Getting Up All Night to Go? It May Be MS-Related Nocturia

Get back in control with these lifestyle adjustments

Woman taking pill in bathroom. Credit: CaiaImageCLOSED / Getty Images

It is estimated that at least 80% of people with multiple sclerosis (MS) will experience some form of bladder dysfunction at some point, according to the National Multiple Sclerosis Society. The clinical name for frequent nighttime urination is “nocturia.” It is sometimes defined as “excessive urination at night,” “needing to rise from sleep to urinate” or “getting up two or more times during the night to urinate.” I think these definitions are a little misleading; nocturia is plainly the urge to urinate.

It's not usually the volume that gets us up, as once we get out of bed there are often just a few drops after all that effort.

In MS, bladder dysfunction may occur when MS lesions block or delay the transmission of nerve signals that control the bladder and urinary sphincters. This can prevent the bladder from emptying properly, causing it to retain some urine.

I know from personal experience that this can be a very frustrating symptom of MS. Interrupted sleep from multiple bathroom trips makes fatigue worse, and for me that can aggravate my other MS symptoms. It's also important to note that healthy bladder function is key to your overall sense of well-being, as well as the health of your kidneys and urinary tract (untreated bladder problems can lead to repeated infections). 

To get back in control of your bladder—and reclaim your slumber—it's important to discuss the problem with your primary care doctor or neurologist.

He or she may prescribe you certain medications, or refer you to a urologist for a complete check up. However, and quite thankfully, nocturia can often be managed effectively with certain lifestyle adjustments. 

Here are some of my top behavioral and diet modifications to prevent MS-related nocturia.


Stay Cool At Night 

Getting hot can aggravate all symptoms, including urinary frequency. Sleep in light clothing and make sure your bedding isn't too hot. Sleep with just a sheet if needed. 

Stop Drinking Fluids Two Hours Before Bed 

You still need to drink 6 to 8 cups of fluid each day (make no mistake, cutting back on fluids will make things worse, as it can lead to dehydration and urinary tract infections). But you can shift the times of day that you consume most fluids. Try to limit fluids after dinner, and stop drinking two hours before bedtime. Tweak the timing as needed based on how you respond. 

Restrict or Eliminate Caffeine and Alcohol 

Caffeinated drinks and alcohol, both of which are diuretics, can lead to frequent urges to urinate and fitful sleep. Limit these drinks if you can, or eliminate them entirely, and see if your nocturia improves. 

Try Pelvic Floor Training

Weak pelvic floor muscles can be part of the problem with nocturia. Exercising these muscles has been shown to improve lower urinary tract dysfunction in women with MS.

Ask your doctor for a referral to a physical therapist who is knowledgeable about these issues and can help you strengthen your pelvic floor. 


Bladder Problems, National Multiple Sclerosis Society. 

What Is Nocturia? Multiple Sclerosis Trust.

Lúcio AC1, Campos RM, Perissinotto MC, Miyaoka R, Damasceno BP, D'ancona CA. Pelvic floor muscle training in the treatment of lower urinary tract dysfunction in women with multiple sclerosis. Neurourology and urodynamics. 2010 Nov. 

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