Important points to consider

• Uninterrupted sleep is important for good health. Effective continence products for use at night will allow you to sleep without being disturbed (by products leaking or needing to be replaced) or enable you to quickly and easily deal with your toileting needs before going back to sleep.
• Many people use combinations of products to suit their changing needs. It is likely you will need different products for night use from those you use during the day.
• Some product types are inherently unsafe for use during the night; for example, a penile compression device or catheter valve. During sleep you may be unable to detect pain which, when awake, would alert you to remove the device.
• Some product types are generally better for day use but there may be variations of the product or modifications which can be made to allow for night time use; for example, large volume urinary drainage bags or more absorbent pads with greater capacity for longer wear time.
• 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.

Pads

• 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) although the most absorbent pads are generally all-in-ones.
• Whether or not a pad is suitable for you overnight depends on how much you leak. During the day discreetness may be of greater concern and you can change a smaller pad more often. At night you may be more concerned about having a good night’s sleep with a dry bed in the morning and smaller pads may be inadequate.
• 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 for night time than for day time.
• Washable absorbent products are not generally so effective for heavy and / or night time use. An exception to this is products made from 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, especially men, find that washable pads are an acceptable and effective alternative for night use ¹ The point at which leakage occurs varies (as the urethral opening can change position with movement) and men tend to leak more than women at night. Thus men need robust night time protection. The multiple layers which make up some washable all-in-one pads, for example, towelling diaper style products, can provide additional absorbent capacity.
• Some manufacturers are starting to develop absorbent products which are designed specifically for men with heavy and/or night time leakage. Try contacting the manufacturers if you are having difficulty finding an effective product for you.
• 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 when at home for night use is acceptable to some people who would find managing washable products during the day difficult. When away from home, disposable products are easier to use and provide greater discreetness.

You can read more information about pads.

Male devices

• Some male devices are unsuitable for night use (penile compression devices) and others work less well when lying down (body-worn urinal).

• It is recommended that penile compression devices are released every two hours to reduce the risk of damage from reduced blood flow.

DO NOT USE A PENILE COMPRESSION DEVICE AT NIGHT

• Body-worn urinals are held in place with a system of straps and successful use relies on the penis hanging down into the cone. This type of device is less likely to be successful for night use; the penis may become retracted and disconnected from the cone, and gravity can cause the urine to drain towards the wide end of the cone.

You can read more information about male devices.

Female devices

• Some female devices are only recommended for short-term use and are therefore not suitable for use during the night. For example, devices that cover the urethral opening have been recommended for a maximum wear period of four hours.

• Internal urethral devices are recommended for intermittent use during periods of exercise.

DO NOT USE INTERNAL URETHRAL DEVICES AT NIGHT

• Internal vaginal devices may stay in place for longer periods as they should not prevent normal bladder emptying. However, they do need to be removed periodically for cleaning (follow manufacturer's instructions).

You can read more information about female devices.

Catheters

• If you have an indwelling catheter it is important that urine can drain freely from the bladder. Often catheters are connected to drainage bags; this is called ‘free drainage’ and unless the catheter becomes blocked, urine can drain freely into the bag and will not build up in the bladder.
• Catheter drainage bags come in two main types: those which are worn on the leg (usually called ‘leg bags’) and those which are secured to a stand on the floor (usually called ‘free standing’ or ‘night’ bags). 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. It is important that these bags are supported on a sturdy stand to avoid contamination of the drainage tap.
• Catheter bag manufacturers usually make drainage bag stands to fit their bags although they are fairly universal.
• Drainage bags can also be connected to male devices such as sheaths. An important aspect of catheter management is security of the join between the catheter and drainage bag tubing which can become disconnected when turning during the night. Tubing straps are available, which some people find can help to avoid this problem.
• Some people prefer to use a catheter valve instead of a drainage bag. This is connected to the catheter and is opened every few hours to allow the bladder to empty in much the same way as if you were going to the toilet. However, this is not possible during the night (unless you wake deliberately) and the bladder could become overfull. Over time, this can have serious consequences for bladder and kidney health. For this reason...

DO NOT USE A CATHETER VALVE AT NIGHT

You can read more information about catheters.

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 read more information about faecal devices.

Toileting aids

• Hand-held urinals are available in a wide range of designs. 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.
• They can also be difficult to manage when full without spilling, although some can be connected to a drainage bag on a stand by the bed. This system may allow you to use the urinal repeatedly during the night. 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.

You can read more information about toileting aids.

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 and chair protectors.

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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