A condition that causes you to wake up more than once during nighttime to urinate is called nocturia. Possible causes may include drinking too much fluid before bedtime, sleep disorders, and bladder obstruction. Doctors often recommend restricting fluids and medicines to reduce symptoms of an overactive bladder.
Sometimes, this condition is called nocturnal urinary frequency. More commonly, it affects older adults (over 60 years old) and both men and women. When people urinate multiple times during the day, it is called frequent urination, but nocturia occurs when you are waking up multiple times after bedtime. Most people with nocturia often feel tired because of frequent wake-ups during the night.
In general, this is a common condition among older adults. For instance, about 50% of people over 50 years old have nocturia. After 50, nocturia affects females more commonly than males. Moreover, some research has shown that 1 in 3 people over 30 years old also have nocturia.
Symptoms
In normal circumstances, people are able to sleep between 6 and 8 hours during the night without waking up to go to the bathroom. However, those who suffer from nocturia wake up multiple times to urinate. As a result, they may feel tired and weak during the day. Check below for some general symptoms of nocturia:
- Waking up to urinate multiple times during the night
- Increased urination (in volume) if polyuria is present. This is a condition in which you are urinating too much in milliliters, but not necessarily multiple times.
- Fatigue (extreme tiredness) and drowsiness during the day.
If any of the previous symptoms occur, do not hesitate to contact your healthcare provider.
Causes
In general, there are multiple causes of nocturia. Check below the most common causes of nocturia:
- Drinking too many fluids before sleep (for instance, beverages that contain alcohol and caffeine may worsen the symptoms of nocturia)
- Diuretics (also known as water pills) – This group of medicines is used to remove excess fluid and salt from the body, causing you to urinate more frequently.
- Reduced capacity of the bladder – It often occurs due to a bladder obstruction, swelling, infections, and pain in the bladder.
- Habit or routine – In some cases, people unintentionally train themselves to wake up and urinate, or they may wake up for an unrelated reason and go to the bathroom during the night.
In addition, nocturia may also occur due to an underlying medical condition. Examples include:
- Hypertension (high blood pressure)
- Heart disease
- Congestive heart failure
- Sleep disorders (such as obstructive sleep apnea)
- Childbirth, pregnancy, or menopause
- Restless legs syndrome
- Edema (fluid buildup in the body)
- Benign prostatic hyperplasia (BPH) or prostate obstruction
What Are The Long-term Effects of Nocturia?
People who develop nocturia and ignore the symptoms or do not get treatment may also experience some complications. Check some of them below:
- Poor sleep quality or insomnia (sleep disturbances)
- Fatigue during the day
- Difficulty focusing and concentrating
- Increased risk of falls and fractures
- Worsened underlying diseases (such as diabetes, heart failure, sleep apnea, pelvic floor problems, and others)
- Reduced quality of life
- Social isolation
- Hematuria (blood in the urine)
The previous list does not contain a complete list of complications, but you can consult with your healthcare professional about ways to reduce the risk of developing them or treat them.
How to Prevent Nocturia?
Unfortunately, there is no way to prevent this condition, and in most cases, it is an adverse reaction to an underlying disorder. In such cases, managing the underlying condition (such as diabetes) may help ease the symptoms of nocturia. It is not always possible to avoid this condition, especially in pregnant or postmenopausal women. Furthermore, lifestyle changes and drinking less liquid before bedtime may help relieve the symptoms of nocturia.
Diagnosis
Doctors often begin the diagnosis of nocturia with a physical examination and questions about the symptoms and medical history. They may also keep a diary of your nighttime bathroom trips and factors that surround them, including how much you drink, what time it was, the volume of urine, and others. You should also inform your doctor about all medicines and supplements you are administering. Physicians may also perform the following tests to determine the underlying condition. Examples include:
- Blood tests to check kidney function
- Imaging tests on the bladder to see how it fills and empties. They often perform an ultrasound, a CT (computed tomography) scan, or an MRI (magnetic resonance imaging) scan.
- Cystoscopy
While primary care providers may help treat a mild form of nocturia, in more severe cases, you can be referred to a urologist.
Treatment
The treatment is often different among people with nocturia because it depends on the underlying condition. For instance, if you develop nocturia due to sleep apnea, doctors may recommend some medicines to treat the condition, but if you have nocturia due to an enlarged prostate gland, physicians may recommend surgery to treat it. Usually, treating the underlying condition helps relieve the symptoms of nocturia. However, doctors may also recommend lifestyle changes and certain medicines to improve the symptoms. Check some lifestyle changes below:
- Reduce the amount of fluids before sleep (especially those with caffeine and alcohol)
- Administer diuretics in the morning or at least 6 hours before sleep
- Take afternoon naps because they help the bloodstream to absorb liquid, and you will urinate after a nap. Potentially, it may reduce the frequency of wake-ups during the night.
- Pelvic floor physical therapy to strengthen the pelvic floor muscles
- Wearing compression stockings that may help with fluid distribution
- Elevate your legs while staying at home because it also helps with fluid distribution
Doctors may prescribe the following medicines as an additional treatment. Examples include:
- Anticholinergics – This group of medicines is often used to treat the symptoms of an overactive bladder. About 40% of people notice improvements after using anticholinergics. Doctors often recommend Darifenacin, Mirabegron, Oxybutynin, or Tolterodine.
- Diuretics – They often prescribe Furosemide or Bumetanide.
- Desmopressin – This medication is often prescribed by doctors to reduce the urine production by your kidneys.
In any case, you should not administer any of the previous medicines without a doctor’s approval. Otherwise, it may lead to unpleasant outcomes.
Frequently Asked Questions
Why do I pee every 2 hours at night?
In most cases, frequent urination during the night indicates an underlying health condition. However, you may also experience frequent urination if you are drinking too many fluids before bedtime.
Is nocturia a serious condition?
While this condition is harmless, the underlying condition can be dangerous. That’s why it is not recommended to ignore the symptoms, and you should see a doctor for a diagnosis and treatment.
What are the main causes of nocturia?
These include:
- Too much fluid, caffeine, or alcohol before bedtime
- Certain health conditions, including diabetes, enlarged prostate gland, sleep apnea, urinary tract infections (UTIs), kidney disorders, and others
- Poor kidney function
If you have any other questions, ask your healthcare professional.
