Also known as nocturnal polyuria, nocturia is the medical term for excessive and frequent urination at night. Normally, the body produces less urine as you sleep so you can go several hours without having to wake up.
Nocturia sufferers do not get this luxury and instead find themselves needing to get up sometimes several times a night to empty their bladders. Note that simply waking up to pee on the occasional night is not considered nocturia—it takes a prolonged period of excessive nighttime urination to make a nocturia diagnosis. There are certain questions which nocturia sufferers face usually.
Urinary incontinence is also not necessarily the same as nocturia; incontinence is a lack of normally voluntary control over urination, while nocturia focuses on a period of time when you lack that control anyway. Incontinence and nocturia can sometimes have overlapping causes, but one does not automatically mean the other.
In addition to being a sleep-depriving annoyance, nocturia can also be a possible sign of an underlying medical condition that warrants treatment to stop frequent urination at night. Additionally, nocturia sufferers may find that they wet the bed as they sleep.
Which Age Group Mostly Deals with Nocturia?
Nocturia affects the elderly more than other age groups for a few different reasons. As we age, the bladder naturally loses some of the elasticity that allows it to hold more urine without needing to evacuate. Also, hormone signals slow down—including the ones that lower urine production at night. Among men, the prostate can (benignly) swell with age and possibly restrict the bladder further. Lastly, the elderly are more prone to various conditions that can result in nocturia symptoms.
Common Causes of Nocturia
Aside from age, there are a few different health conditions that can result in nocturia:
- Pregnancy: A fetus growing inside a woman’s body will place pressure on the bladder and restrict its normal capacity.
- Constipation: Excessive constipation or intestinal blockage can make the bowel distend (stretch), which can then put pressure on the bladder.
- Circulatory problems: Anything that results in circulation issues, ranging from diabetes to heart conditions, can result in nocturia. This is because poor circulation leads to fluids getting left behind during daily activities. When you lie down at night, it gets easier for the circulatory system to work, and the result is that all of that wayward fluid gets properly filtered all at once, filling up the bladder more quickly at night.
- Medication: Some medications can cause nocturia as a side effect. If you suspect that your medicine is behind your nocturia, do not stop taking it without consulting your doctor first. You were prescribed that drug for a reason and stopping on your own can have undesirable consequences.
- Diet: Certain foods and drinks, like alcohol or anything with caffeine, have diuretic effects, which means that they encourage urine production. Even if you don’t drink before going to bed, too much of these diuretics in your diet could lead to nocturia.
Neurological Causes of Nocturia
The bladder, like everything else in the body, is controlled by the brain and the signals and hormones it receives are why it slows down during the night. Any condition that interferes with these brain signals can result in nocturia or other forms of incontinence. These conditions include:
- Parkinson’s disease
- Spinal injury
LUT (Lower Urinary Tract) Causes of Nocturia
- Urinary tract infection (UTI): This is one of the more common sources of nocturia. As the bladder gets irritated and possibly inflamed from a UTI, its capacity to hold urine decreases. You can tell a UTI may be present by cloudy or foul-smelling urine as well as a burning sensation when you pee. Kidney infections can cause nocturia for similar reasons.
- Bladder obstruction: If something is preventing the bladder from fully emptying, it will naturally take less time for it to fill up again, even if the nighttime reductions are functioning normally.
Nocturia Symptoms and Diagnosis
Nocturia is a single symptom: frequent and excessive urination at night. However, within this simple metric are other values you should be aware of that can help your doctor better narrow down the diagnosis. When you speak to your doctor about a possible nocturia problem, try to provide as much of the following information as possible:
- How often you urinate during the day
- How many times per night you get up to urinate
- How often you leak urine (i.e., slight dribble without urge to urinate)
- If you leak urine, when or under what conditions
- Any medications you are on
- Normal eating/drinking habits
- Whether you wet the bed or not
- Any discomfort or painful urination
Alternatively, you can keep a journal of your bladder activity for a few days (three, ideally) before your appointment.
Natural Treatment Options for Nocturia
Nocturia cannot be treated directly. Instead, you need to address the underlying cause to help you stop peeing at night. As a result of how varied the causes can be, the nocturia treatment you use can come in a number of different forms. One simple and natural method is to adjust your fluid intake. Avoid drinking within a few hours of going to bed and cut down on the amount of alcoholic or caffeinated beverages in your diet. This can help reduce the amount of urine your body produces as you sleep. However, if you have a known UTI, then increasing the amount of water you drink can help instead. This is because frequent urination can help flush out the bacteria inside the urinary tract, resulting in more restful nights in the long run.
How to Prevent Nocturia
If your nocturia is the result of edema (fluid buildup) brought on by circulatory issues in the legs, then wearing compression stockings might help; they can help keep circulation running normally.
If medication is causing your nocturia, talk to your doctor about possible changes you can make, e.g., taking it earlier in the day, adjusting your dosage, or switching to a new medication. If you have a condition that agitates the bladder, anticholinergic drugs can be used to calm it down. Alternatively, some medicines can be used to reduce the amount of urine the kidneys produce. If you have a UTI, antibiotics may be called for instead.
Nocturia: Lifestyle Changes to Make
Another treatment for nocturia resulting from edema is napping. Remember, resting and lying down both improve circulatory function and can get lingering fluids drained out more consistently throughout the day.
You can also try doing Kegel exercises. These can strengthen the pelvic floor muscle and help improve bladder control, which is useful when the problem is weakness due to pregnancy, prostate problems, or similar issues. A Kegel is a simple contraction and relaxation of the pelvic floor that can be done anywhere. If you don’t know what your pelvic floor muscle is, it’s what you use when trying to stop yourself from urinating mid-stream or to keep yourself from passing gas. Note: it is inadvisable to perform Kegels with a full bladder.
Sources for Today’s Article:
“Nocturia,” Bladder and Bowel Foundation web site; https://www.bladderandbowelfoundation.org/bladder/bladder-conditions-and-symptoms/nocturia/, last accessed March 4, 2016.
“Excessive Urination at Night (Nocturia),” Healthline web site; http://www.healthline.com/health/urination-excessive-at-night#Overview1, last accessed March 4, 2016.
“Nocturia,” National Association for Continence web site; http://www.nafc.org/nocturia/, last accessed March 4, 2016.
Stang, D., “Kegel Exercises,” Healthline web site; http://www.healthline.com/health/kegel-exercises#Overview1, last accessed March 4, 2016.