Having to urinate repeatedly during the night is known as nocturia. Bladder blockage, sleep disturbances, and excessive fluid consumption are among the possible causes. Limiting fluid intake and using drugs that lessen the symptoms of an overactive bladder are two ways to treat nocturia.
What is nocturia?
A disorder called nocturia makes you wake up in the middle of the night to urinate. Neotic urinary frequency, or the need to urinate more frequently at night, is another name for this ailment.
Nocturia affects all genders and sexes equally and increases in frequency with age (typically beyond 60), sometimes for distinct causes. While it's not unusual for people to wake up once during the night to urinate, more frequent urination could indicate an underlying issue.
Frequent urination is the term used to describe someone who urinates excessively during the day but manages to restrict how often they go to the bathroom at night.
Nocturia is the condition in which you must always use the restroom several times after going to bed and before waking up. You may experience fatigue as a result of the disturbance of your typical sleep cycle, regardless of whether it is caused by an underlying medical issue or something else.
Is nocturia common?
A prevalent ailment that impacts over 50% of persons over 50 is nocturia. After age 50, it is more prevalent in men and those who were assigned male at birth (AMAB).
Nocturia is more common in women and those who were assigned female at birth (AFAB) before the age of 50. Up to 1 in 3 adults over 30 may be impacted.
Symptoms and Causes
What signs of nocturia are present?
You should be able to get six to eight hours of sleep at night without needing to wake up for toilet breaks. Nonetheless, nocturiacs awaken multiple times during the night in order to urinate.
This may throw off your regular sleep schedule, leaving you drained and lacking in energy during the day.
Nocturia symptoms can include:
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Need two or more midnight urinations.
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Increasing the amount of urine produced in the event of polyuria. Polyuria is the condition of urinating excessively in milliliters (total volume of urine), though not always in large quantities.
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Drowsiness and fatigue during the day. This happens because frequent urination can throw off your regular sleep schedule.
What are nocturia's most typical causes?
The inability of certain women to wake up in the middle of the night to urinate can be attributed to variances in anatomy. For instance, women and persons AFAB may suffer pelvic organ prolapse as a result of childbirth, but men and people AMAB have prostates.
Among the reasons why people wake up in the middle of the night to urinate are:
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Drinking too much fluid before bedtime: Beverages with caffeine and/or alcohol might exacerbate it.
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Medications that contain a diuretic: Water tablets, or diuretics, force your body to eliminate extra fluid and salt, increasing the frequency of your urination.
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Reduced bladder capacity: When you urinate, it's possible that your bladder isn't emptying completely. This could be brought on by conditions like bladder pain, edema, infection, or blockage.
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Habit or routine: It's possible that you've unwittingly taught yourself to wake up and use the restroom when you don't need to. Alternatively, you might be awakening for a different reason, but assume you need to use the restroom right away.
You may need to wake up in the middle of the night to urinate due to certain health issues. Among them are:
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Polyuria is when the body excretes more urine than the bladder can store.
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Diabetes.
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High blood pressure.
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Benign prostatic hyperplasia or prostate obstruction.
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Heart disease or congestive heart failure.
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Obstructive sleep apnea or other sleep disorders.
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Pelvic organ prolapse.
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Childbirth, pregnancy or menopause.
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Restless legs syndrome.
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Edema.
What side effects might nocturia cause?
Having to get out of bed in order to urinate is a common side effect of numerous bladder and prostate disorders. If these underlying issues are not treated, it may get worse or you may still need to wake up to urinate.
Losing quality sleep is another nocturia problem, and it's critical to your general health and wellbeing.
Diagnosis and Tests
How is nocturia diagnosed?
It may be helpful to keep a journal of your nightly bathroom visits and the circumstances surrounding each one, since this will aid your healthcare professional in diagnosing nocturia.
This may also include information about how much you drank, how frequently you went, what time it was, and the volume of urine (measured in milliliters) that you urinated.
It can be challenging to gauge how much you urinate, but your neighborhood pharmacy should sell a urine collector with measuring lines. You can also receive one to take home from your provider.
The diary will be examined by your healthcare professional to ascertain the cause(s) and course of therapy for your nocturia. Make sure you keep a record of all the prescriptions you take.
You might be questioned by your provider about the following:
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When did you start having urinal awakenings?
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How many times a night do you need to urinate?
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Does the amount of pee change every time?
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Has the volume of urine changed each time, either more or less?
