Nocturia

Nocturia






Nocturia can be defined as the condition which compels one to wake up during night to urinate one or more times. Aged people have this problem commonly. Nocturia can affect the quality of sleep and may cause significant problems in adults. It can seriously affect the onset of sleep and can cause sleep disturbance.

Symptoms :

Normal adult needs 6-8 hours of sleep for staying energetic. But people having nocturia will have to wake up at least 2 or 3 times during night which may cause serious disturbances in their sleeping pattern.

The affected individual will be urinating largely producing high quantity of urine daily. His body is conditioned to discharge large volumes of urine while sleeping. More volumes of urine are produced during night than during daytime.

Improper sleeping pattern and poor sleep is one of the major symptoms of nocturia. Since he will have to wake up for going to bathroom several times, he finds it difficult to go to sleep again.

Causes :

Cause depends on the types of nocturia a person is affected.

In case of polyuria it can be caused due to high intake of fluids during night. It can be due to diabetes (Type 1 and 2) and also due to pregnancy.

For women it is quite common to experience nocturia after childbirth and menopause stage. Men can get nocturia due to benign prostatic hyperplasia or enlarged prostate gland.

For some people it can be due to decreased capacity of the bladder function during night, excess of urine is produced. Fluid redistribution is a condition in which fluids are reabsorbed into the blood causing accumulation of fluids in legs and fingers leading to Edema or swelling of legs.

Persons who have underlying medical causes like diabetes, Hypertension, cardiac problems, vascular diseases, sleeping disorders may also experience nocturia.

Nocturia may occur due to bladder infection, bladder obstruction cyst in the bladder and due to bladder malignancy. The bladder becomes less capable of retaining the urine during night time.

Diagnoses :

Your doctor will find out the underlying cause by asking series of questions and by recording the total fluid intake and output. You should also discuss with them about the medications you are taking for any diseases.

He may order for urine analysis for finding out the right cause.

Treatment :

Nocturia can be treated by making little changes in the lifestyle. Treatment depends on the underlying cause. For diabetic patients intake of fluid should be restricted after evening.

In case if the problem of discharging urine many times at night is due to sleep apnea you need to take treatment with pulmonologist.

Generally you should restrict the fluid intake after 6PM and avoid taking coffee or alcohol before going to bed. For individuals who are taking diuretic medications you should change the timings and take them before evening.

Your doctor will ask you to write down in a diary about the number of times you void during night. You need to write about what you ate before bedtime and also about the medicines you are using.

You can keep your legs in elevated position which will prevent urine accumulation in the bladder. Try wearing compression stockings that may help you with this problem.

Medications like anticolinergic drugs are prescribed for reducing the activity of bladder. Bumex and Lasix will be given in controlled doses for regulating the total discharge of urine. Medications like Imipramine and Desmopressin are also prescribed for nocturia.

Nocturia – Symptoms, Causes, Treatment

Nocturia – Symptoms, Causes, Treatment

What is Nocturia?

This is a condition involving the need to get up during the night to go to the toilet – and is most likely to happen when individuals get older. This problem is very common amid men who are older since it may be due to an enlarged prostate – referred to as “benign prostatic hyperplasia”. The prostate pushes on the urethra tube and prevents the bladder from emptying totally – causing the need for many trips to the toilet. But, studies recently have shown that many elderly women also suffer from the exact same problem.

Nocturia Symptoms

The indications of nocturia consist of extreme nighttime urination and the need to urinate in the night. This may be instigated by some disruption of the normal concentrations of urine or due to a consequence of the nerves and muscles that manage urinating due to the existence of over-stimulation. For a physician to make a conclusive diagnosis, he will need to examine carefully both the symptoms and the individual’s medical history. Nocturia may be instigated by endocrine, metabolic, as well as cardiovascular illnesses. Extreme urination through the night may also be caused by some drugs that having a diuretic effect or from consuming large quantities of liquid at night – predominantly beverages with caffeine or alcohol.

Causes of Nocturia

Symptoms of nocturia are most normally caused by one or more of numerous different medical problems, including:

• Diabetes


• Use of diuretics


• Sleep apnea


• Congestive Heart Failure


• Cystitis


• Prostate Cancer


• Disorders of the prostate


• Incontinence


• Benign prostate hyperplasia


• Heart failure


• Acute Pyelonephritis


• Extreme consumption of alcoholic beverages


• Hypercalcemic nephropathy


• Acute pyelonephritis


• Excessive amounts of beverages that contain caffeine


• Chronic Kidney Failure


• Excessive drinking prior to bedtime.

Nocturia Treatment

When not being due by a causal disorder, a diversity of changes in lifestyle as well as changes in behavior may help to lessen the incidences when an individual get up for the toilet at night. They may include the limiting the quantity of liquids being drank during the evening and particularly immediately before going to bed, napping in the afternoon, elevating legs during sleep and the use of compression stockings.
One or a combination of any of these lifestyle changes may help however a physician needs to be consulted prior to beginning any treatment, since nocturia might be instigated by a condition that is more severe. Keeping a diary of how frequent you get up during the night and how critically was the need to urinate every time is a good suggestion; it may help you distinguish any issues that might be contributing to the nocturia.

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There are also numerous drugs used to manage nocturia. The first line of drugs that can be used include the anticholinergic medicine, which includes numerous drugs that focus on the treatment of detrusor overactivity – this is the muscle that helps oust the urine. These consist of:

• Darifenacin – rises the bladder capacity and reduces the amount of contractions.


• Tolterodine – works similar to oxybutynin.


• Oxybutynin – relaxes the detrusor muscle and is available in tablet form and patches.


• Solifenacin – works similar to Tolterodine but with fewer side effects.


• Trospium chloride – blocks cholinergic receptors and allows bladder to relax.

In the result that these medications are fruitless treatment of nocturia, a second route of treatment may be used. These include:

• Imipramine – decreases urine production – how is unknown.


• Demsmopressin – matches the hormone vasopressin – results in the kidney creating less urine.


• Furosemide – normalizes urine creation and output while awake but does the opposite when asleep.


• Bumetanide – strong substitute to furosemide.

Numerous of these drugs have hazardous side effects and therefore should be taken under a doctor’s supervision in order to decide the suitable option for treatment. Extra in-depth information on medications may be found on the National Association for Continence website.