NHS '8pm' rule to people waking up tonight needing the toilet

The NHS has an '8pm' rule for people who keep waking up at night needing the toilet. The rule may help to make it less likely that you get out of bed tonight or any other night - and if not, it may be time to see a doctor. It comes after a well-known TV doctor told people waking up in the middle of the night to urinate that they may have to "retrain" their bodies. Nocturia is the medical term for frequently waking during the night needing to pass urine. It often becomes more common with age. It is typical amongst elderly people who may be getting up twice a night. More frequent visits to the toilet may signal an underlying problem that can be treated. If you begin needing to make multiple trips to the toilet at night you may find this distressing or your sleep may be disrupted. But there are also lifestyle issues that can cause it - and these may be something you can fix. According to the NHS website of Guy's and St Thomas' NHS Foundation Trust , there are several things that can cause you to wake up at night needing the loo. It could be due to hormonal changes. The antidiuretic hormone (ADH) helps regulate the amount of water in your body. You produce less of this hormone as you get older. Lower levels of this hormone mean that more urine is produced at night. Prostate glands often start growing as you get older. This gland is a small gland found only in men and trans women. It surrounds the urethra (the tube that urine passes through before exiting the body). An enlarged prostate can press on your urethra and prevent your bladder from emptying properly, so you need to pee more often. There are other causes, too. Urge incontinence (also known as an overactive bladder) is where you experience a sudden urge to pee and may leak before you're able to get to a toilet. Bladder infections can be a factor. These are typically caused by bacteria entering your bladder. Symptoms include dark, cloudy and smelly urine; a burning sensation or pain when passing urine; and being unable to empty your bladder fully. Heart problems, diabetes, sleep related problems and drinking fluids can all be factors. Cut down on fluids before bedtime. Try having your last drink at 8pm rather than 10pm, while still ensuring you consume the recommended daily amount of 6 to 8 cups of fluid — roughly 3 to 4 pints or 2 litres. Cutting back on fluids alone won't make a difference unless you currently drink excessively. Limit caffeinated drinks such as tea, coffee, chocolate and cola, as these can irritate your bladder and disrupt your sleep patterns, as can alcohol. If you frequently suffer from swollen ankles, try resting with your legs raised for around an hour during the day, ensuring your feet are level with or higher than your heart. Wearing support stockings may also provide relief. Certain medications can increase urine production or flow - in many cases, this is intentional, such as with water tablets prescribed for high blood pressure . If you're unsure whether your medication could be contributing to nocturia, speak to your GP. Do not stop taking any prescribed medicines without first seeking medical advice. Think about whether anything else might be disrupting your sleep. A room that is too bright or too cold could be waking you up. If pain is affecting your sleep, raise this with your GP. Try reducing daytime naps to improve your sleep at night, and steer clear of stimulants such as caffeinated drinks in the hours before bed. ITV doctor and NHS GP Dr Amir Khan said recently on Instagram that there is another issue with people going to the toilet at night. "If you're someone who does a just in case wee just before leaving the house, maybe before a meeting, or before bed, sometimes even twice, this is really important for you. It might actually be making your bladder symptoms worse. I see this all the time in clinic, people going again, even when they've just been, because it feels safer than risking urgency or waking up in the middle of the night to go. "But here's what's really happening. Your bladder is a muscle and it works with your nerves to tell your brain when it's full. Now, normally that signal up to your brain shouldn't come until your bladder is holding around 300 to 500ml of urine. "But if you keep emptying it early, you know, those 'just in case wees', you start to retrain that system between your bladder and your brain. And over time, your bladder gets used to being emptied at lower volumes. "I would say to my patients, it's like a car alarm that's become too sensitive. At first it only goes off when there's a real but then it starts going off at everything - a gust of wind, someone just walking past, that's what your bladder is doing. "It starts sending, 'I need to go now' signals even when it's barely full, that's how urgency and urge incontinence develop or get worse. Because instead of emptying everything, you're teaching your bladder to signal to your brain you need to go earlier and earlier."