Lee Suckling: The age you develop 'Old Man Bladder'

Why did nobody tell us that in our early 30s our bladders would age 40 years overnight and start working to a retiree's schedule? Photo / 123RF

Have you noticed a change in your peeing habits? Lee Suckling explains what might be going on.

Every man I know has noticed a weird change in their peeing habits after age 30. That is, we stop being able to sleep through the entire night without getting up to urinate.

Jokingly we all call it "Old Man Bladder", but the struggle is real. During your teens and 20s it's easy to sleep eight hours – sometimes more – without getting up once for a wee. Men's bladders aren't supposed to see notable changes until your 50s, but an informal (and non-scientific) study of my mates has found that not a single one of us can get through the night without a quick trip to the pisser anymore. Why did nobody tell us that in our early 30s our bladders would age 40 years overnight and start working to a retiree's schedule?

Overgrown prostates (one reason for too-frequent urination) are rare at this age, and obstructive sleep apnea (or OSA, another contributor to night-time urination) comes with a lot of other problems such as trouble breathing. What's causing otherwise healthy young men to increase our urine output during the quiet hours? No beneficent god would decide "and at 4am, thou shalt pee".

Here's my theory: we're more stressed after age 30, so we aren't sleeping as well in general. It's well-known that anxiety is good at waking you up in the middle of the night. People who are suffering with an acute or chronic episode are likely to experience sleeping troubles as well – I know when I'm anxious about something I'll have a restless night in bed. When you wake up more, your brain is conscious more. This creates more opportunities to remind itself that you need to use the loo. Plus, it's harder to ignore it once it becomes a habit. Cue Old Man Bladder.

None of this is helped by the fact that we actually produce more urine in the evening than during the day. Nocturia, the scientific term for getting up more than once in the night to pee, is caused by our bodies producing less of an anti-diuretic hormone as we age. That hormone usually enables us to retain more fluid. What's more, when you lie down with your legs elevated, the fluid gets mobilised in your body and finds its way to your bladder quicker. It's less work for your heart to pump the fluid out of your body when lying down, and the result the ability to rid yourself of up to a kilogram of water weight. This is annoying during the middle of the night and infuriating when there's only 30 minutes left until you're supposed to wake up anyway.

Caffeine and alcohol are two other culprits. Even if you're one of those people who can drink a cup of coffee after dinner and have no problem getting to sleep an hour later, one of your organs thinks differently. Caffeine is the number one bladder irritant out there. It makes the bladder contract at lower volumes which increases your urgency and frequency to pee. Alcohol stops the kidneys from being able to reabsorb water, and this becomes more obvious after your early 20s (it's also why hangovers become worse and you stop being able to drink like you did at university).

When there's no underlying medical condition, there's only one cure for Old Man Bladder. Severely restrict fluid intake during the evening. When I'm conscious of this I'll stop drinking anything after about 6pm, but generally I'll want at least some sips of

water right up until about 9pm. I accept that getting up to pee once in the night is a decent compromise for avoiding a mouth as dry as the Waikato during a bad summer.

Aside from that, I don't have much more advice for you, gents. Except for the following. Waking up to pee half an hour before your alarm goes off isn't the most unpleasant thing that can happen to you during the night. Think about it. The worst case is actually not waking up and still urinating anyway.