Nocturia - Excessive Nighttime Urination

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Introduction

Nocturia is a condition that causes people to wake up numerous times during the night and urinate.  Nocturia is a common cause of insomnia, the inability to sleep at night.  There are many simple and not so simple causes of nocturia.  Treating the underlying conditions that cause it, lifestyle changes, and medication treats nocturia.
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Anatomy

Your bladder holds and collects the urine from your kidneys.  When a certain level of urine has accumulated in your bladder, your body signals you to urinate.  People urinate more frequently during the daytime.  At night, the amount of urine decreases, allowing you to sleep for about six to eight hours at a time.  Having to urinate once during the night is considered normal and there may be occasional nights when you go more frequently, such as after drinking a large amount of fluids before bedtime.
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Causes

Nocturia causes people to wake up numerous times during their sleep to urinate.  Everyone may wake up from time to time to urinate, but for people with nocturia, it is an ongoing problem.  Nocturia can cause people to wake up six or more times during the night to go to the bathroom.  It is a common cause of insomnia, especially among older adults.

There are many causes of nocturia including, urinary tract infections, prostate problems, certain medications, diabetes, kidney failure, heart failure, liver failure, pregnancy, and sleeping disorders, such as sleep apnea.  Sleep apnea is a condition that causes people to stop breathing during sleep and then gasp for air.  Nocturia can also result from drinking too much fluid right before bedtime.
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Symptoms

Nocturia will cause you to wake up numerous times during the night to urinate.  You may have to go to the bathroom as many as six or eight times.  Nocturia is not the same thing as bedwetting or incontinence.  With nocturia, you do not wet the bed and are awakened when you need to go to the bathroom.  You may experience nocturia every now and then or it may be a nightly problem.  You may feel tired during the day because nocturia has disrupted your ability to get a good night’s sleep.
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Diagnosis

You should contact your doctor if you experience nocturia.  Your doctor will review your medical history.  It is helpful to bring a list of all of the prescription and nonprescription medications that you take or all of your medication bottles to your doctor to review.  Your doctor may ask you to keep a record of how many times you urinate during the night, the amount of urine that you void, and your weight taken at the same time each day.  Your doctor will listen carefully to your symptoms and conduct a general examination and some tests.  A sample of your urine and blood may be tested.  You may be referred to other specialists, such as an urologist, neurologist, or sleep medicine doctor, to help confirm a diagnosis. 
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Treatment

The type of treatment you receive depends on the cause of your nocturia.  Simple lifestyle changes, such as reducing the amount of fluid that you drink before bedtime or taking certain prescription medications earlier in the day, may be all that some people need.  Treatment for an underlying condition, such as diabetes or sleep apnea, can help reduce symptoms.  Prescription medicine to reduce the number of episodes during the night may be used.
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Prevention

You may help prevent nocturia by reducing the risk factors that you can control.  It is important to follow your doctor’s instructions to treat and monitor the medical conditions that you may have, such as diabetes.  It can be helpful to avoid alcohol, caffeine products, and carbonated drinks because they can increase urine output.  You should not consume excessive amounts of liquids two hours before going to bed.
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Am I at Risk

Risk factors for nocturia:


_____ The risk of nocturia increases with age. 
_____ Certain medical conditions can cause nocturia, including urinary tract infections, prostate problems, diabetes, kidney failure, heart failure, and liver failure.
_____ During pregnancy, women may experience nocturia because of pressure on the bladder and hormonal changes.
_____ Sleep apnea, a sleeping disorder, is associated with nocturia.
_____ Certain medications, including diuretics, lithium, cardiac glycosides, and others can contribute to nocturia.  You should make a list or bring all of your medication bottles to your doctor to review.  Do not stop taking any medication without your doctor’s approval first.
_____ Drinking too much fluid right before bedtime increases the risk of nocturia.
_____ Drinking coffee and drinks that contain caffeine, carbonated drinks such as soda pop, and alcohol increase the risk of nocturia.

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Complications

Nocturia can contribute to significant sleep loss.  Overtime, sleep loss can lead to daytime drowsiness and decreased functioning.  Sleep is vital for good health and functioning.  You should contact your doctor if you experience nocturia and disrupted sleep.
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Advancements

The number of trips to the bathroom during the night may be a marker of the severity of obstructive sleep apnea.  In one study, three or more trips to the bathroom to urinate during the night was significantly more likely in patients with severe sleep apnea than mild or moderate sleep apnea.
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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on February 16, 2022. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.