Nighttime Urination Linked to Higher Death Risk

Study Shows Frequent Urination at Night Associated With Increased Mortality Rate

Medically Reviewed by Laura J. Martin, MD on June 01, 2010
From the WebMD Archives

June 1, 2010 (San Francisco) -- Men and women who have to get up two or more times a night to urinate appear to be at an increased risk of death, researchers say.

The increased risk of mortality was seen in all age groups -- 20- to 49 year-olds, 50- to 64-year-olds, and 65- to 90-year-olds -- says Varant Kupelian, PhD, a research scientist at the New England Research Institute in Watertown, Mass.

"Nocturia [defined in the study as having to urinate two or more times a night] is a predictor of mortality, and surprisingly more so in relatively younger men and women, rather than in the elderly," he tells WebMD.

The greater risk of deaths in younger adults "suggests that what we are catching [with frequent night urination] is a marker or warning sign for subclinical disease or for the impending development of chronic disease," he says.

In older adults, falls and fractures that occur when people get up to go to the bathroom in the middle of the night may account for some of the increase in mortality, Kupelian says.

Relationship of Nocturia to Mortality

In the study, Kupelian and colleagues mined data gathered during a large national health survey to determine the relationship of nocturia to mortality. Analyses were conducted on a sample of 15,988 men and women age 20 and older.

Nocturia was assessed using the question: "How many times a night do you usually get up to urinate (pass water)?"

The researchers found that over a nine-year period:

  • Men aged 20-40 who woke up two or more times a night to urinate had a 2.56-fold increased risk of dying.
  • Women ages 20-29 with nocturia had a 10% increased risk of mortality, but that could have been due to chance.
  • Men aged 50-64 with nocturia had a 60% increased risk of dying.
  • Women ages 50-64 with nocturia had a 94% increased risk of dying.
  • Men aged 65-90 with nocturia had a 49% increased risk of dying.
  • Women aged 65-90 with nocturia had a 32% increased risk of dying.

The analysis took into account other factors that can affect mortality, including age, other medical conditions, marital status, body mass index, and smoking.

Frequent Nighttime Urination

"Getting up two or three times a night to urinate doesn't mean you're going to die. But you should advise clinicians of the problem and undergo a thorough workup to determine if there is an underlying cause to your nocturia," says Tomas Griebling, MD, associate professor of urology at the University of Kansas Medical Center in Kansas City.

Griebling tells WebMD that nocturia can be treated with medication to control overactive bladders and with behavioral modification.

"Even simple steps like avoiding fluids at night may help," says Griebling, who moderated a press briefing at the annual meeting of the American Urological Association to discuss the findings.

"We do not know if treatment can alter the risk of mortality," says Kepulian, but it might decrease the number of trips to the bathroom during the night and reduce sleep disturbances.

The research was funded by Ferring Pharmaceuticals.

This study was presented at a medical conference. The findings should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.

Show Sources


105th Annual Scientific Meeting of the American Urological Association, San Francisco, May 29-June 3, 2010.

Varant Kupelian, PhD, research scientist, New England Research Institute, Watertown, Mass.

Tomas Griebling, MD, associate professor of urology, University of Kansas Medical Center, Kansas City.

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