Night/Early-morning "anxiety" caused by need to urinate

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@faye8

I was having the urge to void accompanied by difficulty starting my stream. The Flomax seems to be helping that, and seems to allow
me to more fully empty my bladder

Thanks for the reply. I have no issues initiating/starting to urinate. I fortunately don't need medicine to assist with that. I sleep well through the night...no leaks or major accidents - I retain every drop while sleeping. But around 4:00 - 5:00 a.m. as I am starting to awaken into that semi-conscious twilight sleep, I find myself in a distressing, anxiety-filled weird dream or disturbed, semi-wakeful state. Then I note that I "could probably go to the bathroom." There is no urgency...no sprint to the bathroom. I just finally decide: "OK...I guess I'll get out of bed to urinate." Then when I crawl back into bed, within 5 minutes I am aware that I am no longer anxious...no weird dreams or anxious thoughts resume. I can relax and drift off to sleep for another hour or two. I have no anxiety while awake and going through my day. I don't think much about my cancer. The biggest thing on my mind is wondering "how long I can go today without needing a fresh diaper?" I just hope my anxiety disappears, hopefully faster than slower.

Since my surgery two years ago, I still will get up 2-3 times a night to urinate. When it happened before my RP, it was due to my enlarged prostate. I am a light sleeper, and when I wake up I just decide to go. Usually, I don’t have that pressing on my prostate “urge” like I used to. I have talked to my urologist and a sleep doctor and they said this is all normal for someone my age(73). My urologist also said that the surgery may have softened my bladder and that causes me to go. As far as anxiety, I get more urge to go when I’m getting ready to go out, like to a ballgame or shopping. I really believe that some of it is just in my head. Hope this helps. Best wishes🙏

Fortunately I have two dogs to remind me when it’s time to pee. It so happens their schedule to pee corresponds with my need. It has also been my experience that as we age, sleeping through the night becomes a rare occurrence. Many of my same age friends describe the same experience. Rather than trying to fight it, I allow it to be what it is. Sleep then seems to sneak up on me without trying (sometimes). Anyway, for me it’s part of the plan. Best you on your journey…

@sicernon3
15 years after surgery and 12 years after radiation, I get up at most once a night to pee. I take Myrbetriq Which reduces the urge to go and also helps with incontinence. Gemtesa Is another drug that does the same thing. If you’re getting up too many times at night, this may help you, It sure worked for me.

@sicernon3 Yes indeed...one thing I told my urologist is that shortly before my first PSA in four years, and before my December biopsy (surgery was April), it was roughly September of 2024 that I started getting up to urinate between 4:00 a.m. and 5:00 a.m. It had never happened before, and I asked my urologist if that is a sign of prostate cancer. he said "no...as we age, our bladders get smaller." I said/asked: "What...I've been in health care...hospital-based clinical health care...for forty years and had never heard that!" He said said "yep...that is an additional reason why so many women wear "pads"...urinary incontinence pads after 50 years old (some earlier). I was dumbfounded. What doesn't "fit" is that prior to my surgery and in those nightly urinations, I never had the anxiety/distress that I now have post-surgically. It is like my continually, slowly shrinking bladder is signaling my brain which sends an anxiety message to me, that is not relieved until I get out of bed to pee. Weird.

Is being tense or anxious your concern, or is it the need to urinate, or is it that you wake up an hour earlier than you used to. Each may be an issue that could be resolved individually.

@duberdicus Thanks for the message. It only took a few times of slowly, strangely awakening and being aware that I was full of anxiety...like I was wired with too much caffeine (I am caffeine-free now)...that I noticed: "well, you're awake now, and I guess I could get up to urinate" even though "at most", I only had mild urgency. It was more just an awareness like all other mornings prior to my surgery that" "Oh...I am awake...I guess I could go urinate now." Then within a handful of times doing that, I realized that after crawling back in bed post-urination, my anxiety was gone. I have experimented a little too, like nothing to drink after 6:00 p.m....no liquids of any kind. Those nights I sleep through the night and I awaken normally without any anxiety or sense that I had a bad dream. Then I switch back to having something to drink as late at 9:00 or 10:00...just a few sips of water. I always urinate before going to bed, so my bladder is as empty as it can be for my night's sleep. But...those nights, I awaken between 4:00 - 5:00 a.m. with that bit of wired anxiety, and again, just get up to urinate because I decide to - not because I necessarily needed to (but do on occasion). Then once I go back to bed, it quickly realize that I am no longer feeling wired/anxious/tense. I have a sense of relief. I never had this occur before my RP surgery. It has only been since my surgery. Guess I have to live with it until it hopefully subsides.

Just finished Proton Therapy a week ago. I started getting up every 2+ hours. Strong urge to urinate. Dreams have me searching for something. Sometimes it is a search for a place to pee. Last night it was closer to every hour. When I get up, I can’t go right away (or very little). I have to wait about 5 minutes and then I can go. I’m hoping this will slowly improve.