Overactive Bladder at Night: Treatment and Prevention
Overactive bladder (OAB) is not uncommon, especially as we age. OAB symptoms include having a constant urge to go, occasional leakage (especially when active, sneezing, or laughing), and frequent trips to the bathroom.
Another common, disruptive symptom of OAB is called nocturia. This refers to getting up more than once during the night to use the bathroom. It is possible to have nocturia along with OAB, or to have just this symptom, even when daytime urination is normal.
Causes of Nocturia
Nocturia can be caused by OAB, but it may also be the result of other conditions. The cause may be as simple as drinking too many fluids before bedtime. Nocturia may also be caused by more serious conditions like diabetes, edema in the legs, congestive heart failure, a bladder obstruction, or a bladder infection. Taking medications that lead to greater urine production, especially diuretics, can also be a cause.
Types of Nocturia
Nocturia, whether from OAB or another cause, comes in one of two forms. Polyuria means that you are producing more urine during the night than is normal. Low nocturnal bladder capacity means that your bladder cannot hold as much fluid during the night as it should be able to. Some people experience a mix of the two types of nocturia.
Preventing Nighttime Urination
One of the easiest ways to prevent an overactive bladder at night is to restrict fluid intake before going to bed. Stop drinking beverages a few hours before bedtime, but make sure you get enough fluids throughout the day.
Other simple lifestyle changes that can help reduce and prevent nocturia include avoiding beverages with caffeine and alcohol, maintaining a healthy weight, and timing when you take any diuretic medications so that they do not impact your nighttime urine production.
Prevent Fluid Build-Up
If your frequent nighttime urination is caused by edema, or swelling in your legs, there are some preventive measures you can take. Try elevating your legs throughout the day. Taking a nap can help with nocturia too, so have an afternoon nap with your legs up. Wearing compression stockings can also help to prevent the fluid buildup.
Keep Track of Fluids and Urination
It may also help you to control your nighttime urination if you keep a diary of how much and what you are drinking, when you are drinking, and when and how much you urinate. Keep track during the day and at night. If, after preventive lifestyle changes, you still cannot control your nocturia, you may need to see your doctor. Having this record will help your doctor make a diagnosis and create a prevention or treatment plan.
Treatment with Medications
If preventive measures and lifestyle changes fail to reduce your nighttime urination frequency, your doctor may want you to try medications. A class of drugs called anticholinergics is used for treatment of OAB. Anticholinergics reduce the bladder spasms that create the urge to go. These drugs can help with overnight OAB as well.
A treatment used for OAB can also be used for nocturia. The underlying cause of OAB is sometimes neurological. The nerves that send signals to the bladder to contract may be giving you the urge to go.
A small device that sends regulated impulses to the bladder can be implanted under your skin, near the tailbone. This type of device has been successful at reducing symptoms of OAB and is both a safe and reversible procedure.
Surgery as a Last Resort
When prevention and medications fail, your doctor may suggest a surgical procedure to treat your nighttime OAB. Whether or not surgery will help with treatment depends on the underlying cause.
For men, frequent urination is often caused by an enlarged prostate. Having surgery to reduce the size of the gland can remove the obstruction that causes OAB symptoms.
Marinkovic, S.P., Gillen, L.M., & Stanton, S.L.
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