Most men assume that waking up two or three times a night is just part of getting older. They drag themselves to the bathroom, shuffle back to bed, and hope for the best — night after night, year after year. What they don't realize is that this pattern, known as nocturia, is not only stealing their sleep but quietly damaging their long-term health. We sat down with Dr. Marcus Ellison, a board-certified sleep specialist with over 18 years of clinical experience, to get a frank conversation about the overlooked connection between incontinence and sleep in men — and what men can actually do about it starting tonight.

Dr. Ellison has spent the better part of two decades watching men come into his clinic exhausted, frustrated, and often ashamed. "They'll list a dozen symptoms before they mention the bathroom trips," he says. "There's so much stigma attached to incontinence in men that most guys would rather blame stress or bad coffee than admit they're leaking." What follows is an edited and condensed version of our conversation — one that covers the science, the emotional toll, and the surprisingly simple strategies that help men reclaim deep, restorative sleep.

The Problem Nobody Talks About

Dr. Ellison doesn't mince words when he describes what he sees in men's sleep studies. "Incontinence and disrupted sleep are almost always traveling together," he says. "You rarely fix one without addressing the other." His observation is backed by hard numbers. According to the National Institutes of Health (NIH), nocturia — defined as waking at least once per night to urinate — affects roughly 50% of men over the age of 50. For men over 70, that number climbs closer to 80%.

But the real danger, Dr. Ellison explains, isn't just the lost sleep. It's what the sleep disruption does downstream. "When your sleep is fragmented night after night, your body never enters the deep restorative stages — Stage 3 and REM sleep. Your cortisol stays elevated. Your cardiovascular system takes a hit." He pauses. "Most of my patients don't connect those dots."

The Mayo Clinic has connected those dots in compelling research, linking nocturia in men to significantly elevated risks of cardiovascular disease, hypertension, and even all-cause mortality. One study found that men waking two or more times per night had a 1.5 to 2 times greater risk of cardiovascular events compared to men who slept through the night. "That's not a footnote," Dr. Ellison says. "That's a headline."

For men dealing with light leaks or post-void dribbling throughout the night, having reliable protection can at least remove the anxiety layer from the equation. Many of Dr. Ellison's patients have found that wearing Orykas light leaks boxer briefs helps them stop obsessing over whether they've leaked — allowing their brain to settle into deeper sleep cycles instead of staying on high alert.

The Isolation That Follows

Gary Hendricks, 61, a retired high school football coach from Columbus, Ohio, knows this pattern better than most. For three years, Gary barely told anyone — not his doctor, not his adult kids, not even his wife of 32 years — that he was waking up four times a night to use the bathroom and frequently not making it in time.

"I'd lie in bed rigid, listening for any sign that I needed to go," Gary recalls. "I stopped sleeping on my side of the bed. I started putting a towel down. I was embarrassed in my own house." During the day, the exhaustion compounded everything. He quit his morning walks, stopped accepting weekend fishing invites, and began canceling plans out of fear. "I didn't want to be somewhere I couldn't find a bathroom fast," he says quietly.

His wife finally insisted he see his primary care doctor. What Gary discovered was that his condition wasn't just "old age." He had an enlarged prostate — a condition the American Urological Association (AUA) identifies as one of the leading causes of nocturia and urge incontinence in men over 50 — combined with sleep apnea that was amplifying his nighttime bathroom urges. "My doctor said fixing one problem without the other was like patching half a roof," Gary says.

The Discovery: A Turning Point in Sleep and Confidence

"One of the first things I tell patients," Dr. Ellison says, "is that the goal isn't perfection — it's reducing the anxiety enough to let sleep happen. The moment a man stops white-knuckling the night, his brain chemistry starts to shift."

For Gary, that shift started with two changes happening simultaneously: a fluid cutoff protocol recommended by his urologist, and discovering washable incontinence underwear that didn't feel like a diaper. "My doctor told me to stop all fluids — including that nightly decaf — by 6 p.m.," he says. "I thought that was extreme. But within a week I went from four bathroom trips to two. That was huge."

Dr. Ellison calls the fluid cutoff timing the single most underrated behavioral intervention in sleep medicine. "Most men are drinking a glass of water with their evening meds at 9 or 10 p.m. and wondering why they're up at 2 a.m.," he says. "The kidney doesn't lie. You put fluid in, fluid comes out. Give yourself a two-to-three hour buffer before bed, and your bladder has time to catch up."

The underwear discovery was equally transformational for Gary. A friend mentioned Orykas absorbent boxer briefs — washable, discrete, and built for overnight protection. "The first night I wore them, I slept four hours straight," he says. "I wasn't staring at the ceiling wondering if I'd leaked. I just... slept." He eventually added a washable bed pad to his setup as extra nighttime protection, which his wife also appreciated. "She stopped worrying too. That mattered a lot to me."

