Important points to consider

People often use different products at night than they use during the day. For example, a larger, more absorbent pad or a larger urine collection bag at night.

Uninterrupted sleep is important for good health. Using products that contain leakage effectively will allow you to sleep without being disturbed by products leaking or needing to be replaced.

If you must waken to use the toilet, other products may enable you to do so quickly and easily before going back to sleep.

IMPORTANT: Some product types are unsafe for use when asleep. A penile compression device or catheter valve should not be used when asleep as they can lead to the bladder overfilling, which can lead to health problems.

Think about which product types might suit you, taking all factors into consideration, and then think about whether this product or combination of products would be safe at night and, if not, how it could be modified to suit your night time needs.

Product Suggestions

The sections below give information about product choice for use at night. Click on the links to be taken to the relevant product sections for more detail.

Absorbent products

• A suitable pad for night use will contain all leakage until the morning, prevent leakage from the pad onto bedding and keep your skin dry within the pad area.

• Depending on how much you leak this might mean you have to use a larger pad at night than you do during the day.

• Most disposable pad manufacturers make pads in a range of absorbencies including very absorbent pads for night use. These are available in most pad styles (disposable pads, all-in-ones or disposable pants). In general, all-in-one pads are the most absorbent pad type.

• Most washable absorbent products are not generally so effective for use when asleep. An exception to this is terry towelling which, although a rather old fashioned material, is very effective at absorbing urine. The towelling, which does not have a waterproof layer, is folded and secured in place with resealable tabs or safety pins and worn with waterproof pants. Some people find this an acceptable and effective alternative for night use, especially men.¹ Because men tend to leak more than women at night and the urethral opening can change position with movement, some men appreciate this form of protection, in which multiple layers can be adjusted to provide absorbency where it is needed.

• You may find that combining a washable pant or all-in-one pad with a small disposable insert pad gives you a cost-effective, leak-free solution.

• Using washable products at night when at home is acceptable to some people who use disposable products during the day. When away from home, disposable products are easier to use because no laundry is needed.

You can read more information about all types of absorbent products in the sections on Absorbent products for women and Absorbent products for men.

Catheters

• Indwelling catheters are normally connected to a urine collection bag which come in two main types: those that are worn on the leg (usually called ‘leg bags’) and those which are secured to a stand on the floor or on the side of the bed (usually called ‘free standing’ or ‘night’ bags).

• It is important that urine can drain freely from the bladder. If your urine collection bag fills up when you are asleep, this can cause leakage or can lead to an overfull bladder, which can cause health problems.

• Generally people need larger volume drainage bags for night use to cope with the greater amount of urine produced throughout the night. Night drainage bags are available in volumes of up to two litres. They can be connected directly to the catheter, or to the leg bag drainage tap, which should be left open so that urine can flow through the leg bag and into the night bag.

• It is important that night bags are supported off the ground to avoid contamination of the drainage tap.

• Sometimes the joint between the catheter and the urine collection bag tubing can become disconnected when turning during the night. Tubing straps are available, which some people find can help to avoid this problem.

• Some people with an indwelling catheter use a catheter valve, which prevents urine from passing through the catheter and are released periodically to empty their bladder. A catheter valve should not be closed when asleep as this may cause the bladder to overfill and lead to health problems. For use during the night, the valve should be connected to a urine collection bag and left in the open position.

You can find more information about catheters here and about urine collection bags here.

Male devices

• Penile compression devices (clamps) should not be used when asleep. It is recommended that penile compression devices are released every two hours. Failure to do so may lead to damage from reduced blood flow and may cause the bladder to overfill.

• Body worn urinals work less well when lying down. Successful use relies on the penis hanging down into the cone, which is held in place by straps. When lying down, the penis may become retracted and disconnected from the cone, and gravity can cause the urine to drain backwards out of the cone rather than into the collection bag.

• Sheaths can be worn when asleep, connected to a urine collection bag.

You can find more information about male devices here.

Female devices

• Internal vaginal devices may stay in place for longer periods as they should not prevent normal bladder emptying.

• However, any internal device can cause discomfort or irritation so that it may be best to limit their use to daytime or to certain activities when wearing a pad may be less convenient. Disposable bladder supports are intended to be used only for up to twelve hours in any twenty-four hour period.

You can find more information about female devices here.

Faecal devices

• Faecal devices such as anal plugs are mainly used during daytime activities; they are removed once the activity is completed. They can cause discomfort and may not be suitable for night use. You may find a pad is better for night time.

• Adhesive faecal collectors are generally used for people confined to bed during the day or night. These people are usually unwell with very loose stool. Used appropriately, this type of device can minimise the need for unnecessary disturbances during sleep.

You can find more information about faecal devices here.

Toileting aids

• Toileting aids are intended to make using the toilet safe or to act as an alternative to the toilet for people who find it difficult to reach the bathroom.

• Toileting aids are not, therefore, of use when you are actually asleep. However, if you often need to waken to use the toilet, an aid could make this easier, reducing the interruption to your sleep.

• A hand-held urinal, available in a wide range of designs, may enable you to empty your bladder conveniently.

• Most urinals do not work well when used lying down or in bed. Some people find it hard to achieve an effective position and the result can be leakage onto bedding. Urinals are more likely to work better if you can sit on the side of the bed.

• Hand-held urinals can be difficult to manage when full without spilling. The risk of spillage can be reduced by the use of super absorbent powder (available in sachets) which absorbs the urine and changes the consistency to a thick, gel like substance.

• Commodes are designed specifically to provide toilet facilities in a more convenient place. If you are unable to walk safely to the toilet during the night, a commode by the bed could be a practical solution.

• Commodes are available in a wide range of designs including those intended to look like furniture for greater discreetness. Some commodes can be connected to the bed for greater security during transfers.

Follow these links to find more information about toileting aids for women and toileting aids for men.

Bed protectors

• Leakage of urine onto bedding is not only distressing but can be costly when replacement items and / or frequent washing is required.

• If you don’t have confidence that the body-worn products you use for night time containment will be 100% effective, you may want to have additional bed protection.

• Disposable and washable protective covers are available for all bedding items (mattresses, duvets, pillows) to fit beds of all sizes.

• There is also a range of absorbent bed pads which aim to both protect the bedding and contain leakage. Larger washable bed pads are intended for use as either back up for body-worn products or, as some people prefer, to be their sole night time product. If your night leakage is intermittent this has the advantage that you do not need a body-worn product all the time - the bed pad is there in case you have a leak. The bed pad is intended to hold the urine while staying dry in contact with your skin. However, it is important that you do not wear any bed clothes beneath your waist as these will remain wet and this could lead to skin irritation.

• You can read more information about bed protection here.

Tips from product users

• Do as much 'personal testing' as you can to get the most suitable products.
• Keep wet wipes or a cloth and water by your bedside.
• Use a larger pad for night time - small pads tend to get crunched up with restlessness during the night.
• If you sleep under a duvet and are likely to leak heavily, have an extra sheet between you and the duvet to minimise laundry.
• A large sheet of plastic under a commode or beside the bed can often save a carpet or floor from damaging spills.
• If you sleep on your front, have the wide end of an insert style pad against your abdomen. This will help contain leakage which spreads downwards with gravity.

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