Fine all day, up all night? It's probably not your bladder.

A full bladder every time you get up at night means your body is making water at night. Here is where it comes from and how to see it on your own ankles tonight. In a trial, light socks worn in the day cut night trips by 54 percent within two weeks, against 31 percent on look-alike socks. You put them on in the morning and forget them.

You go to bed. You fall asleep fine. And then the night starts.

this peeing at night is starting around 2 and every hour after until I get up

And in the morning, the strangest part. The same woman, who is 72, wrote:

Then urination is normal the rest of the day.

Fine all day. Up all night.

And by bedtime, the sock leaves a line around the ankle. That line matters, as you will see.

If that is you, you may have been told it is your bladder. But think about it for a moment. A bladder that is weak, small or nervous does not clock off at breakfast. It would trouble you in the day too.

And look at what comes out at night. Not a few drops. A full bladder, every time.

It's a strong void [...] My wife is shocked that I can produce so much urine that many times a night.

A strong void, many times a night, from a man who stops drinking two hours before bed. That is not a small bladder. That is a body making water at night.

So the real question is: where is that water coming from?

What it costs

It is not just the sleep. It is the day after.

I am exhausted during the day. I'm still working full-time and I enjoy working I'd like to keep working but this is becoming detrimental to my ability to work.

The worse is waking up to pee an hour or less before the alarm. It gets exhausting.

And it is the walk itself, in the dark, half asleep, two or three times a night.

Years ago I passed out on the way back to bed after a trip to pee in the middle of the night. [...] I suffered some significant rug burns on the right side of my face, as well as permanent hearing damage in that ear from the impact.

Why the usual advice has not worked

Cutting drinks in the evening. It takes away the glass at 8 pm. It does not touch the water your body collected over the whole day.

A pill for the bladder. It calms a bladder that rushes. If yours is fine all day, it is aimed at the wrong place. If a doctor prescribed it, keep taking it.

A pill to sleep through it. You still wake to a full bladder.

Living with it. It tends to creep up, not go away.

None of them asks where the night's water spends the day.

Your legs, at 6 pm

All day you are upright, and all day gravity pulls a little water out of your blood into the soft tissue of your ankles and calves. It does not hurt. You barely feel it. But by evening the sock is pressing into a slightly fuller leg than the one it went on in the morning, and it leaves a line.

That line is one place the water shows.

I drink water all day long at work but hardly pee all day.

Where does the day's water go, if not into the bladder? Some of it settles in your legs. Here is how it comes back.

At bedtime you lie down, and your legs are level with your heart for the first time all day. The pressure that held the water down there lets go, and it flows back into your blood. Researchers have measured it: in men over 60 who make a lot of urine at night, the fluid around the cells of the legs dropped after half an hour lying down with the legs raised.

Your blood now holds more water than your body wants, so it turns down the hormone that holds urine back at night. Your kidneys get to work. All night.

That is why every trip is a full bladder, and why the day is fine. During the day, part of that water was not in your bladder at all. It was in your legs.

And in the morning you get up, and the day fills them again. That is why it does not pass on its own, and why it is the same night, every night.

In a study of 1,688 Dutch men aged 50 to 78, 91.9 percent of those who got up twice or more made over a third of their whole day's urine at night. And in wheelchair users with spinal cord injuries, researchers found that the more water sat in the legs, the bigger the share of urine made at night, and that wrapping the legs cut the urine passed at night.

The fix is in the day

If the water collects in your legs during the day, the day is where to deal with it.

Light graduated compression socks squeeze gently, tightest at the ankle and lighter up the calf. Worn while you are up, they work against the pull of gravity, so less water settles in your legs. At bedtime they come off, and there is less to send back to your kidneys at night.

On when you get up.
Off when you go to bed.That is the whole rule, printed on the card in every order.

One man's story, then the trial

One man found it by himself and wrote about it under a urologist's video. He is not our customer, and the socks he wears are not ours. He had been up two to five times a night; he raised his legs in the evening and wore compression socks in the day:

Now I raise my legs up on four pillows. Watch about three hours of TV. And in those hours I found that I urinate 3 to 4 times. Probably 3/4 of a pint!! this is at 7 PM. But what happens is, I only urinate about once every night now. I actually had a night where I didn't urinate at all. Which didn't happen for years.

I wear my compression socks during the day, then I take them off before I lay down to watch TV.

He did two things, and one story is not proof. So here is what light socks worn by day did on their own, against socks that only looked the same.

"Aren't compression socks for swollen ankles, and only while you wear them?"

One wearer's vascular surgeon told them this, and told them to stop:

My vascular surgeon told me compression socks only help when you're wearing them, as soon as you take them off they are useless.

That is the point here. The water that swells your ankles by evening is the water that comes back into your blood when you lie down. The socks are on while it would settle, by day. What you count is the night, after they come off.

"Won't they be tight and hard to get on?"

I've not been wearing my c socks much because they are a pain to get on.

They are light, and not too light. We made the day socks for this one problem, at the trial's pressure, about 12 to 14 mmHg at the ankle: not so tight you dread pulling them on, not so light they are just socks. They are sized by ankle and calf. To put them on, turn the sock inside out down to the heel, slide your foot in, then roll it up the leg. Getting compression socks on is the most common complaint of people who wear them, and a sock you dread is a sock you stop wearing.

"Should I wear them to bed, to be sure?"

I wore mine to bed but it was a big mistake. [...] My legs got much more swollen and the skin got dry and flaky.

That was someone who slept in theirs. On when you get up, off when you go to bed. Sleeping in them works against the idea.

"What about the pills I take?"

A man of 71, on medication for years, wrote:

I follow everything you mention now for many years and also take medication, guess the next step is the operation which sounds a bit scary.

Keep taking what your doctor prescribed. The socks are not a medicine and do not replace one. They go alongside.

"I already wear compression socks, and I still get up."

have worn compression socks throughout each day for 40 years. [...] Make 5-6 times per night

That man is 75. His post also names urges all through the day, nerve damage in the feet and sleep apnoea, and socks change none of those. If that sounds like you, read who the socks are not for first. If it does not, look at how yours are worn: the trial's socks were light, worn from morning to evening, at least eight hours, and off at bed. Socks worn at night, now and then, or tight enough to dread are a different test.

The price, and the two ways this can go

Buy one pair and get one free: two pairs for $49. Set that against another prescription, and another year of the hallway at 3 am. This is a pair of socks in the morning.

And you will not have to guess whether it is working. The trial counted the nights at two weeks, so every order comes with a card for your nightstand: count tonight's trips, then mark every night for the fourteen nights after you start.

You can go on living with the hallway at 3 am, and the tired afternoons that come after it.

Or you can look at your ankles tonight, press your thumb into your shin, and start in the morning.