I’m a urologist — my 3 tips can stop you from having to pee overnight

Now you can stop making a pee-line for the bathroom in the middle of the night.

Northwestern Medicine urologist Dr. Edward Schaeffer has shared guidance about how men can better manage the frequency with which they hit the bathroom when they could be sleeping instead.

Schaeffer, who specializes in prostate cancer, offered some nocturnal tips while appearing on Dr. Peter Attia’s “Drive” podcast this week — and some of the recommendations are actually quite surprising.

“A lot of it is just education and behavioral modifications,” explained Schaeffer, program director of the Genitourinary Oncology Program at Northwestern’s Robert H. Lurie Comprehensive Cancer Center.

“So educating people that a lot of what you take in will come out, that the idea of the kidneys are designed to maintain our body’s fluids status and that kind of homeostasis.”

Schaeffer also noted that the urge to purge overnight, otherwise known as nocturia, is related to pressure on the bladder caused by an enlargement of the prostate.

One in eight men will be diagnosed with prostate cancer during their lifetime, according to The American Cancer Society, and they estimate that in 2023, there will be 288,300 new cases of prostate cancer.

1. Don’t drink a lot of liquids before bed

Not only is how much you drink important when thinking about urinary frequency, but it’s also what you’re drinking and what time you’re consuming it.

“A lot of people come in with night-time urinary frequency, and a lot of that you can modify with education,” Schaeffer explained.

“Saying, ‘Hey, don’t drink a glass of water right before you go to bed,’ 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,’” he said.

“That kind of component of the education, timing of when you take in those fluids, and then what’s in those fluids, specifically caffeine.”

He additionally revealed that there are some fluids that already have natural diuretics in them — like iced tea with caffeine — that can be problematic overnight.

“If you’re taking or drinking something that’s a diuretic, you’re going to produce more urine and that will result in more urinary symptoms within two to four hours after taking that fluid in,” he said.

2. No alcohol before bed

During the podcast, the two spoke about the effect that alcohol can have on your nocturnal urination.

According to the Cleveland Clinic, drinking alcohol during the evening can increase the desire to urinate in the middle of the night.

Schaeffer explained that there is a “naturally secreted hormone,” an anti-diuretic hormone, that prevents you from producing more fluids.

“Alcohol, by the way, inhibits this hormone, which is why alcohol before bed is a great recipe for having to get up and pee for two reasons, you get the fluid in the drink, and then you get a molecule that inhibits the release of anti-diuretic hormone,” Attia said.

“Absolutely, the classic one for that is beer, because it’s a higher liquid volume intake,” Schaeffer explained.

He added that the “peak” of the anti-diuretic hormone decreases per decade.

3. Wearing knee-high stockings can help

Schaeffer explained that peripheral edema — or retention of fluid in the legs — can affect how much you are urinating for both men and women.

He said that at night when you’re lying down, the fluid can leave and enter the vascular space, which your kidneys can read as “increased fluid.”

He said peripheral edema, even if it’s subtle, is one of the main drivers of frequent nighttime urination.

“One of the behavioral modifications is … knee high stockings for people who, if I see them at 8, 9, 10 o’clock in the morning and they have any edema, any kind of ringing around their socks, then I definitely strongly encourage them to do that,” he said.

“I tell people that if you’re getting up twice a night and you have a little bit of edema, we do some behavioral modifications, we can reduce your nocturnal urinary frequency by kind of one — so you can go from two times a night to one time a night just by changing what you drink and wearing TED stockings,” he continued.

He noted that this tip might not be true for everybody, but it can help people without having to turn to multiple medications.