Need to pee 3 times a night. : Hi all does... - AF Association

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Need to pee 3 times a night.

ETHEL103 profile image

Hi all does anyone else with a fib have to get up for a wee more than once. Its driving me mad.?

42 Replies

Not sure if there’s a connection, but it’s quite common for folk with paroxysmal AF to pee a lot every time they have an episode. No idea if there is much you can do about it apart from limiting your liquid intake as early as possible before going to bed……not very scientific but if it don’t go in, I guess it won’t come out. One slight problem, it flies in the face of staying hydrated, especially when the weather’s hot!!

Yes, even when I don’t think I’m in AF sometimes but when I had a holter monitor it showed I had frequent episodes which I wasn’t aware of. I never found the ‘reduce fluid’ worked, I just turned into a prune!

BobD profile image

The distressed heart secretes an enzyme which tells the body to shed salt so you pee a lot. Simples. Nothing you can do about it other than get rid of AF. Don't be tempted to try and reduce hydration as that will just make AF worse.

Frodo profile image
Frodo in reply to BobD

Hi Bob, do you have any links to scientific / medical info about this? This was a symptom for me when I was first ill years ago (so not age related) ignored by doctors - so thinking doctors don't know about it??

BobD profile image
BobDVolunteer in reply to Frodo

Doctors (GPs) don't know most of what goes on with AF to be honest. It is only being part of AFA snce it started in 2007 and being part of so many conferences and presentations over that time that I know what I do. Sorry but the information is just part of my brain and can't tell you where it orginated. There is a name for the enzyme but since I don't like using abbreviations I never used it and have forgotten what it is called. It was commonly discussed here a few years ago but from previous responses today it seems people have forgotten about it. Try searching "excess micturition". Edited, if you search "micturition" there are a few posts five or six years ago on the subject.

KipperJohn profile image
KipperJohn in reply to BobD

When I was first diagnosed with PAF in 2011 nobody responsible for my care told me about this - it took ages to find out -probably from your good-self on this site - and whenever I was taken to A and E or admitted it was often stressful having to continually ask for a bottle! Since my ablations and now recently a return to monthly episodes it is thankfully nowhere near as bad. However, if it’s not AF it’s a possible indicator for diabetes, or prostate cancer in men - and several other issues - so worth checking out.

Ethel, my GP told me that as we grow older our kidneys function better when we're lying down.


Bawdy profile image
Bawdy in reply to jeanjeannie50

My kidneys must be working perfectly, would like more quality sleep though, ha ha

Hi. Got to be honest. Not a side effect for me. Hopefully nothing serious, but speak to your pharmacist about it. I find mine is very helpful and knows the answers to a lot of my questions.

I get up three times every night to pee. I'm not in afib that I know of because when I am I really know it. It could be due to the amount of fresh veggies I eat daily. I try to reduce fluids late in the day. Interesting question, though.

secondtry profile image
secondtry in reply to willec49

Yes, I would like to know more about this as I can pee once, twice or three times in the night and I can't tie it down to one thing, tried plenty of things. I suspect (no evidence) it is when I turn over in the night and put a tad more pressure on my bladder, which because I'm of an age (67) triggers the urge which wakes me up. I am pretty sure it is not AF as I am very symptomatic and remember the days when I woke up with it.

Re ETHEL103's question, it may well be AF as I used to get it and still do occasionally in the afternoons but thanks to my friend Flecainide I just get the peeing now (due to heart enzyme release) without the AF.

When I have an AF episode, I can get up to pee 10-12 times. As Bob says it’s due to the heart releasing an enzyme. During that time, I drink loads of water because otherwise I would dehydrate and make the AF episode longer.

Yes, when I have AF I’m always back and forth to loo to do a wee.


Try 4 times a night. It's your age lol 😁

I'm a 2 to 3 trips a night person irrespective of whether I'm in AF. I'm rarely in AF at night as it happens. Not sure of your age but alas as women get older and lose our oestrogen the elasticity of the bladder muscles weakens and we tend to pee more. It's very common and the only fix is to do exercises. Don't ask...😉

Interesting comment upthread that as we age kidneys work better when we are lying down. I have to get up for a wee 3 or 4 times each night. During the day I rarely wee. I always assumed it was due to my 30+ years of teaching when there just wasn't time or opportunity for toilet breaks, but I guess it's because I'm old. On the plus side, I never have to search for an emergency weeing place when we go out, which my husband always has to do with increasing urgency as he ages. I've only had 1 episode of AF in the last 2 years (triggered by getting covid). It lasted 5 hours and I was weeing every 15 minutes, not a nice way to spend the night.

Can't say that I've found that to be the case. Very unusual for me to have to go during the night, even when in AF.

I get up normally ine anyway but I think when I get these Afib in the night I end up about five times, it’s so annoying......

You should be so lucky😉. Sometimes I have to get up five or six times, (occasionally more) and, as far as I know, it’s not connected to AF.

Limiting my liquid intake makes no difference at all. Three times is a good night for me. Hope it helps to know that some of us pee more often than you!

Thankyou everyone for your responses. Seems I'm not alone.

Hi ETHEL03 ,I am 70 now ,also have the same problem, however my friends who have never had AF also have to pee more at night ,especially those that have had children,think it’s just a problem of getting older, inconvenient I know .

