Preventing nighttime voiding and incontinence
As you get older, your kidneys make more urine at night when you are asleep. Since your bladder has more urine you need to get up more often to void.
What can I do to cut down on the amount of urine at night?
Limit your fluids in the evening. Stopping evening fluids with the completion of the evening meal, commonly at 6 p.m. can help. But remember to maintain adequate fluid intake during the day of 6 - 7 glasses (8 ounce size).
What types of drinks or foods may be more irritating?
Beverages containing caffeine and alcohol will be more irritating. So eliminate all caffeine and alcohol containing beverages in the afternoon and especially in the evening. Do not drink these beverages after 6 p.m. Remember that even decaffeinated drinks (tea, coffee, soda) have some caffeine and should be avoided. Chocolate has caffeine so if you like chocolate ice cream, pudding or cake as a nighttime snack, this may worsen your nighttime problem.
What else can I do to cut down on nighttime voiding?
As you age, your body starts to retain water (called edema) in the lower legs and ankles. To decrease this edema or swelling, lie down on your left side for 1 ½ to 2 hours during late afternoon to evening hours. When watching TV or after lunch, prop your legs on a stool or chair. Then proceed with regular evening activities for a few hours before bedtime. This will cause you to excrete some of this excess water before retiring so that it is not such a load on your bladder throughout the night.
Try not to use a bedpan or urinal unless you are afraid of falling on the way to the bathroom. Get out of bed to urinate to help your bladder empty more fully.
[Adapted with permission from Newman, DK. (2002) Managing and Treating Urinary Incontinence, Baltimore: Health Professions Press]
- Arya LA, Myers DL, Jackson ND. (2000) Dietary Caffeine intake and the risk for detrusor instability: A case-control study, Obstetrics & Gynecology. July, 96(1): 85-89.
- Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN), Evidence-based clinical practice guideline, Continence for Women. 2000.
- Brown JS, Grady D, Ouslander JG, Herzog AR, Varner RE, Posner SF, (1999) Prevalence of urinary incontinence and associated risk factors in postmenopausal women, Obstetrics & Gynecology; July, 94(1): 66-70.
- Brown, JS, Seeley, DG, Fong, J., Black, DM, Ensrud, KE, Grady, D. (1996) Urinary incontinence in older women: who is at risk? Obstet Gynecol;87:715-21.
- Bump RC, McClish DM. (1992) Cigarette smoking and urinary incontinence. Am J Obstet Gynecol;167(5):1214-1218.
- Bump RC, McClish DM. (1994) Cigarette smoking and pure genuine stress incontinence of urine. A comparison of risk factors and determinants between smokers and nonsmokers. Am J Obstet Gynecol;170(2):579-82.
- Bump RC, Sugerman, H., Fantl, JA, McClish DM. (1992) Obesity and lower urinary tract function in women: effect of surgically induced weight loss. Am J Obstet Gynecol;166:392-9.
- Burgio KL, Matthews KA, Engel BT. (1991) Prevalence, incidence and correlates of urinary incontinence in healthy, middle-aged women. J Urol;146:1255-9.
- Bryant, CM., Dowell, CJ., Fairbrother, G. (2000) A randomized trial of the effects of caffeine upon frequency, urgency and urge incontinence. Neurourology and Urodynamics. 19: 501-502.
- Cohen, SM., Johansson, SL. (1992) Epidemiology and etiology of bladder cancer. Urol Clin N America;19:421.
- Creighton, SM and Stanton, SL. (1990) Caffeine: Does it affect your bladder? British Journal of Urology; 66:613-614.
- Deitel, M., Stone, E., Kassam, H.A., Wilk, E.J., Sutherland, D.J.A. (1988) Gynecologic-obstetric changes after loss of massive excess weight following bariatric surgery. Journal of the American College of Nutrition. 7 (2): 147-153.
- Diokno, AC., Brock, BM., Herzog, AR., Bromberg, J.(1990) Medical correlates of urinary incontinence in the elderly. Urology. 36: 129-138.
- Dougherty, MC, Dwyer, JW, Pendergast, JF, Boyington, AR, Tomlinson, BU, Coward, RT, Duncan, RP, Vogel, B, Rooks, LG. (2002) A randomized trial of behavioral management for Continence with older rural women. Research in Nursing & Health.;25:3-13.
