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Do you pee more than sleeping at night?

Nocturia

If you say yes, you might be having what the doctors call nocturia. There could be several reasons why you are spending more time in the bathroom at night. Possibly, you may have excess urine formed throughout the day (polyuria) or only at night (nocturnal polyuria) or you may have problems with urine storage (bladder problems). 

You may talk to a urologist to learn why and how severe your problem is to treat. Here in this article, I am going to resolve some of your concerns hoping that you put this behind you and sleep well now on.

Symptoms, causes, diagnosis, treatment and after care

SYMPTOMS

Frequent urination twice or more each night and poor sleep. Nocturia and the resulting sleep disruption can impact your quality of life.  It can decrease your  productivity and cause fatigue and depression.

Our body can hold  urine for 6 to 8 hours without disturbing sleep. However, this may get haywire due to hormonal changes as we age. Importantly nocturia could be a symptom of something going on in our body. It is not a disease by itself.

Drink too less near bedtime and be sure to empty your bladder just before going to bed.

CAUSES

Drinking too much water during the day(polydipsia) or before going to bed or after everytime you wake up in the night can cause nocturia. Excess caffeine and alcohol consumption can trigger the problem.

Check for medicines you take: Certain medicines like water pills such as diuretics (medicines that make more urine), excess vitamin D, lithium, phenytoin, etc may cause or aggravate nocturia. A discussion with your doctor regarding this can be of great help.

Check for UTIs: Yes, urinary tract infections can set pee triggers. So you tend to frequently urinate both during the day and night time. UTIs are accompanied with burning urination,fever and cloudy urine. Do not ignore informing these symptoms to your urologist.

Do you have lifestyle conditions: Lifestyle diseases such as diabetes, high blood pressure and the medicines you take to treat them may be causing you to produce more urine. Vascular problems such as restless leg syndrome, swelling of legs also alter peeing habits. Talk to your doctor about these conditions.

Talk to your urologist: Urinary diseases such as nocturnal polyuria, reduced bladder capacity (previous bladder surgery, bladder fibrosis), prostate obstruction, enlarged prostate, overactive bladder, interstitial cystitis can cause nocturia. Fix an appointment with your urologist for clarity and course of treatment.

In women, it could be a pelvic change: Pregnancy, childbirth, menopause, vaginal prolapse may be linked with nocturia. Situation will be in control as the pelvic floor heals and strengthens over time with treatment and exercise. Talk to your OBG or urologist for further support.

It could be your heart or lungs: This may sound alarming yet we cannot rule out this factor. Conditions such as high blood pressure, heart failure,  are a high concern with nocturia as one of the associated problems. If you do not have symptoms other than frequent urination you need not worry. Talk to your doctor if you experience chest symptoms such as chest pain, discomfort, tiredness, fatigue, weight loss and more.

DIAGNOSIS

After a tete-a-tete with your urologist regarding your symptoms, your urologist may advise you to maintain a bladder diary and undergo some lab studies including urine analysis, bladder scans, blood tests, cystoscopy and urodynamic testing to check for bladder urine storage and release function.

Among all the tests, bladder diary gives a wealth of information about number of voids, conscious bladder capacity, urine volume in the day and in the night and your drinking habits.

TREATMENT

Lifestyle changes:

  • Restrict fluid intake at night 2 to 4 hours before going to bed. Reduce alcohol and caffeine intake throughout the day.
  • Manage medicines which have diuretic effects. Take them at least 6 hours before bedtime so you don’t have to urinate during the night.
  • Elevate your legs or use compression sock to redistribute fluids back into the bloodstream and reduce the need to urinate.
  • Enjoy afternoon naps to compensate for disruptful nighttime sleep. However, too long or too often naps can further disrupt night sleep.
  • Use products to manage leaks and keep you dry from bed-wetting such as waterproof mattress covers, absorbent briefs etc.

Medicines:

  • Medicines to help the kidneys produce less urine.
  • Medicines to relax the bladder muscle and to correct overactive bladder.
  • Medicines to regulate urine production and high blood pressure.
  • Medicines to treat an underlying illness
  • It is important to note here that changing the timing and dose of prescribed medicine may also help in case of medicines for diabetes and high blood pressure or heart disease.

After care

With long-term lifestyle changes and caring for other health problems, your symptoms should improve. You should be able to sleep well again.

Pay attention to the things that help you sleep through the night. Keep up with these changes to prevent nocturia in the future. Keep in touch with your health care provider to let him/her know if you don’t improve over time.

Questions to ask your doctor regarding nocturia and its treatment

  • Do I need to see a specialist?

Yes, frequent urination at night is a urological problem and hence it is important you see a urologist.

  • If I need a specialist, can you give me a referral?

Mostly, the problem is resolved in the urology clinic. However, if there is an underlying problem which is causing related signs and symptoms you will be referred to the specialist.

  • Will I need to have tests to find the cause of my nocturia?

Yes, tests are important to understand the root cause if it is not evident with medical history and bladder diary.

  • What other problem could be causing my symptoms, and why?

Other health problems such as lifestyle diseases, heart problems, and urological diseases can hamper the way your kidneys process waste and form urine. Also, the medicines you take for other health problems, caffeine intake, alcohol use also play a part in changes to how urine is stored and emptied. Even pregnancy and childbirth can temporarily increase frequent urination.

  • What treatments do you think are right for me and why?

Every patient has a unique health situation. Consult the urologist for the right medical course.

  • After I start treatment, are there problems I should I watch for?

Sometimes yes. Your urologist may advise for a review after the treatment. You should feel better under their care.

  • How soon after treatment will I feel better?

Medicines begin to act immediately and you must feel better within a few days.

  • When should I call you?

Please use the book appointment feature to set up a call with me and I will be happy to hear from you.

  • Will I need treatment for the rest of my life?

Not always. Certain health conditions can be treated acutely while others may require lifelong treatment.

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2 Comments
  1. Reply
    Larry Miller

    Great content! Keep up the good work!

  2. Reply
    Anonymous

    Useful information

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