You have a fair few correlations going on here. For example, I would think most people with AF on here are over 50 - so that has to be a factor. I know I wake up a lot in the night, but I drink water and tea all evening so I only have myself to blame for that. I suspect it's just "one of those things", although BobD gave, as usual, a factual and informative answer so I am sure he is right.

Yes, I am actually in AF now, it started around 3:30 this morning and since then I have had to go 4-5 times. I am drinking 2 litres of water a day as I find that AF usually starts overnight and dehydration appears to me to be a trigger, woke up feeling really thirsty

Lots of interesting thoughts. A couple of things to add, I have an afternoon nap and usually pee after that, if I miss for a couple of days I get swollen ankles and last time AF 🙄 Also you could be checked for a urine infection because just a little irritation can set you off.

I pee even more times than that when having an episode and they are of large amounts. I have lost 2 kilos in weight on occasion overnight. I believe that equates to 2 litres

The first time I had an afib attack it was horrendous -peeing enormous quantities . I even had to go in the ambulance it was so bad. Now I find during an attack I have to go 3/4 times at the beginning then it settles down and I can usually sleep. On normal nights I get up once usually sometimes twice.

I'm in PAF and generally get up once in the night, at 67 this appears to be normal, so don't believe there's a connection ?

Yes. It's very annoying as you say, but you have to grin and bare it. It usually coincides with sleeplessness as well which is even more irritating.

All the best.


Interesting, I’m exactly the same. Don’t know where it all comes from. I had a Pace and Ablate procedure 4mths ago. I, obviously, still have AF, and am aware of episodes during which time I am in and out of the loo !!! I don’t think there’s an answer

I hate to say this but most of us will eventually succumb to the “Ageing Bladder”.As a retired physio who specialised in women’s health, I had many, many patients with this problem. I would be reluctant to advise taking medication for this for AF patients.

It sucks getting old.

I've given up all caffeine except for one square of dark chocolate a day. I daily drink two runners drinks to replace electrolytes. Sis go hydro Is the one I recommend. Note beta blockers can make you retain potassium. I have the opposite problem of low potassium. Drink the sport drink then follow with another of water. Your heart and brain need electrolytes to function properly. I also make sure I drink plenty right before bed. Dehydration will be hard on your heart so stay hydrated. I eat my biggest meal halfway through the day so dinner for lunch. Gave up all processed foods. I'm allergic to dairy and wheat so you might want to see what cutting those out will do for you. Food pushes upwards on the heart when you lay down to sleep and that stress the heart so make your last meal of the day light. I'm a retired biochemist so following the science on what makes for a happy heart. I sometimes get up once a night about four hours in and have paroxysmal afib.

Oh yes, there's quite a connection with a-fib and needing to urinate. I'm sure others here would be able to explain in medical jargon as to why it happens.

Yes I definitely wee far more frequently when in AF. When I mentioned this to the doctor, he just said oh do you. Not very helpful.

Have you been tested for sleep apnea? I used to get up 2-3 times every night and would go to the bathroom. My EP insisted (over my objections) that I go for a sleep study. Turned out I had some pretty significant apneaic episodes (60 or so an hour) that were causing me to wake up. Now use a CPAP and rarely wake up at night.

Reference my reply to to BobD above, if the cause is not AF then , in my view, notwithstanding age, it’s worth checking for other issues like diabetes and, for us blokes, prostate cancer. I don’t believe just putting up with it is either reasonable or good advice.

Almost every time I've gone into AFIB, within about 20 min I start having to pee about every 15 min. From what I've read, this is due to the release of Atrial Natriuretic Peptide (ANP) and has something to due with helping your body eliminate salt in an attempt to reduce blood pressure.

All men should get regular PSA blood tests as they get older. This will flag up any problems and also if cancer is present in the prostate will flag it up early enough for less invasive treatment and a possible cure.

I'm so glad this issue of the experienced connections between AF and frequent urination has come up again. I'm not sure the connection is widely known among most medical professionals and I cetainly didn't connect my PAF (increasing in frequncy) with an increasingly overactive bladder! My GP referred me to Urology - who discovered nothing structurally amiss and the next step would be exercise and bladder retraining .

However due to incresing frequency of AF, cardiologist put me on a beta blocker and flecainide. Now 6 weeks on, the relief! no longer the thump (of the heart) in the night and better sleep and less peeing. I mentioned this new possible connection to the Urologist who was intrigued by it - knew the connection with natriureptic enzyme with heart failure but not with AFand promised to look further into it. Joked it would be useful to pass on her patients to a cardiologist!

Yes I do if my rate is high afib, like 120-130. I just drink more because I do not want to get dehydrated which is supposed to stress your heart more.

I saw Michael Mosley on TV program suggest inulin (High fibre powder) to help with poor sleep. My poor sleep was due to trips to the loo. It helped my sleep, as I was able to nod off again quickly. It also reduced but didn't stop my urge to pee in the night. Now many years later and in permanent AF but only rarely need to go in the middle of the night. Think exercise was the thing that helped most.

I was getting up five or six times a night. Then I got pulled off of my anti-arrhythmic medication and within five days the night peeing was drastically reduced. Something to consider.

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