- Davis, GD., Goodman, M. (1996) Stress urinary incontinence in nulliparous female soldiers in airborne infantry training. Journal of Pelvic Surgery. 2(2): 68-71.
- Dowd, T.T., Campbell, J.M., Jones, J.A. (1996) Fluid intake and urinary incontinence in older community-dwelling women. Journal of Community Health Nursing. 13(3): 179-186.
- Dwyer PL, Lee, ETC, Hay. DM. (1988) Obesity and urinary incontinence in women. British Journal Obstet Gynecol;95:91-6.
- Elia, G., Dye, TD., Scariati, PD. (2001) Body mass index and urinary symptoms in women. Int Urogyncol J; 12:366-69.
- Engberg, SJ., McDowell, BJ., Burgio, KL., Watson, JE., Belle, S.,( 1995) Self-care behaviors of older women with urinary incontinence. JOGN; 21(8):7-14.
- Fantl, JA, Newman, DK, Colling, J. et.al. (1996) Urinary Incontinence in Adults: Acute and Chronic Management Clinical Practice Guideline, No 2, Update, Rockville, MD: US Department of Health and Human Services. Public Health Service, Agency for Health Care Policy and Research, AHCPR Publication No. 96-0682. March.
- Fischer, JR., Berg, PH., (1999) Urinary incontinence in United States air force female aircrew. Obstetrics and Gynecology. 94(4):532-536.
- Fitzgerald, S., Palmer, MH., Berry, SJ., Hart, K.. (2000) Urinary incontinence: Impact on working women. AAOHN Journal. 48(3), March:112-118.
- Griffiths, D.J., McCracken, P.N., Harrison G.M., Gormley, E.A. (1993) Relationship of fluid intake to voluntary micturition and urinary incontinence in geriatric patients. Neurourology & Urodynamics. 12: 1-7.
- Gray M, (2001) Caffeine and Urinary Continence, JWOCN, 28: 66-69.
- Hojberg K-E, Salvig JD, Winslow NA, Lose G, Secher NJ (1999) Urinary incontinence: prevalence and risk factors at 16 weeks of gestation, British Journal of Obstetrics and Gynaecology, August, 106:842-850.
- Johnson, TM., Kincade, JE., Bernard, SL., Busby-Whitehead, J., DeFriese, GH. (2000) Self-care practices used by older men and women to manage urinary incontinence: results from the national follow-up survey on self-care and aging, JAGS., 48(8):894-902.
- Jorgensen S, Heiin HO, Gyntelberg F (1994) Heavy lifting at work and risk of genital prolapse and herniated lumbar disc in assistant nurses, Occup. Med., vol. 44: 47-49.
- Kayser-Jones J, Schell ES, Porter C, Barbaccia JC, Shaw H. (1999) Factors contributing to dehydration in nursing homes: inadequate staffing and lack of professional supervision JAGS 47:1187-1194.
- Koley, B., Koley, J., Saha, JK. (1984) The effects of nicotine on spontaneous contractions of cat urinary bladder in situ. British J Pharmacol. 83:347-55.
- Koskimaki, J, Hakama M, Huhtala H, Tammela TLJ. (1998) Association of smoking with lower urinary tract symptoms. J Urol 159: 1580-2.
- Lamarine RJ, (1994) Selected Health and Behavioral Effects Related to the Use of Caffeine, Journal of Community Health, December, 19(6): 449-466.
- Lee RA, Balick MJ. (2006). Rx: Caffeine. Explore, 2, 55-59.
- Lee JG, Wein AJ, Levin RM, (1993) The effect of caffeine on the contractile response of the rabbit urinary bladder to field stimulation, General Pharmacology, 24(4): 1007-1011.
- Lubowski, DZ., Swash, M., Nicholls, R.J.,Henry, MM. Increase in pudendal nerve terminal motor latency with defaecation straining. British Journal of Surgery. 75: 1095-1097, 1988.
- Moller LA, Lose G, Jorgensen T (2000) Risk factors for lower urinary tract symptoms in women 40 to 60 years of age, Obstetrics & Gynecology, 96(3): 446-451.
