But when does nighttime urination become a concern?

Doctors say it depends on age. For those under 60, waking to urinate once per night is generally normal. As we age, levels of the antidiuretic hormone (ADH) decline, which reduces the body’s ability to retain water. This means more frequent trips to the bathroom. For people in their 70s, urinating twice a night is typical. In their 90s, up to four times is considered normal.

However, needing to urinate more than expected—especially when paired with other symptoms—could signal an underlying issue. Potential causes include urinary tract infections, kidney stones, diabetes, high blood pressure, prostate issues, or even heart disease.

For example, with diabetes, high blood sugar irritates the bladder and increases thirst, causing more nighttime bathroom visits. Symptoms such as excessive thirst, blurry vision, and unexplained weight loss may also appear.

If nocturia worsens or is accompanied by other changes, consult a healthcare provider promptly.