WHAT IS NOCTURIA?

The most noticeable symptom is waking up at night to urinate, but it can also cause:

• Difficulty falling back asleep
• Daytime fatigue due to interrupted sleep
• Concerns about falling when getting up at night
• Frustration from the constant sleep disruption

Nocturia can be caused by a wide range of conditions, from lifestyle habits to medical conditions. Some of the most common causes include:

• Increased nighttime urine production. Known medically as nocturnal polyuria, your body produces too much urine during the night, which can happen due to a drop in certain hormones as we age.
• Bladder or prostate issues. Men, especially those with benign prostatic hyperplasia (BPH), may experience difficulty fully emptying the bladder, leading to frequent nighttime urination.
• Sleep disorders. Conditions like obstructive sleep apnea can cause repeated awakenings, which may be mistakenly attributed to the need to urinate.
• Certain medical conditions. Congestive heart failure, diabetes, and poorly controlled blood pressure can all lead to nocturia.

Your doctor will review your medical history and discuss your symptoms. A voiding diary may be recommended. This diary tracks how much urine you produce, offering a clearer picture of the root causes. It helps understand how much fluid you’re drinking during the day, the pattern of your nighttime urination, and whether any other urinary symptoms are present, such as urgency or frequency.

Treating nocturia depends on its underlying cause. Some common approaches for both men and women include:

1. Lifestyle changes
   • Reducing fluid intake in the late afternoon and evening
   • Limiting salty foods, as high salt intake can increase urine production
   • Urinating twice in quick succession before bed to ensure your bladder is fully empty
   • Ensuring your sleeping environment is comfortable and free from disruptions
2. Therapy
   • Pelvic floor muscle exercises (Kegels). Strengthening the muscles that support the bladder can improve control over urination. This therapy is effective for both men and women.
   • Bladder training. Scheduled voiding helps increase the amount of urine your bladder can hold, reducing the need to urinate at night.
3. Medications
   • Alpha-1 blockers like tamsulosin can be helpful in men with BPH, making it easier to empty the bladder fully.
   • Bladder relaxants can increase bladder capacity and reduce urgency.
   • In some younger patients, desmopressin can reduce nighttime urine production. However, it requires careful monitoring as it can lead to dangerous drops in sodium levels, especially in older adults.
   • Topical vaginal estrogen may help improve bladder control in postmenopausal women.

Contact our office to schedule an appointment with one of our specialists if nocturia impacts your quality of life or worsens over time. Our doctors can help determine the cause and create a plan to manage your symptoms.

1. Can nocturia be a sign of a more serious health problem?

Yes, nocturia can be a symptom of an underlying condition such as diabetes, heart failure, or sleep apnea. Also, if you experience symptoms like blood in your urine, pain, or sudden changes in urination patterns, seek medical care right away, as it could be a sign of kidney stones, an infection, or a more serious underlying condition.

2. Can reducing fluid intake before bed completely stop nocturia?

Reducing fluids can help, but it may not fully resolve as nocturia can be caused by other factors like bladder issues or medical conditions that require their own treatment.

3. How does pregnancy affect nocturia?

Pregnant women often experience nocturia, but it usually resolves within three months after childbirth as the body adjusts.