What Peeing In The Middle Of The Night Could Reveal About Your Heart Health

Waking up in the middle of the night is a common occurrence among a chronically sleep-deprived society, as is trying to engage in untrustworthy sleep shortcuts or trying to get too much sleep at once. Occasionally getting up to pee is also not out of the ordinary, especially during nights you're experiencing insomnia, or if you drank too many fluids before bedtime. But consistently waking up at least one time to urinate on most nights could point to a condition called nocturia. Also known as "nocturnal urinary frequency," this nighttime condition affects more than half of adults over age 50. There's no single cause of nocturia; rather, it may be related to other underlying health conditions, including sleep disorders, diabetes, and hypertension. For some adults, nocturia is also connected with heart issues, including coronary artery disease (CAD).

According to the Centers for Disease Control and Prevention (CDC), CAD is the most common form of heart disease in the U.S. This disease can silently develop over time due to plaque buildup in the arteries and eventually lead to a heart attack. A heart attack is actually one of the first obvious signs of undiagnosed CAD. Adults who have CAD might also experience chest pain, fatigue, and shortness of breath because of a lack of blood supply to the heart. Overall, this condition can put you at risk for future heart failure as it weakens your heart muscle. This is why it's important to look out for symptoms of possible disease progression, with nocturia being among the possibilities, as nocturia is a possible early sign of CAD development.

While the exact causes are still being researched, scientists believe the nocturia-CAD link is associated with fluid buildup that may accumulate during the day and then get released into the bloodstream at night. The result of this sudden flow of fluids? Nighttime urination. The possible link between nocturia and CAD was first confirmed in the 2010s. In 2012, researchers shared such findings from a retrospective cohort study. Published in the British Journal of Urology International, the authors recorded evidence supporting nocturia as a health marker for CAD, especially in male adults under the age of 60. They also found increased mortality rates in older adults with moderate nocturia.

Nocturia can also be a warning sign for adults who already live with CAD. One study published in 2021 in the Taiwan Society of Cardiology's Acta Cardiologica Sinica evaluated 380 patients with CAD with imaging tests and found that those who had an overactive bladder were more likely to have severe heart disease. Separately, results from a cohort study published in 2023 in Frontiers in Public Health suggested a link between nocturia and an increased risk of heart-related death. While this doesn't mean nocturia itself is fatal, people who have CAD may consider frequent nighttime urination as warning signs of possible heart disease progression and overall cardiovascular system problems.

If you're worried about your nighttime bathroom habits, it's worth talking with a medical provider. While nocturia itself is not considered life-threatening, some of the possible causes like CAD can be serious. It's especially important to follow up with a doctor if you have a history of heart problems or certain risk factors for heart disease development.