Nocturia, or nocturnal polyuria, is the medical term for excessive urination during the night. During sleep time, your body produces less urine that is more concentrated. This means that most people don’t need to wake up during the night to urinate and can sleep uninterrupted for six to eight hours.
If you need to wake up several times in the night to urinate, you may be suffering from excessive urination at night. As well as disrupting your sleep, nocturia can be a sign of an underlying medical condition.
Causes of nocturia range from lifestyle choices to medical conditions. Nocturia is most common among older adults, but it can occur at any age.
A variety of medical conditions can cause nocturia. One of the most common causes of nocturia is a urinary tract infection (UTI) or bladder infection. These infections cause frequent burning sensations and urgent urination throughout the day and night, and treatment usually requires antibiotics.
Other medical conditions that can cause nocturia include:
- infection or enlargement of the prostate
- bladder prolapse
- overactive bladder (OAB) syndrome
- tumors of the bladder, prostate, or pelvic area
- kidney infection
- edema, or swelling, of the lower legs
- neurological disorders, such as multiple sclerosis (MS), Parkinson’s disease, or spinal cord compression
Nocturia is also common in people with organ failure — typically either heart or liver failure — and those who suffer from diabetes.
Nocturia can be an early symptom of pregnancy. This can develop at the beginning of pregnancy, but is more common later, when the womb presses against the bladder.
Nocturia can be a symptom of obstructive sleep apnea. This can occur even if the bladder is not full. Once the sleep apnea is controlled, the nocturia usually goes away.
Some medications may cause nocturia as a side effect. This is particularly true of diuretics (water pills), which are prescribed to treat high blood pressure.
You should seek emergency medical care from a doctor if you lose the ability to urinate, or if you can no longer control urination.
Another common cause of nocturia is excessive fluid consumption. Alcohol and caffeinated beverages are diuretics, which means that drinking them causes your body to produce more urine. Consuming either alcohol or caffeinated beverages in excess can lead to waking up and needing to urinate at night.
Other people who have nocturia have simply developed a habit of waking up during the night to urinate.
Diagnosing the cause of nocturia can be difficult. Your doctor will need to ask a variety of questions. It can be useful to maintain a diary for a few days, recording what you drink and how much, along with how often you go to the toilet.
Questions your doctor may ask you include:
- When did nocturia start?
- How many times a night do you have to urinate?
- Are you producing less urine than you did before?
- Do you have accidents or have you wet the bed?
- Does anything make the problem worse?
- Do you have any other symptoms?
- What medications are you taking?
- Do you have a family history of bladder problems or diabetes?
You may also undergo testing such as:
- blood sugar test (to check for diabetes)
- blood urea test
- urine culture
- fluid deprivation test
- imaging tests, such as ultrasounds
If your nocturia is caused by a medication, taking the medication earlier in the day may help.
Treatment for nocturia can sometimes include medication, such as anticholinergic drugs, which help lessen the symptoms of an overactive bladder, or desmopressin, which causes your kidneys to produce less urine.
Nocturia can be a symptom of a more serious condition, such as diabetes or a UTI that could worsen or spread if left untreated. Nocturia due to an underlying condition will usually stop when the condition is successfully treated.
Nocturia can be a difficult and sometimes embarrassing condition to live with, but there are steps you can take to lessen its impact on your life.
Reducing the amount you drink before going to bed can help prevent you from having to urinate at night. Avoiding drinks that contain alcohol and caffeine may also help, as can urinating before you go to bed. Some food items act as diuretics as well, like chocolate, spicy foods, and artificial sweeteners. Kegel exercises can help strengthen your pelvic muscles and improve bladder control.
Pay close attention to what exacerbates your symptoms so you can try to modify your habits accordingly. Some people find it helpful to keep a diary of what they drink and when.
Because nocturia affects your sleep cycle, it can lead to sleep deprivation, fatigue, dizziness, drowsiness, and depression, if left untreated. Talk to your doctor to discuss which lifestyle changes and treatment options can help you.