In nocturia or nocturnal polyuria, a person wakes up more than once every night to urinate. It is one of the most troublesome conditions, but most patients don’t give it attention and don’t seek medical treatment to improve the condition.
Most people can sleep six to eight hours without urinating, as our kidneys produce less urine at night. It is normal to wake up once to void during the whole night. Some people wake up more often to urinate during the night, which can disrupt their sleep frequently.
Occasionally, peeing more than once is not a worrying issue, as it can be due to various reasons. But, if you wake up more than twice a night, you may have nocturnal polyuria. According to numerous studies, men and women over 40 years complain about waking up from sleep at least once per night. This condition is more common in older people.
What are the symptoms of nocturnal polyuria?
People with nocturia can also have frequent daytime visits to the washroom. It is different from polyuria, as nocturia is a condition in which people frequently urinate, while in polyuria, people urinate excess volume. Nocturia can cause significant health consequences, as frequent nighttime washroom visits interrupt sleep. The symptoms of nocturnal polyuria are:
- Waking up from sleep twice or more in a night
- Repeated interruption in sleep can sometimes cause sleeplessness
- Fatigue and daytime sleeping
- Decrease focus, confusion, and cognitive dysfunction due to less sleep
- For older people, frequent nighttime rush to the bathroom creates a higher risk of falls
Causes of Nocturia
It is possible to experience frequent nighttime urination despite no underlying medical diseases. Various causative factors are responsible for nocturnal polyuria, including:
- Age: With the increase in age, a person can experience waking up frequently to urinate at night.
- Fluid intake: Acute nocturia can be due to increased fluid intake in a day or before sleeping, consuming excess alcohol, or caffeinated drinks before bedtime.
- Upper urinary tract disorders: The various upper urinary tract conditions can cause nocturnal polyuria, such as bladder infection, urinary tract infection, overactive bladder, bladder malignancy, and chronic renal disease.
- Lower urinary tract dysfunction: Nocturia is one of the prominent symptoms of lower urinary tract disorders, such as bladder obstruction or benign prostatic hyperplasia (BPH) in men.
- Pregnancy: In early pregnancy, we can notice nocturnal polyuria. But, in the later stage of pregnancy, the growing womb causes pressure on the bladder resulting in more visits to the washroom at night.
- Other medical conditions: A person suffering from certain diseases can suffer from nocturnal polyuria, such as congestive heart diseases, obstructive sleep apnea, leg swelling, or diabetes.
- Medications: Some drugs (diuretics) may cause nocturnal polyuria as an aftereffect.
- Stress: People under anxiety or stress wake up frequently during the night. The hormonal imbalance due to stress causes bladder contraction, which leads to frequent urination.
- Pelvic organ prolapse (POP): Women with severe POP or weak pelvic muscles can suffer from nocturnal polyuria.
Diagnosis of Nocturia
To diagnose the condition and the underlying causative disease, your healthcare provider may suggest the following investigations:
- Complete complaint history: Your healthcare provider asks about your symptoms and suggests you keep a bladder diary to keep track of trips to the bathroom and the amount of fluids intake.
- Urinalysis: Urine culture provides information about any infection or blood elements.
- Blood test: It helps diagnose kidney problems, cholesterol levels, diabetes, or other problems.
- Bladder scan: It detects any abnormalities in the bladder.
- Cystoscopy: Any ingrowths, tumors, or other bladder issues can be visible by a narrow tube with a tiny camera.
Treatment of Nocturia
Treatment of nocturnal polyuria consists of managing the underlying cause, such as prostate enlargement needs surgery or medications or urinary tract infection needs medical intervention. Regardless of causative treatment, the following are treatment approaches:
- Limit fluid intake 2-4 hours before going to bed. Limiting alcohol, sugary drinks, and caffeinated beverages can reduce the frequent visits to the washroom.
- In leg swelling conditions, the elevation of the legs reduces the need for urination by helping redistribution of fluid into the bloodstream.
- Frequent waking up at night causes sleep deprivation, and a nap during the daytime can refresh you.
- Medications such as diuretics increase urine output, so if you have to take diuretics, do so at least six hours before going to sleep.
- Medications: Your healthcare provider prescribes various drugs based on the causative illnesses, such as diuretics for high blood pressure levels, anticholinergic drugs for bladder issues (spasms and overactive bladder), and anti-diabetic medicines, along with some other medicines to help kidneys produce less urine.
The condition will improve with lifestyle changes and proper management of underlying diseases. So, you should pay close attention to any bodily changes and keep in touch with your doctor for a healthy life.