What the Science Says You Should Do

Dr. Ellison walks through the evidence-based strategies he recommends most often to his patients dealing with incontinence and sleep disruption:

  • Fluid cutoff 2–3 hours before bed. This is the number one behavioral change. Avoid all liquids — water, herbal tea, alcohol — within two to three hours of your target bedtime. Alcohol is particularly problematic: it suppresses ADH (antidiuretic hormone), dramatically increasing urine production overnight.
  • Elevate your legs in the evening. Men who sit all day accumulate fluid in their lower legs. When they lie down, that fluid redistributes to the kidneys and bladder. Elevating your legs for 30–60 minutes before bed reduces this fluid shift significantly.
  • Reduce salt and processed foods after 4 p.m. Sodium drives fluid retention and nighttime urination. The National Association For Continence (NAFC) highlights dietary sodium as a frequently overlooked driver of nocturia.
  • Address sleep apnea. This one surprises most men. Sleep apnea increases atrial natriuretic peptide (ANP), a hormone that signals the kidneys to produce more urine. Treat the apnea — often with a CPAP — and nocturia episodes frequently drop without any other changes.
  • Pelvic floor exercises. Not just for women. The AUA recommends pelvic floor muscle training for men with urge and stress incontinence, with studies showing meaningful reductions in leakage within 8–12 weeks.

For men who prefer a different cut or who are transitioning from disposable products, Dr. Ellison also notes that the style of protective underwear matters for adherence. Men who dislike the brief style of traditional products often do better with boxer-cut options, while others prefer the fit of Orykas incontinence briefs — particularly those who've always worn briefs and want to stay comfortable with a familiar silhouette.

Life Today: Sleeping Through the Night Again

Gary Hendricks is two years into his new nighttime routine. He goes to bed by 10 p.m., has his last sip of water by 7. He does 15 minutes of leg elevation while reading. He wears his Orykas boxer briefs and keeps a bed pad under the sheet — more habit than necessity now, he admits with a laugh. "I wake up once most nights," he says. "Sometimes not at all. My wife says I'm a different man."

He's back to his morning walks. He went fishing last September — two nights in a tent — for the first time in four years. "I packed two pairs and a laundry bag," he says. He's not the only one. Men in similar situations often find it easier to travel and manage on the go with the right gear; Orykas even carries incontinence accessories like travel-friendly laundry bags designed for exactly that kind of independence.

Dr. Ellison sees Gary's story play out repeatedly in his clinic. "The men who do best are the ones who stop treating this as a personal failure and start treating it as a solvable problem," he says. "Incontinence and disrupted sleep are medical issues. They respond to medical and behavioral solutions. The only barrier is shame — and that barrier is optional."

For men just starting to address the issue, he recommends not trying to overhaul everything at once. Start with the fluid cutoff. Talk to your doctor about your prostate health and sleep quality. And if nighttime anxiety about leaking is keeping you awake, get protective underwear that actually works — something reusable, discreet, and built for real life. Trying a few different styles is easier with Orykas value packs, which let men find the right fit without committing to a single option upfront.

"Sleep is not a luxury," Dr. Ellison says. "It is the foundation of every other health outcome you care about. Fix your nights, and your days start to heal themselves."

Frequently Asked Questions

1. Is it normal for men to wake up multiple times a night to urinate?

Waking once a night is considered within the normal range for men over 50. Waking two or more times — especially if it disrupts your sleep — is classified as nocturia and warrants a conversation with your doctor. The NIH reports that nocturia affects the majority of men over 60 and is associated with increased cardiovascular risk when left unaddressed. It's common, but it's not something you simply have to live with.

2. Can incontinence cause serious health problems beyond poor sleep?

Yes. Chronic sleep disruption caused by nocturia has been linked by Mayo Clinic researchers to elevated cardiovascular risk, hypertension, depression, cognitive decline, and falls in older men. Additionally, the anxiety and isolation that often accompany incontinence can worsen mental health outcomes significantly. Treating incontinence as a health priority — not just an inconvenience — is medically justified.

3. What is the most effective behavioral change for reducing nighttime bathroom trips?

According to sleep specialists and urologists, the single most impactful behavioral change is enforcing a fluid cutoff 2–3 hours before bedtime. This means no water, alcohol, caffeine, or herbal teas in that window. Alcohol and caffeine are particularly disruptive because they suppress antidiuretic hormone and increase urine output. Most men who implement this consistently see a meaningful reduction in nighttime voids within one to two weeks.

4. What type of incontinence underwear works best for overnight use for men?

For overnight use, men generally need a product with higher absorbency than what a daytime light-leak liner provides. Boxer-cut styles with a full absorbent panel tend to offer better coverage for movement during sleep. Pairing underwear with a washable bed pad adds a second layer of protection. Men with heavier overnight flow or those recovering from prostate surgery often find the Orykas absorbent boxer briefs work well for overnight protection while remaining comfortable enough to actually sleep in.

5. Should I talk to my doctor about incontinence, or is it something I can manage on my own?

You should absolutely talk to your doctor. Incontinence in men — especially when combined with disrupted sleep — can be a symptom of treatable underlying conditions including an enlarged prostate (BPH), sleep apnea, diabetes, or heart disease. The CDC and AUA both recommend that men report urinary symptoms to their healthcare provider rather than self-managing indefinitely. Behavioral strategies and protective products are valuable tools, but they work best alongside proper medical evaluation, not instead of it.

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