There’s nothing more frustrating than stumbling to the bathroom in the dead of night, lying awake for ages in an effort to fall asleep again, and then doing exactly the same thing again a couple of hours later. Nocturia (the need to urinate more than once during the night), affects millions of adults daily—but you don’t need to suffer in silence. In many cases, the problem can be improved or even cured.
What is nocturia?
Experts recommend 6-8 hours of sleep each night. Getting up to use the bathroom once is unlikely to cause much disturbance to your sleep pattern, but several interruptions can seriously disrupt your sleep, leaving you exhausted and irritable the next day. Long-term sleep problems can also lead to more severe health consequences.
Who is most likely to suffer from nocturia?
Nocturia (also known as ‘polyuria’) tends to affect people as they get older, so most sufferers are in the 55-84 age range. In fact, it’s estimated that two-thirds of adults will suffer from nocturia at some time in their life.
What causes nocturia?
Sometimes nocturia has a very simple cause—drinking too much fluid just before bedtime, especially if that fluid contains caffeine or alcohol. Our bodies also produce an anti-diuretic hormone (ADH) which helps us retain urine, but the production of this hormone slows as we age, leaving us needing to go more frequently.
Another contributing factor concerns the pelvic floor muscles, which help us to control the flow of urine. If they weaken, it gets more difficult to ‘hold’ urine in. Tight bladder muscles can limit the capacity of the bladder, and an enlarged prostate can interfere with bladder control too. Conditions such as heart disease, diabetes, and multiple sclerosis can all result in an increased need to urinate. And although it may not directly contribute to nocturia, conditions that interrupt rest (such as sleep apnea) can cause us to wake more easily, so we feel the need to urinate even if the urge wouldn’t have been strong enough to waken us.
How is nocturia treated?
There are four stages of treatment for nocturia, and patients normally progress through them a step at a time unless the cause is very obvious.
Step 1: Address any lifestyle factors
Simple lifestyle changes sometimes help reduce the need to use the bathroom frequently during the night. Limiting drinks and avoiding alcohol or caffeine-based drinks in the evening will reduce the amount of fluid your body needs to process. If you need to take diuretic medication for another complaint, it may be smart to take it earlier in the day. Elevating your legs in bed or wearing compression socks can help too.
Step 2: Identify physical causes
If there’s a physical cause for your nocturia, identifying it will help your doctors to suggest treatments that may help.
Step 3: Treatment for medical causes
The next step when trying to tackle nocturia is to address any such identified medical cause. For example, a patient may have undiagnosed diabetes, so controlling diabetes might help improve the nocturia. If a weak pelvic floor makes it hard for you to control the flow of urine, then daily exercises to strengthen and tone the muscles will allow you to ‘hold’ your urine for longer. An enlarged prostate can also be treated to bring relief.
Step 4: Treating nocturia with medication
Sometimes, medication can provide the answer to the problem. If the problem is linked to a reduction in the anti-diuretic hormone, then desmopressin (a synthetic replacement) can boost your body’s ability to hold your urine for longer. If a tight bladder is a cause, then medication to relax it can make a huge difference.
People often feel embarrassed about their nocturia or assume it’s a natural part of aging that must be endured. But constantly interrupted sleep is very debilitating and can have a huge negative impact on your whole life. If you are regularly getting up twice or more at night, why not have a chat with your family doctor? You may find the problem can be fixed quickly and easily.