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.
Causes of nocturia range from lifestyle choices to medical conditions. Nocturia is more common among older adults, but it can occur at any age.
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:
- infection or enlargement of the prostate
- bladder prolapse
- overactive bladder (OAB)
- tumors of the bladder, prostate, or pelvic area
- kidney infection
- edema or swelling of the lower legs
- obstructive sleep apnea
- neurological disorders, such as multiple sclerosis (MS), Parkinson’s disease, or spinal cord compression
Nocturia is also common in people with organ failure, such as heart or liver failure.
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.
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.
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.
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:
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
- desmopressin, which causes your kidneys to produce less urine at night
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.
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.
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.