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Frequent Nighttime Urination Implications

By Mary Otte

According to the American Urological Association (AUA), waking up more than once a night to urinate is enough to be diagnosed with frequent nighttime urination, otherwise known as nocturia. Nocturia disrupts your body’s circadian sleep rhythm, the long term disruption of which has been associated with cardiovascular disease, depression and also cancer—the latter theoretically due to suppressed melatonin production.

Though it can happen to anyone at any age, nocturia is most often found in people over 60, increases in frequency with age and is prevalent in both sexes. Nocturia, however, is not to be considered a normal part of aging and can be an indicator of numerous serious conditions aside from those associated with disrupted circadian cycles. You should consult with your doctor as soon as possible if you have been getting up to urinate two or more times a night.

Nocturia, though considered a condition, can be the symptom of another ailment like chronic or frequent bladder infections, a tumor on the prostate or bladder, bladder prolapse (anatomical bladder displacement, often due to menopause or childbirth), or disorders that impair sphincter control. It is also common in people with congestive heart failure, liver failure, undercontrolled or undiagnosed diabetes. Pregnancy, enlarged prostate gland, obstructive sleep apnea, overproduction of urine and diuretic medications are also associated with nocturia.

Good sleep and good health go hand in hand, especially as we age. Sleep recharges the body and is as important to our wellbeing as proper nutrients and drinking water. Cognitive ability, physical activity, immune system health and mood fluctuation are all directly impacted by the amount of good, continuous and regular sleep we are able to get.

Another pitfall of continuously interrupted sleep is the increased risk of falls and fractures—the leading cause of hospitalization in the senior population, both during the trip to the bathroom at night and during the day, when grogginess and feelings of confusion amplify any existing instability or frailty.

Sometimes, however, a few simple lifestyle changes will be enough to control symptoms. Be sure to check with your doctor before relying on these noninvasive treatments alone.

     
  • Limit alcohol and caffeine intake, especially from afternoon to bedtime.
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  • Cut back on nighttime fluids, but stay hydrated. Staying hydrated is important for everyone, but especially the elderly. Cutting back on nighttime fluids doesn’t mean cutting back on fluids. Make sure to still get the proper amount, just do so earlier in the day. Fruits, veggies and salads are a great way to get extra hydration as well as important nutrients out of a meal.
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  • A hot cup of tea or an alcoholic nightcap are popular pre-bedtime beverages, but they’re also known culprits in stimulating urine production and are best enjoyed 2-3 hours before sleep.
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  • Take prescribed diuretics earlier in the day, no later than late afternoon.

Limiting evening fluid intake or switching prescribed diuretics times to the mid to late afternoon instead of before bed may be all the treatment you need, but it’s imperative that you speak with your doctor before making any changes to medications or if you are living with the symptoms of nocturia. There are medications that can reduce the symptoms of overactive bladder and help to regulate or even decrease urine production. You don’t have to live with frequent nighttime urination, and your quality of life will improve once you’re not.

Even though nocturia is sometimes due to drinking to excess nighttime fluids or weakened bladder muscles, it’s always better to know with certainty, especially with the slew of other conditions nocturia could potentially point to, many of which require more complicated solutions than skipping that after dinner coffee.

To make sure you’re getting the best treatment options, set up an appointment with your doctor to discuss the symptoms and then start recording them leading up to the appointment in a sleep/urination diary. This will help the doctor obtain a comprehensive understanding of your symptoms.

Things to keep track of: Do you get up frequently every night or occasionally? How many times per week? Does the amount of urine seem excessive? Is the need urgent but not productive (small amount of urine even though you had to get up)? Write down what you’re experiencing, how much fluid you’re taking in, voiding, how often—even during the day—and if the color is consistent. Aside from having an excellent log for your doctor, these data will also give you a better idea of what your nighttime triggers are.

Be sure to let your doctor know how the frequent urination is affecting your overall sleep, i.e. the quality of sleep between trips and how long it takes to fall back asleep after using the restroom. Also how it’s affecting your days. Have your naps increased or gotten longer? Do you feel like you’re walking around in a daze for all or part(s) of the day? The information you collect along with whatever series of tests your primary care physician deems appropriate will determine treatment options to get you back on the path to a good night’s sleep and better health.