If you’re frequently rushing to the bathroom, waking up multiple times a night to urinate, or experiencing sudden urges that are hard to control, you’re not alone.
These can be signs of overactive bladder (OAB), a condition that affects approximately 1 in 5 adults.
What is Overactive Bladder?
Overactive bladder is a syndrome (group of symptoms) characterized by:
- A sudden, difficult to delay urge to urinate that may or may not be associated with leakage of urine
- The frequent need to urinate
- A bothersome need to wake up at night to urinate
Why is Overactive Bladder an Important Health Condition?
Even without leakage, OAB can disrupt work, travel, sleep and social activities and can affect a person’s quality of life. It can lead to fear of leaving the house and avoidance of social activities, and it can impact relationships and work productivity.
Health risks associated with OAB include anxiety and depression, skin rashes if incontinence is present, sleep deprivation. Patients waking at night and rushing to the toilet are also at increased risk of falls and hip fractures.
Why Does This Happen?
The exact cause of overactive bladder isn’t always clear. In many cases, it’s related to how the bladder and nervous system communicate. For example, the normal control that our brain has over the bladder to stop it from contracting may be weakened, or the brain may receive too much signalling from the bladder when it is not actually full.
Possible contributing factors include:
- Changes in nerve signaling between the brain and bladder that can occur anywhere along those pathways (the bladder lining or muscle cells, the nerves to the bladder, the spinal cord, or the networks within the brain)
- Pelvic floor muscle dysfunction
- Hormonal changes
- Certain medications
- Underlying health conditions
The Nervous System and Mental Wellbeing
Bladder function is controlled by the nervous system, and injury or disease affecting the brain or upper spinal cord can lead to a neurogenic type of overactive bladder.
Less obvious conditions affecting the brain, like aging and mental health challenges, can also be associated with OAB. Overactive bladder in some cases shares a cause with some mental health conditions such as depression and anxiety. Furthermore, certain bladder conditions such as OAB can influence your mental wellbeing, while certain mental health concerns can impact bladder and pelvic function.
FAQ
+ What’s the difference between overactive bladder and stress incontinence?
Overactive bladder is driven by urgency, when you feel a sudden need to go and may leak before reaching the bathroom.
Stress incontinence, on the other hand, involves leakage with pressure (like coughing, sneezing, or exercise).
Some people also experience both urgency and stress incontinence, named mixed urinary incontinence
+ Can overactive bladder go away on its own?
Symptoms can fluctuate, but OAB typically improves with targeted treatment rather than resolving completely on its own.
+ What is considered “frequent urination”?
Most people urinate about 6–8 times during the day. Needing to go more often than this, especially if it feels urgent or disruptive, may be a sign of overactive bladder.
+ Is it normal to wake up at night to urinate?
Yes, it’s normal to wake up at night to go pee. However, waking two or more times regularly may indicate nocturia which can be associated with overactive bladder.
+ What does urinary urgency feel like?
Urinary urgency is a sudden, strong need to urinate that is hard to hold back. It can feel intense and may occur even when the bladder is not full.
+ What role does stress or mental health play?
The bladder and nervous system are closely connected. Stress, anxiety, and poor sleep can heighten urgency and sensitivity. Supporting mental wellbeing is often an important part of treatment and may include strategies like mindfulness, counselling, and therapies such as EXOMIND.
+ How do I know if my pelvic floor is part of the problem?
Both weak, tight & overactive pelvic floor muscles can contribute to bladder symptoms. A pelvic floor assessment helps determine what is happening and guides appropriate treatment. Pelvic floor assessments with our pelvic floor physiotherapist can be booked by calling 403-688-6166.
