A good night’s sleep helps you feel rested and refreshed in the morning. However, when you have the frequent urge to use the restroom at night, a good night’s sleep can be hard to achieve. If you find yourself waking up to urinate more than twice each night, you may have a condition called nocturia. The National Association for Continence reports that this is most common in people over the age of 60.
Nighttime urination isn’t the same as a related condition called enuresis (bed-wetting). Enuresis is when you can’t control your need to urinate at night. While nighttime urination typically results in sleep loss, it can be a symptom of an underlying condition.
What causes nighttime urination?
Aging is one of the biggest contributing factors to nighttime urination. As we age, the body produces less of the antidiuretic hormone that helps us retain fluid. This results in increased urine production, especially at night. Muscles in the bladder can also become weak over time, making it more difficult to hold urine in the bladder.
Aging isn’t the only contributing factor to nighttime urination. Other common causes include chronic urinary tract infections, drinking excess fluids (especially caffeinated and alcoholic ones) before bed, bacterial infection in the bladder, and medications that encourage urination (diuretics).
Women may experience frequent urination as a result of pregnancy and childbirth. These circumstances can weaken the bladder and pelvic floor muscles.
In some cases, nighttime urination is a symptom of an underlying medical condition. Disease and conditions associated with frequent urination include chronic kidney failure, congestive heart failure, diabetes, and enlarged prostate. It may also be a symptom of sleep disorders such as obstructive sleep apnea, insomnia, or restless leg syndrome.
What are the symptoms of nighttime urination?
Most people can get a full six to eight hours of rest without the need to urinate. However, nighttime urination causes you to get up several times at night to use the restroom. In its most severe forms, this condition causes you to get up five to six times at night.
Symptoms associated with nighttime urination include overproduction of urine, urinating too frequently, and feeling the urgent need to urinate but producing little urine.
Nighttime urination can cause problems. You can’t feel rested when you’re frequently using the restroom. Also, nighttime urination can increase the likelihood for falls and injury in the elderly.
How is nighttime urination diagnosed?
Your doctor will diagnose nighttime urination by evaluating your symptoms and performing a physical examination. They may ask certain questions to determine potential causes for the condition. Questions may include how many times you get up to urinate at night, how long you have been experiencing nighttime urination, and questions about your regular activities before bed. For example, if you drink lots of fluids or take diuretics before bedtime, these can lead to nighttime urination.
Your doctor may order tests to determine the cause of frequent urination. Urinalysis looks at the chemical compounds present in urine. Urine concentration determines if your kidneys properly excrete water and waste products. Other tests include a urine culture and post-void residual urine measurements. This test takes an ultrasound of pelvic area to see how much urine remains in the bladder after urination.
Your doctor may order further tests if they suspect you have an underlying medical condition. They may order further tests to make a diagnosis. These tests include blood sugar, blood urea nitrogen, blood osmolality, creatinine clearance, and serum electrolytes.
These tests can determine how well the kidneys function. They also measure the concentration of certain chemical compounds in your blood. These tests can determine if nighttime urination is a side effect of kidney disease, dehydration, or diabetes.
What are the treatment Options for Nighttime Urination?
Treatment for nighttime urination often depends on its cause. For example, you may drink too much before bed. Your doctor may recommend restricting your fluids after a certain time.
Certain behaviors can also reduce the frequency of nighttime urination. Taking an afternoon nap can help you feel more rested. Keep your legs elevated during the day or wear compression stockings. This encourages fluid circulation and can also help minimize nighttime urination.
Medications may also help reduce nighttime urination. Medications can alleviate symptoms, but can’t cure nighttime urination. Once you stop taking them, your symptoms will return.
A class of drugs called anticholinergics can relax muscle spasms in the bladder. They can also reduce the need to urinate more frequently. If you experience bed-wetting, some anticholinergics can reduce this. However, these medications can cause side effects such as dry mouth, dizziness, and blurred vision.
Some doctors recommend taking a diuretic that encourages urination earlier in the day. This can reduce the amount of urine in your bladder at night. Taking a synthetic form of antidiuretic hormone may also help to reduce nighttime urination.