When nighttime nocturia is disrupting your sleep

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Is it possible you have this condition – it occurs in more than 50 percent of men and women, you are over the age of 60, and the condition will increase with each decade that passes?  If you can answer “yes” to each one, you may actually have a condition called nocturia or having the need to wake up during the night to urinate.

Normally a person should be able to sleep six to eight hours straight during the night without having to get up to go to the bathroom.  When a person is waking up more than twice a night to urinate this is considered to be nocturia.  The frequent waking up to head to the bathroom disrupts a normal sleep cycle resulting in excessive tiredness the next day affecting their quality of life.

Causes of nocturia

There are many reasons why a person may experience nocturia which include:

·      High fluid intake, particularly before bedtime and especially if it is in the form of coffee, caffeinated beverages, or alcohol.

·      Untreated diabetes – both type 1 and type 2

·      Congestive heart failure

·      Edema of lower extremities

·      Diuretics

·      Bladder obstruction or overactivity

·      Bladder infection, inflammation, or recurrent urinary tract infections

·      Interstitial cystitis

·      Bladder malignancy

·      Benign prostatic hyperplasia or BPH in men

·      People who sleep poorly.  Some people who awaken frequently during the night will automatically go to the bathroom because of that and not because they awoke because they had to necessarily void.

Treating nocturia

The first step in treating nocturia is to set up an appointment with a family physician.  It can be very helpful to the physician if a person keeps a fluid and voiding diary to take to the appointment.  A couple of days’ worth of recording how much a person drinks, how often they have to go to the bathroom, amount of urine output, medications taken and any other related symptoms such as a urinary tract infection, can be valuable information for a physician to review and assess determining the possible causes and treatment for nocturia.

If a family physician is unable to diagnose or treat nocturia, a person may be referred to a urologist.  Treatment depends on the cause of nocturia but it may include the following:

·      Restricting fluids in the evening (especially coffee, caffeinated beverages, and alcohol)

·      If on diuretics, time intake of them mid- to late afternoon or at least 6 hours before bedtime.

·      Elevate legs throughout the day to prevent fluid accumulation

·      Wear compression stockings during the day which also helps prevent fluid accumulation

·      Certain medication may be prescribed depending on the cause of nocturia.  These might include medications to reduce symptoms of overactive bladder, diuretics assisting in regulating urine production, or medications to help the kidneys produce less urine.

·      Double void or urinate twice right before bed.  Go to the bathroom, then brush your teeth and go through the rest of your bedtime routine.  Then, before getting into bed – even if you feel like you don’t have to go – try to urinate once more and see if you can squeeze out another tablespoon or so. 

·      Kegels, done regularly, can help control nighttime nocturia.