.
‘I tell people that if you’re getting up twice a night and you have a little bit of edema, we do have some behavioral modifications and we can reduce your nocturnal urinary frequency.’
Edema indicates fluid is being retained in the space between cells in the body.
When someone goes to bed, doctors say this fluid can then flow back into the bloodstream and be filtered into the bladder by the kidneys — making them pee.
To avoid this, doctors say knee-high stockings will reduce fluid retention in the feet — hence reducing the risk of night-time urination.
Avoid beer before bed
It may sound obvious, but Dr Schaeffer also said people should avoid drinking alcohol before bed, including beer.
Dr Schaeffer warned the drink’s high fluid content meant it would quickly cause the bladder to fill, while the alcohol it contains suppresses the anti-urine production hormone.
Dr Peter Attia added: ‘Alcohol, by the way, inhibits this hormone which is why alcohol before bed is a great recipe for having to get up and pee.
‘You get the fluid in the drink and then you get a molecule that inhibits the release of the anti-diuretic hormone.’
Doctors also advise people against drinking alcohol before bed, saying it can disrupt their sleep.
Why do older men have bladder problems?
Virtually all men will, at some point in their lives, be affected by urinary problems or know someone who is affected, Dr Schaeffer said.
This is linked to the male body’s architecture behind urination and changes in the body that happen as men age.
The above diagram shows how the urethra runs through the prostate
The urethra — or tube that carries urine and semen out of the body — runs directly through the middle of the prostate.
But the prostate — which is responsible for making part of the semen — gradually expands in men as they get older.
Doctors are not sure why this is the case, but say it may be linked to fluctuations in hormone levels.
The larger prostate then puts pressure on the urethra, forcing the bladder to work harder to push urine out of the body.
This, in turn, reduces its capacity to hold urine and raises the risk of facing more frequent urination, including at night.
Over time, older men also have lower spikes in the hormone ADH before bed, leading their bodies to make more urine at night and increasing their frequency of urinating.
