9 Questions and Answers about Nocturia

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NocturiaIf you suffer from nocturia (nocturnal polyuria; excessive urination during the night), you probably have a few questions you’d like answered about this uncomfortable topic and disorder.

When asleep, the body shuts down for the six to eight hours and doesn’t produce as much urine as it does when awake. Waking up a few times over the course of the night to use the washroom might indicate the presence of nocturia.

Urinary tract infections (UTIs) are the most common reason for urinary incontinence. Other causes, but not as common, are bladder prolapses, diabetes, anxiety, kidney infection and edema (water retention that causes swelling of the lower legs).


1. How Many Times Is Considered Normal to Get Up to Pee at Night?

Getting up to pee occasionally through the night is OK and perfectly normal. Perhaps you drank too much water or had a coffee or tea too soon before bed. It only becomes an issue when it consistently happens more than two times a night. Urinary incontinence is reported in more than a third of women over the age of 40 according to research.

2. I Wet the Bed – Is This Because I Have Nocturia?

Nocturia is different from bed-wetting because in bed-wetting the person sleeps right through it, whereas with nocturia the person wakes up to use the washroom. In fact, it’s a common cause of sleep loss in those who experience it. Urinary incontinence is a common problem that some adults and teenagers have, and feelings of shame can accompany it because we associate bed-wetting with toddlers and younger children, but remember, nocturia isn’t bed-wetting. There are many possible reasons for a leaky bladder and until you figure out what they are with the help of a doctor, there’s no need to feel bad over nocturia—it’s something you can’t control.

3. Which Health Conditions Make Nocturia Worse?

Nocturia can be aggravated by a number of things. In men it can be a sign of an enlarged prostate. This happens when the prostate presses on the urethra, which hinders the bladder from fully emptying. Diuretics or other medications often prescribed for high blood pressure can also cause the need to urinate throughout the night. Other health conditions that can cause nocturia are bladder issues, edema (swelling of the legs), and diabetes when it isn’t controlled.

4. How Much Caffeine Should I Drink Each Day, if Any?

A study published in the journal Urology Annals in 2011 confirmed that drinking coffee does contribute to and worsen urination at night. Drinking coffee at 4.5mg/kg increased the need to urinate, both in volume and flow rate. The study recommended that people with bladder issues and nocturia should avoid caffeine altogether or be cautious in consuming foods with caffeine.

5. Can I Drink Alcoholic Beverages? If So, How Many Each Day?

Much like coffee, drinking alcoholic beverages can increase the incidence of nocturia. It’s best to avoiding alcohol after 6:00 p.m. so as not to exacerbate the problem.

6. How Does Pre-Diabetes Cause Nocturia?

Pre-diabetes can cause frequent urination at night. The issue here is the overproduction of glucose in the blood. The presence of extra sugar in the urine in turn stimulates the production of more urine. Those with pre-diabetes or diabetes (if not controlled) will therefore urinate much more frequently, and have a high chance of experiencing nocturia.

7. Can Surgery Help My “Dropped” Bladder?

Surgery is one solution for a dropped bladder, but it shouldn’t be taken lightly and needs to be thoroughly discussed with a doctor before a decision is made. There are many reasons for a dropped bladder, of which stress is one; perhaps working on the areas of your life that cause stress is a good first step to take before deciding on something as drastic as urinary incontinence surgery. Also, if you want to have children, consider waiting to have the surgery because all of the pushing and strain during childbirth can undo the results of the surgery.

8. Will I Be Incontinent after Prostate Surgery?

After prostate surgery, it takes time for the walls of the pelvic floor to build up and get strong again. Learning how to control pelvic floor muscles will help speed up recovery and reduce any chance of incontinence after surgery. Without strengthening the muscles, the leaky bladder effect might continue.

9. How Is Nocturia Diagnosed?

Before visiting your doctor to see if you might suffer from nocturia, it’s a good idea to keep a diary of how much fluid you take in every day, how many times a night you get up to urinate, and the volume of urine produced. Keep track for two days. Your doctor will ask you these questions, so it’s best to go in prepared. In this log, also note what medications you are currently on and if you have had any urinary tract infections, as your doctor may want to do a urinalysis.

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Sources for Today’s Article:
“Effect of Caffeine on Bladder Function in Patients with Overactive Bladder Symptoms,” Urology Annals, 2011; doi:10.4103/0974-7796.75862.
“Excessive Urination at Night (Nocturia),” Health line web site; http://www.healthline.com/health/urination-excessive-at-night#Overview1/, last accessed March 7, 2016.
“Excessive Urination at Night (Nocturia),” Prevention web site; http://www.prevention.com/health/getting-night-pee, last accessed March 7, 2016.
“Bed-Wetting in Teenagers and Adults: What You Can Do,” Embarrassing Problems web site; http://www.embarrassingproblems.com/problem/bed-wetting-adults/bed-wetting-adults-actions, last accessed March 8, 2016.
“Nocturia or frequent urination at night,” Sleep Foundation web site; https://sleepfoundation.org/sleep-disorders-problems/nocturia, last accessed March 8, 2016.
“Nocturia (Night-Time Urination),” Net Doctor web site; http://www.netdoctor.co.uk/conditions/liver-kidney-and-urinary-system/a3031/nocturia-night-time-urination/, last accessed March 8, 2016.
“Nocturia (Getting Up at Night to Pass Urine),” Kent Gynaecologist web site; http://www.kentgynaecologist.com/nocturia.html, last accessed March 8, 2016.
“How Would Pre-Diabetes Cause Nocturia?” Diabetes web site; http://www.diabetes.co.uk/Diabetes-and-Nocturia.html, last accessed March 8, 2016.
“Urinary Incontinence Surgery in Women: the Next Step,” Mayo Clinic web site; http://www.mayoclinic.org/diseases-conditions/urinary-incontinence/in-depth/urinary-incontinence-surgery/art-20046858/, last accessed March 8, 2016.
“Continence Management Following Prostate Surgery,” Continence web site; http://www.continence.org.au/pages/continence-management-following-prostate-surgery.html, last accessed March 8, 2016.
“Nocturia,” Cleveland Clinic web site; https://my.clevelandclinic.org/health/diseases_conditions/hic_Bladder_Irritating_Foods/hic_nocturia, last accessed March 8, 2016.

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Dr. Alwyn Wong, DC

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Dr. Alwyn Wong has been involved in the health and fitness industry for over fifteen years and brings with him a wealth of experience. He uses an integrated treatment approach, combining active release techniques (ART®), acupuncture, chiropractic, nutritional consulting, and program design to treat his patients, many of whom have included professional athletes from the NFL, NHL, NBA, MLB, and PGA, as well as Olympic, and IFBB athletes. Although his focus has shifted to more clinical work, he remains as... Read Full Bio »