Simply put, nocturia is too much urination at night. The condition involves regularly waking up in the night to urinate.
There are many different causes for this condition, which can make it difficult to diagnose.
However, once the causes are known, there are many treatments available. There are also ways to help prevent nocturia, and tips for sleeping well with the disorder.
Nocturia is often confused with a condition called overactive bladder (OAB).
OAB is caused by early and uncontrolled spasms of the bladder muscle, which makes a person have to urinate when their bladder is not actually full. This means regular urination throughout the day, and often during the night.
While people with OAB may experience frequent urination at night, people with nocturia tend to only experience frequent urination at night.
Many people with nocturia produce a normal amount of urine overall, but simply produce much more urine at night.
The treatment for nocturia depends on its cause, so there can be many different working treatments.
For example, if nocturia is caused by an infection, antibiotics may clear up the symptoms. If it is caused by a medication, doctors may consider changing the person's medication or simply recommend they take it earlier in the day.
In some cases, for example if an individual with nocturia also has an enlarged prostate, surgery may be necessary. Nocturia caused by other serious conditions, such as diabetes, cancer, or heart failure will also require more extensive treatment.
The important thing to understand is that in order to treat nocturia, the underlying disorder needs to be identified and treated.
Doctors may also prescribe medications to treat nocturia. Antidiuretics such as desmopressin can be taken to reduce the amount of urine produced. Other drugs that may help are anti-cholinergics or anti-muscarinics, such as:
People who have nocturia that is caused by lifestyle choices may find that the symptoms go away as they change their habits. If the symptoms persist, however, it may be time to see a doctor to make sure it is not caused by an underlying medical condition.
Tips for sleeping well
Many doctors and urologists will recommend that people restrict the amount of alcohol and caffeine they drink throughout the day.
Even if these substances are not the cause of the disorder, both are diuretics and may make symptoms worse. Doctors may also suggest that people with nocturia drink fewer liquids during the evening and before bed.
Foods that are rich in liquids and foods that act as diuretics can be avoided as well. Examples include:
- cranberry juice
- citrus drinks, such as lemonade, orange juice, and grapefruit juice
- tomatoes and other acidic foods
- spicy foods
- artificial sweeteners
Keeping a food diary is a helpful tool for many people. Writing down what is eaten every day can help identify a link between symptoms and problematic foods.
Some people also benefit from training their bladder to help regain control of its contractions. If the bladder is used to contracting every hour to tell the body it is time to urinate, it will often continue this habit.
Over time, it may be possible to train the bladder to pass urine every 2-4 hours instead, or to hold it in overnight. This is best done under the guidance of a doctor.
Because there are a number of causes of nocturia, ranging from basic lifestyle choices to serious medical conditions, diagnosis can sometimes be difficult. Nocturia is most common in adults over the age of 60, but it can occur at any age.
Medical conditions may cause nocturia symptoms, and people can expect their doctor to ask them questions about their symptoms to help determine the causes.
Possible medical causes and factors for nocturia include:
- urinary tract infections
- bladder infections
- enlargement of the prostate or prostate cancer
- congestive heart failure
- kidney stones
- kidney disease
- kidney failure
- hypercalcemia (too much calcium in the blood)
- certain pancreatic cancers
There are also other more rare causes, such as autonomic dysreflexia and medullary cystic disease. People should always talk to their doctor for a full and extensive diagnosis.
Lifestyle choices influencing nocturia include:
- excessive fluid consumption before bed
- overhydration throughout the day
- alcoholic beverages
- caffeinated beverages
Another thing to consider is that the habit of waking up during the night to urinate can actually change the body's internal clock. Even if someone has stopped drinking liquids before bed, they may still wake up to urinate simply because their body is used to doing so at that time of night.
It is not uncommon for people to go to the bathroom at night, especially when drinking extra liquids before bed. Normally, the body makes less urine during the night to help a person get a full night of sleep. This is also one reason the urine in the morning is more concentrated.
People who regularly wake up to urinate more than once every night are experiencing nocturia. This can disrupt sleep patterns and may be a sign of a medical condition.
The symptoms of nocturia can be similar for many people, but the causes may be different. So, a doctor will want to ask questions and monitor the symptoms in order to understand their underlying cause.
Doctors may ask people who come to see them about nocturia many questions, such as:
- How many times do they urinate each day?
- How many times do they wake up to urinate?
- Did the symptoms of nocturia come with any other symptoms?
- Does the body produce less or more urine than before?
- What makes the symptoms worse? What makes the symptoms better?
- Is there a personal or family history of bladder problems, kidney diseases, or diabetes?
- Are there any medications they are taking that may cause these symptoms?
- Do they experience incontinence or wet the bed during the night?
Along with the questioning, doctors may ask people to undergo regular tests, such as:
- urine culture samples
- blood sugar tests
- fluid deprivation tests
- blood urea tests
People with nocturia may see it as an annoyance in their lives. It may even be considered embarrassing.
Luckily there are many different methods of treatment, such as medications and healing the underlying cause of the symptoms. There are even lifestyle choices and habits that can help ease the symptoms.
With patience and the guidance of a doctor, the underlying reason behind the symptoms can be found and treated in most cases.