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How much coffee do you have on a daily basis?
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Does having to urinate a lot at night prevent you from getting adequate rest?
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Do you consume alcoholic beverages? How many times a day, if so?
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Has there been a recent change in your diet?
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When and what kinds of medications do you take?
A urine culture or urinalysis may be prescribed by your doctor to check for infections, proteins, and other substances.
Additional examinations that could be useful in identifying the root cause include:
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Blood examinations to assess renal health.
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To find out if your bladder fills or empties, get imaging testing.
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Cystoscopy.
The majority of primary care physicians can assist with nocturia; however, depending on the underlying cause, you might also need to see a urologist or another expert.
Management and Treatment
How can I cut down on how often I urinate in the middle of the night?
Usually, the underlying cause must be treated first. For instance, you might need to consult a sleep specialist if you suffer sleep apnea. You might need to have surgery or take medication to address an enlarged prostate.
It is possible that your healthcare practitioner will suggest certain lifestyle modifications despite the reason for your nocturia. This is due to the fact that modest lifestyle adjustments are frequently low risk and can significantly lower the frequency of your nocturnal bathroom visits.
Modifications in lifestyle for nocturia include:
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Limiting fluid intake in the evening, particularly coffee-based drinks.
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Taking diuretic drugs early in the day, or at least half an hour before going to bed.
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Napping in the afternoon. Because naps cause your blood to absorb liquids, you will need to use the restroom afterward. This may lessen the number of late-night restroom visits you make.
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Raising your legs when seated at your house. This facilitates the distribution of fluids.
To strengthen your pelvic floor muscles, consider pelvic floor physical therapy.
Compression stockings, which aid in fluid distribution as well.
Your provider may also think about prescribing medication as an extra course of treatment. Among these drugs are:
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Anticholinergics: These drugs lessen overactive bladder symptoms. The success rate with anticholinergics is up to 40%. Mirabegron (Myrbetriq®), darifenacin (Enablex®), oxybutynin (Ditropan®), and tolterodine (Detrol®) are a few examples of this kind of drug.
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Diuretics: Medication that helps control urine production includes furosemide (Lasix®) and bumetanide (Bumex®).
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Desmopressin (DDAVP®): aids in the kidneys' decreased urination.
It is always a good idea to discuss the best course of therapy with your healthcare professional. Make sure you enquire about prescription drugs and what they think will provide you with the greatest chance of success.
Why do I have to urinate twice a night?
Frequently urinating during the night may indicate a medical issue. Or, it can indicate that you're consuming too much alcohol right before bed. Making a few little lifestyle adjustments, like as giving up alcohol two to three hours before bed, could be a good idea.
If this doesn't help, talk to a healthcare professional about your symptoms. To find out whether there is another reason why you urinate so frequently, you might require medication or testing.
Prevention
Is nocturia preventable?
Nocturia cannot be avoided. It frequently occurs as a secondary effect of an underlying illness. Taking care of long-term illnesses like diabetes could benefit it. It is, however, occasionally inevitable. Pregnancy and the menopause are not something you can really avoid.
When there isn't an underlying illness causing nocturia, changing one's lifestyle to include drinking less liquids after dinner can be helpful.
Outlook / Prognosis
Is nocturia a problem of concern?
Although nocturia itself is not life-threatening, its underlying causes can be. Urging multiple times during the night should not be disregarded, as it may indicate a more severe health issue.
However, this isn't always the case. More often than not, some people urinate. Therefore, unless nocturia interferes with your sleep pattern, you shouldn't be concerned about it harming you if your test results show no medical issues.
Living With
When ought I to visit my medical professional?
You don't have to live with nocturia; it is a curable ailment. If you find yourself needing to urinate more than once or twice a night, get in touch with your doctor. You might feel worn out from the frequent wake-ups, and it might be an indication of something more serious.
What inquiries ought to I make of my provider?
It is common to have inquiries concerning a medical problem. You can inquire about nocturia with your healthcare professional regarding the following topics:
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Which tests are necessary for me?
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What circumstances might be triggering my nighttime urination?
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Which medical procedures would you suggest?
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Does this indicate a more significant issue?
In summary
Nocturia is a difficult and annoying ailment. If you're getting up numerous times during the night to go potty, call a healthcare professional.
Lifestyle adjustments frequently have a big effect. However, medicine is occasionally required, particularly if you have a prostate or bladder problem. Thankfully, the majority of cases are very curable.
