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Excessive Urination at Night (Nocturia)

What is nocturia?

Nocturia, or nocturnal polyuria, is the medical term for excessive urination at 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 6 to 8 hours.

If you need to wake up two times or more per night to urinate, you may have nocturia. Besides being disruptive to your sleep, nocturia can also be a sign of an underlying medical condition.

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Causes

Causes

Causes of nocturia range from lifestyle choices to medical conditions. Nocturia is more common among older adults, but it can occur at any age.

Medical conditions

A variety of medical conditions can cause nocturia. Common causes of nocturia are a urinary tract infection (UTI) or bladder infection. These infections cause frequent burning sensations and urgent urination throughout the day and night. Treatment requires antibiotics.

Other medical conditions that can cause nocturia include:

Nocturia is also common in people with organ failure, such as heart or liver failure.

Pregnancy

Nocturia can be an early symptom of pregnancy. This can develop at the beginning of pregnancy, but it also happens later, when the growing womb presses against the bladder.

Medications

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 your urination.

Lifestyle choices

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 alcohol or caffeinated beverages in excess can lead to nighttime waking and needing to urinate.

Other people who have nocturia have simply developed a habit of waking up during the night to urinate.

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Diagnosis

How it’s diagnosed

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 to record what you drink and how much, along with how often you need to urinate.

Questions your doctor may ask you include:

  • When did the nocturia start?
  • How many times per 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?

They may also have you undergo testing such as:

  • blood sugar test to check for diabetes
  • other blood tests for blood counts and blood chemistry
  • urinalysis
  • urine culture
  • fluid deprivation test
  • imaging tests, such as ultrasounds or CT scans
  • urological tests, like cystoscopy
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Treatment

Treatments

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:

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.

Read more: How to treat an overactive bladder at night »

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Prevention

How to prevent it

There are steps you can take to lessen the impact of nocturia on your life.

Reducing the amount you drink 2 to 4 hours before going to bed can help prevent you from needing 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 can be bladder irritants, such as chocolate, spicy foods, acidic foods, and artificial sweeteners. Kegel exercises and pelvic floor physical therapy can help strengthen your pelvic muscles and improve bladder control.

Pay close attention to what makes your symptoms worse so you can try to modify your habits accordingly. Some people find it helpful to keep a diary of what they drink and when.

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Outlook

Outlook

Because nocturia affects your sleep cycle, it can lead to sleep deprivation, fatigue, drowsiness, and mood changes if left untreated. Talk to your doctor to discuss lifestyle changes and treatment options that can help you.

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