- Mommsen, S; Foldspang, A. (1994) Body mass index and adult female urinary incontinence. World Journal of Urol;19:319-22.
- Newman, DK. (2002) Managing and treating urinary incontinence. Baltimore: Health Professions Press.
- Newman, D.K. (1999). 2nd Ed. The Urinary Incontinence Sourcebook, Lowell House, California.
- Nuotio, M., Jylha, M., Koivisto, AM., Tammela, TLJ., (2001) Association of smoking with urgency in older people. European Urology; 40: 206-212.
- Nygaard, IE., Thompson, FL., Svengalis, SL., Albright, JP. (1994) Urinary incontinence in elite nulliparous athletes. Obstetrics & Gynecology. 84 (2): 183-187.
- Nygaard IE., Linder, M. (1997) Thirst at work- an occupational hazard? Int Urogyn and Pelvic Floor Dysfunction; 8(6):340-343.
- Nygaard IE. (1997) Does prolonged high-impact activity contribute to later urinary incontinence? A retrospective cohort study of female Olympians. Obstet Gynecol; 90(5):718-722.
- Nygaard, I (1995) Prevention of exercise incontinence with mechanical devices. Journal Reprod Med. 40:89.
- Palmer, MH., Fitzgerald, S., Berry, SJ., Hart, K.. (1999) Urinary incontinence in working women: an exploratory study. Women and Health. 29(3):67-80.
- Roe, B., Doll, H., (1999) Lifestyle factors and continence status: comparison of self-report data from a postal survey in England.,.JWOCN: 26(6): 312-319.
- Ruggieri, MR., Whitmore, KE., Levine, RM. (1990) Bladder purinergic receptors. J Urol: 144:176-81.
- Sherman, RA., Davis, GD, & Wong, MF. (1997) “Behavioral treatment of exercise-induced urinary incontinence among female soldiers” Military Medicine 162,690-694.
- Snooks, SJ, Barnes, PRH, Setchell, M., Henry, MM., (1985) Damage to the innervation of pelvic floor musculature in chronic constipation. Gastroenterol :89:977-981.
- Spence-Jones C, Kamm MA, Henry MM, Hudson CN (1994) Bowel dysfunction: a pathogenic factor in uterovaginal prolapse and urinary stress incontinence, British journal of Obstetrics and Gynaecology, February,101:147-152.
- Subak LL, Whitcomb E, Shen H, Saxton J, et al: (2005). Weight loss: A novel and effective treatment for urinary incontinence. Journal of Urol, 174, 190-195.
- Tampakoudis P, Tantanassis T, Grimbizis G, Papeletsos M, and Mantalenakis S. (1995) Cigarette smoking and urinary incontinence in women – a new calculative method of estimating the exposure to smoke. Eur J Obstet Gynecol and Reprod Bio; 63: 17-30.
- Thomas, AM, Morse, JM., (1991) Managing urinary incontinence with self-care practices. J Gerontological Nurisng;17(6):9-14.
- Thyssen, HH, Clevin, LS. Olesen, L., Lose, G (2002) Urinary Incontinence in Elite Female Athletes and Dancers. Int Urogynecol J;13: 15-17.
- Tomlinson, BU, Dougherty, MC, Pendergast, JF, Boyington, AR, Coffman, MA, Pickens, SM. (1999) Dietary caffeine, fluid intake and urinary incontinence in older rural women. International Urogynecolgy 10:22-28.
- Wells, TJ (1997) Nursing Management in Urinary incontinence., O’Donnell, PD ED., St Louis: Mosby:439-433.
- Wilson PD, Berghamns, B., Hagen, S., Hay-Smith, J., Moore, K., Nygaard, I., et al. (2005) Adult conservative management. In Abrams P, et al (eds). Incontinence, Proceedings from the 3rd International Consultation on Incontinence. Plymouth, United Kingdom: Health Publications; 855-964.
- Wyman, J.F., Elswick, R.K., Wilsom, M.S., Fantl, J.A. (1991) Relationship of fluid intake to voluntary micturitions and urinary incontinence in women. Neurourology & Urodynamics.: 463-473.
Posted October 2006
Updated October 2011